The death toll from the pandemic could be three times higher than official COVID-19 records suggest, according to a study that found stark differences between countries and regions.
As many as 18.2 million people likely died of COVID-19 in the first two years of the pandemic, researchers found in the first peer-reviewed global estimate of excess deaths. They pointed to a lack of testing and unreliable mortality data to explain the discrepancy with official estimates of around 5.9 million deaths.
“Globally, this is the biggest mortality shock since the Spanish flu,” said Christopher JL Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, where the study was conducted. conducted. COVID-19 has led to a 17% increase in deaths worldwide, he said in an interview. The flu pandemic that began in 1918 killed at least 50 million people.
The findings, published in the medical journal Lancet, focused on excess deaths to avoid undercounting and gauge the extent of the pandemic’s devastation. As deaths continued to pile up, scientists compared mortality between January 1, 2020 and December 31, 2021 to comparable data for previous years.
Evidence suggests the spike in mortality is a direct result of COVID-19, the researchers said. But some deaths may also have occurred indirectly, they said, caused by a lack of access to healthcare and other essential services during the pandemic, or by behavioral changes that led to suicide or death. substance addiction.
“Studies from several countries, including Sweden and the Netherlands, suggest that COVID-19 was the direct cause of most excess deaths,” said Haidong Wang, associate professor of health metric sciences at the Seattle-based institute, in a statement. “Understanding the true death toll from the pandemic is essential for effective public health decision-making.”
Improving death data can give governments a clearer picture of how best to direct efforts to protect their citizens, said Jennifer Ellis, who leads Bloomberg Philanthropies’ Data for Health program that works with countries. low- and middle-income to strengthen information gathering.
“The pandemic has made it clear that tracking how many people are dying and why is critical for governments to formulate better-informed policies and improve health outcomes,” Ellis said.
So far, only 36 countries have released data on causes of death for 2020. The researchers used weekly or monthly data on deaths from all causes for the past two years and up to 11 previous years for 74 countries and 266 states and provinces through searches of government websites, mortality databases and the European Statistical Office.
A statistical model was used to predict excess deaths for countries that did not report weekly or monthly data. Excess deaths were 9.5 times higher than those reported in South Asia and 14.2 times higher in sub-Saharan Africa, the researchers found.
Due to its large population, India alone accounted for around 22% – or 4.1 million – of the world’s deaths. The United States and Russia were next with 1.1 million each, followed by Mexico, Brazil and Indonesia.
In the end, scientists estimated that there were more than 120 deaths per 100,000 people worldwide. The study found that 21 countries had estimated death rates above 300 per 100,000, led by Bolivia and Bulgaria.
Obesity and age
Mask-wearing, physical distancing and other public health measures have led to declines in other communicable diseases, which has reduced mortality in some countries. The places with the lowest estimated excess mortality rate were Iceland, Australia, Singapore and New Zealand.
The study found that the prevalence of obesity and advanced age in a population were two of the main determinants of excess mortality, Murray said.
“Countries that have high obesity really had much worse excess mortality,” he said. And ‘age is such a damning risk factor for Covid that it’s no surprise that older societies in North America, Europe and Eastern Europe have had death rates much higher surpluses.”