14.9 million excess deaths due to COVID-19 pandemic in 2020 and 2021

New estimates from the World Health Organization (WHO) put the total number of deaths directly or indirectly associated with the COVID-19 pandemic (known as “excess deaths”) at approximately 14.9 million (range 13.3 million to 16.6 million) between January 1, 2020 and December 31, 2021.

These sobering figures show not only the impact of the pandemic, but also the need for all countries to invest in more resilient health systems to be able to sustain essential health services during a crisis, including stronger health information systems,” said WHO Director-General Dr. Tandusse. WHO is committed to working with all countries to strengthen their health information systems to produce better data for improved decision-making and outcomes.”

Excess deaths are calculated as the difference between the number of deaths that have occurred and the number of deaths that would have been expected in the absence of a pandemic, based on data from previous years.

The excess number of deaths includes deaths directly (due to disease) or indirectly (due to the impact of the pandemic on the health system and society) associated with COVID-19. Deaths indirectly related to COVID-19 can be attributed to other health conditions where people are unable to access appropriate prevention and treatment due to an overwhelmed health system as a result of the pandemic. Some deaths were averted during the pandemic due to the reduced risk of certain events (e.g., motor vehicle accidents or occupational injuries), which could also affect the estimated number of excess deaths.

Most excess deaths (84%) were concentrated in Southeast Asia, Europe, and the Americas. Approximately 68% of excess deaths globally were concentrated in just 10 countries. Of the 14.9 million excess deaths over 24 months, middle-income countries accounted for 81% (53% in lower-middle-income countries and 28% in upper-middle-income countries), while high-income and low-income countries accounted for 15% and 4%, respectively.

These estimates, which cover 24 months (2020 and 2021), include excess deaths by age and sex. These estimates confirm that there are more deaths among men than women globally (57% for men and 43% for women) and that the number of deaths is higher among the elderly. The absolute number of excess deaths is influenced by the size of the population. The number of excess deaths per 100,000 people provides a more objective picture of the pandemic than the reported COVID-19 mortality data.

Measuring excess mortality is an essential element in understanding the impact of a pandemic,” said Dr. Samira Asma, assistant director-general of WHO’s Data, Analysis and Action Department. Changes in mortality trends can provide decision makers with information to guide policies related to mortality reduction and effective prevention of future crises. The true extent of excess mortality is often obscured by the limited investment in data systems in many countries. These new estimates use the best available data and are generated in a methodologically sound and fully transparent manner.”

Dr. Ibrahima Socé Fall, Assistant Director General for Critical Incident Response, said, “Data is the foundation of our work every day to improve health, keep the world safe and serve vulnerable populations. We know where the data gaps are, and together we must strengthen our support to countries so that each has the ability to track outbreaks in real time, ensure the delivery of essential health services, and safeguard population health.”

The estimates are the product of a global collaboration supported by the work of the COVID-19 Mortality Assessment Technical Advisory Group and national consultation efforts.

The COVID-19 Mortality Assessment Technical Advisory Group, jointly convened by WHO and the United Nations Department of Economic and Social Affairs (UN DESA), consists of many of the world’s leading experts who have developed an innovative approach to generating comparable mortality estimates even when data are incomplete or unavailable.

This approach is invaluable because many countries still lack reliable mortality surveillance capacity and therefore cannot collect and generate the data needed to calculate excess deaths. With this publicly available method, countries can use their own data to generate or update their own estimates.

The UN system is making a concerted effort to produce an authoritative assessment of the global death toll from the pandemic,” said Mr. Liu Zhenmin, UN Under-Secretary-General for Economic and Social Affairs. This work is an important part of the ongoing collaboration between UN DESA and WHO and other partners to improve global mortality estimates.”

Mr. Stefan Schweinfest, Director of the UN DESA Statistics Division, added, “Data gaps make it difficult to assess the true scope of the crisis, with serious consequences for people’s lives. The pandemic is a clear reminder of the need for better coordination of data systems within countries and increased international support to build better systems, including registration systems for deaths and other vital events.”