According to an analysis of excess mortality published in The Lancet, COVID’s global death toll could be as much as three times higher than official estimates.
From the start of 2020 to the end of 2021, official estimates of the global deaths directly attributed to COVID-19 5.9 million, however this new estimate puts excess deaths at a staggering 18.2 million.
The highest number of excess deaths were reported for India (4.07 million), more than eight times its 489 000 reported COVID deaths, followed by the U.S. (1.13 million), where the official count reached 824,000 by the end of 2021. According to the study, the excess mortality rate in the US (179.3 per 100 000) was about on par with Brazil (186.9 per 100,000). South Africa’s mortality rate was 293·2 per 100 000, just below the rate for Southern Sub-Saharan Africa (308.6 per 100 000). Sub-Saharan Africa’s mortality rate was 101.6 per 100 000, as a result of significant regional variation.
First author Haidong Wang, PhD, of the University of Washington, said in a statement: “Understanding the true death toll from the pandemic is vital for effective public health decision-making. Studies from several countries including Sweden and the Netherlands, suggest COVID-19 was the direct cause of most excess deaths, but we currently don’t have enough evidence for most locations.”
The massive undertaking derived models using all-cause mortality reports for 74 countries and territories and 266 subnational locations, which included 31 locations in low and middle-income countries. These locations reported all-cause death from 2020-2021, and up to 11 years prior. Excess mortality reports were also obtained for the 9 South African provinces 12 Indian states.
Overall, the global rate of estimated excess mortality from COVID was 120.3 deaths per 100 000. A total of 21 countries exceeded 300 per 100 000, with Bolivia having the highest mortality rate at 734.9 per 100 000. Bulgaria, Eswatini, North Macedonia, and Lesotho had the next highest mortality rates. Iceland had the lowest excess mortality rate (-47.8 per 100 000). Australia, Singapore, New Zealand, and Taiwan also had negative excess mortality rates.
Behind India and the U.S. for most excess deaths were Russia (1.07 million), Mexico (798 000), Brazil (792 000), Indonesia (736 000), and Pakistan (664 000). These seven countries were noted to account for more than half of the excess deaths globally during the study period.
Changes in mortality rates also reflected the impact of other diseases suppressed by the same measures that limited the spread of COVID. The researchers wrote: “The most compelling evidence to date of a change in cause-specific mortality in the pandemic period is the decrease, especially in the Northern Hemisphere, in flu and respiratory syncytial virus (RSV) deaths seen in the months of January to March, 2021,” they added. “Given the scarce and inconsistent evidence of the effect of the COVID-19 pandemic on cause-specific deaths, and the extremely scarce high-quality data on causes of death during the pandemic, our excess mortality estimates reflect the full impact of the pandemic on mortality around the world … not just the deaths directly attributable to SARS-CoV-2 infection.”
Limitations included different modelling strategies being used to estimate excess mortality rate, and excess mortality rate by week or month was not estimated.
Source: MedPage Today
