August 16, 2022
Enlarge / A woman watches white flags on the National Mall on September 18, 2021 in Washington, DC. Over 660,000 white flags were installed here to honor Americans who have lost their lives to COVID-19 epidemic.

An estimated 14.91 million people worldwide died in 2020 and 2021 due to the COVID-19 pandemic, according to an analysis of global excess deaths released Thursday by the World Health Organization.

The estimate—with a 95 percent confidence interval of 13.3 million to 16.6 million—is significantly larger than the number of reported deaths directly caused by COVID-19 during that time, which was around 5.42 million by official counts. But, estimates of excess death try to capture the true toll of the pandemic—direct and indirect deaths. The estimate is done by comparing the number of deaths that occurred during a time period to those expected to occur in that period based on historical mortality data and modeling. Such modeling also accounts for historical differences, such as fewer traffic and influenza deaths during the pandemic due to movement and health restrictions.

Thus, excess death estimates aim to capture not only reported COVID-19 deaths, but unreported COVID-19 deaths, and deaths indirectly caused by COVID-19. Those can include people dying of preventable, non-COVID conditions because they delayed or avoided health care in fear of becoming infected, or because their healthcare system was overburdened with COVID-19 patients and unable to provide optimal care.

“These sobering data not only point to the impact of the pandemic but also to the need for all countries to invest in more resilient health systems that can sustain essential health services during crises, including stronger health information systems,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said in a statement.

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The estimates can point to the countries that struggled to respond to the pandemic and the actual devastating toll.

India, for instance, reportedly delayed the release of WHO’s analysis for months because of a dispute over the estimates. WHO estimates that 4.74 million people died in India in 2020 and 2021 due to the pandemic, nearly a third of the world’s total pandemic death toll. India previously reported only approximately 481,500 deaths in that period.

Overall, just 10 countries accounted for 68 percent of the excess deaths: India, Russia, Indonesia, the US, Brazil, Mexico, Peru, Turkey, Egypt, and Iran. The analysis also broke down excess deaths by sex and age, finding that males accounted for more of the excess deaths (57 percent male) as did older adults. All of the data can be found here.

The analysis estimated that the US excess death toll reached nearly 932,500 by the end of 2021. The country reported a little over 848,000 deaths directly caused by COVID-19 for that period, while the reported COVID-19 deaths now stand at 997,000. The US Centers for Disease Control and Prevention has its own excess death estimate for the pandemic, which is now at approximately 1.12 million.