The WHO estimates of excess mortality associated with the COVID-19 pandemic

TLDR

The WHO tracks global mortality and has been monitoring COVID‑19 since early 2020, but reported COVID‑19 death statistics are unreliable due to testing, diagnostic, and certification differences, and the pandemic has caused widespread collateral loss of life and livelihoods. This study aims to provide a comprehensive, consistent measurement of the pandemic’s impact by estimating monthly excess deaths for 2020 and 2021. Using an overdispersed Poisson count model with Bayesian inference, the authors predict all‑cause deaths in data‑lacking locations, describe the data and methods, and emphasize the need for better reporting while cautioning against ranking countries by summary measures. The analysis estimates 14.83 million excess deaths worldwide—2.74 times the 5.42 million reported as COVID‑19 deaths—and shows large regional variations across the six WHO regions.

Abstract

The World Health Organization has a mandate to compile and disseminate statistics on mortality, and we have been tracking the progression of the COVID-19 pandemic since the beginning of 20201. Reported statistics on COVID-19 mortality are problematic for many countries owing to variations in testing access, differential diagnostic capacity and inconsistent certification of COVID-19 as cause of death. Beyond what is directly attributable to it, the pandemic has caused extensive collateral damage that has led to losses of lives and livelihoods. Here we report a comprehensive and consistent measurement of the impact of the COVID-19 pandemic by estimating excess deaths, by month, for 2020 and 2021. We predict the pandemic period all-cause deaths in locations lacking complete reported data using an overdispersed Poisson count framework that applies Bayesian inference techniques to quantify uncertainty. We estimate 14.83 million excess deaths globally, 2.74 times more deaths than the 5.42 million reported as due to COVID-19 for the period. There are wide variations in the excess death estimates across the six World Health Organization regions. We describe the data and methods used to generate these estimates and highlight the need for better reporting where gaps persist. We discuss various summary measures, and the hazards of ranking countries' epidemic responses.