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A health worker conducts a COVID-19 test on the third consecutive day of mass testing in Beijing, on May 5.Mark Schiefelbein/The Associated Press

The first two years of the COVID-19 pandemic has killed nearly 15 million people around the world, a new detailed estimate from the World Health Organization has found.

The latest estimate, focusing on direct and indirect mortality caused by the pandemic, is nearly triple the official count of 5.4 million deaths in the same period. Deaths since January were not included in the study.

In releasing the new data on Thursday, the WHO said the world has vastly underestimated the true toll of the pandemic. Official statistics have undercounted the deaths caused directly by the coronavirus, while also missing the millions of deaths from indirect effects, such as those who died of other causes when they were turned away from hospitals filled with COVID-19 patients.

The new study was produced by a technical advisory committee of experts on “excess mortality” – the difference between the actual number of deaths and the number of deaths that would normally be expected if a pandemic had not occurred. More than 40 international experts were involved in the study.

In total, the number of global excess deaths from January, 2020, to December, 2021, was in the range of 13.3 million to 16.6 million, with the best estimate being 14.9 million, the WHO said.

“COVID has illuminated a staggering toll, with already 14.9 million excess deaths, but it has also illuminated a staggering data gap,” said Samira Asma, the WHO assistant director-general for data and analytics.

“Too much is unknown and there is too much delay in getting life-and-death information,” she told a media briefing on Thursday.

Excess deaths rates associated with COVID-19 pandemic from all causes, 2020–2021

Per 100,000 population (mean)

0 and below*

0 to 100

100 to 200

400 and above

300 to 400

200 to 300

*Negative excess deaths could be a result of non-COVID-related deaths (such as deaths due to road traffic injuries and seasonal flu) that were averted due to public health measures (e.g., lockdown, social distancing, mask wearing, working from home).

MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE:

WORLD HEALTH ORGANIZATION

Excess deaths rates associated with COVID-19 pandemic from all causes, 2020–2021

Per 100,000 population (mean)

0 and below*

100 to 200

0 to 100

400 and above

300 to 400

200 to 300

*Negative excess deaths could be a result of non-COVID-related deaths (such as deaths due to road traffic injuries and seasonal flu) that were averted due to public health measures (e.g., lockdown, social distancing, mask wearing, working from home).

MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE:

WORLD HEALTH ORGANIZATION

Excess deaths rates associated with COVID-19 pandemic from all causes, 2020–2021

Per 100,000

population (mean)

0 and below*

0 to 100

100 to 200

200 to 300

300 to 400

400 and above

*Negative excess deaths could be a result of non-COVID-related deaths (such as deaths due to road traffic injuries and seasonal flu) that were averted due to public health measures (e.g., lockdown, social distancing, mask wearing, working from home).

MURAT YÜKSELIR / THE GLOBE AND MAIL, SOURCE: WORLD HEALTH ORGANIZATION

In India, for example, official records showed 481,000 deaths from the coronavirus by the end of last year, while the WHO is now estimating that 4.7 million people died – nearly 10 times as many as the official count. It means that India suffered more deaths from the pandemic than any other country in the world.

In some other countries, too, the gap was massive. Egypt’s estimated death toll is 12 times higher than the official count. In Indonesia, the estimate is seven times greater than the official number, while in Russia it is 3.5 times higher.

Some observers have suggested that Africa was relatively unscathed by the pandemic – but the new estimates debunk this claim. The WHO is estimating that 1.2 million people died as a result of the pandemic in sub-Saharan Africa by the end of last year, compared with an official count of 155,000 in the same period.

About 84 per cent of the pandemic’s deaths were in Southeast Asia, Europe and the Americas, according to the new estimate. About 85 per cent were in middle-income or low-income countries, with men accounting for 57 per cent of deaths, the data show. It did not significantly challenge Canada’s official mortality data.

The WHO estimate was reportedly delayed for months because of objections from the government of India, which was unhappy that the data would show millions of uncounted deaths in the country. On Thursday, the government again complained about the estimate, saying the methodology was unreliable. But other studies have reached the same conclusion as the WHO estimate, showing a huge undercount in India.

Even before the pandemic, the WHO had found that 60 per cent of global deaths were unregistered, and more than 70 countries did not keep records on the cause of death. “In the 21st century, this is a shocking statistic,” said Stephen MacFeely, director of the WHO’s data and analytics department.

“These estimates today should be a clarion call for better and more timely mortality data,” he told the media briefing.

Dr. Asma said the undercounting of deaths can cause governments to misunderstand their priorities and to invest too little in health care, which deepens the inequalities in the world.

“Knowing how many people died due to the pandemic will help us to be better prepared for the next,” she said.

“We need to honour the lives tragically cut short, lives we lost, and we must hold ourselves and our policy-makers accountable.”

An unanswered question is whether governments would have responded more effectively to the pandemic if they had fully understood the catastrophic death toll. Experts are calling for more accurate information tools to help the world respond better to future crises.

“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,” said WHO director-general Tedros Adhanom Ghebreyesus.

Studies in several regions and countries in recent months have already established that the official death records are greatly flawed.

In Africa, for example, the WHO has said that the number of deaths caused by the pandemic is much greater than the official toll, largely because of a lack of testing. As of last October, only 70 million COVID-19 tests had been conducted in Africa, far fewer than the 550 million tests administered in the United States, even though Africa’s population is three times bigger than that of the U.S.

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