Global COVID-19 Mortality
Between January 2020 and December 2021, an estimated 18.2 million people died worldwide due to the COVID-19 pandemic, which is approximately three times higher than the 5.94 million officially reported COVID-19 deaths during this period. 1
Official vs. Actual Death Toll
The discrepancy between reported and actual deaths is substantial:
- Reported deaths: Nearly 6 million deaths were officially attributed to COVID-19 between January 1,2020, and December 31,2021 2
- Excess mortality estimates: 18.2 million deaths (95% uncertainty interval 17.1-19.6 million) occurred worldwide due to the pandemic when measured by excess mortality 1
- Global excess mortality rate: 120.3 deaths per 100,000 population (95% UI 113.1-129.3) 1
Geographic Distribution of Deaths
The highest burden of COVID-19 mortality was concentrated in specific regions and countries:
Countries with highest absolute death tolls 1:
- India: 4.07 million excess deaths (3.71-4.36 million)
- United States: 1.13 million excess deaths (1.08-1.18 million)
- Russia: 1.07 million excess deaths (1.06-1.08 million)
- Mexico: 798,000 excess deaths (741,000-867,000)
- Brazil: 792,000 excess deaths (730,000-847,000)
- Indonesia: 736,000 excess deaths (594,000-955,000)
- Pakistan: 664,000 excess deaths (498,000-847,000)
Regions with highest excess mortality rates 1:
- South Asia experienced the largest number of excess deaths
- North Africa and the Middle East had substantial excess mortality
- Eastern Europe showed elevated death rates
Mortality Rates by Country
Excess mortality rates per 100,000 population varied dramatically 1:
- Russia: 374.6 deaths per 100,000 (369.7-378.4)
- Mexico: 325.1 deaths per 100,000 (301.6-353.3)
- Brazil: 186.9 deaths per 100,000 (172.2-199.8)
- United States: 179.3 deaths per 100,000 (170.7-187.5)
- 21 countries exceeded 300 deaths per 100,000 population 1
Temporal Evolution of Mortality
The pandemic showed distinct mortality patterns across waves 3:
- Approximately 43.1% of all deaths occurred during the first wave despite lower case numbers 3
- Case numbers increased exponentially in the fourth wave compared to the first wave, but mortality proportions decreased 3
- This shift reflects inadequate initial pandemic preparedness, reduced severity of later variants, and protection from prior infection and vaccination 3
United States-Specific Mortality Impact
The U.S. experienced a widening mortality gap compared to European peers 4:
- In 2021, the U.S. mortality gap caused 892,491 excess deaths—a 34.8% increase over expected mortality 4
- Excess deaths nearly doubled between 2019 and 2021 (+84.9%) 4
- COVID-19 directly contributed 223,266 excess deaths in 2021 (25.0% of all excess deaths) 4
- However, 45.5% of the increase in excess deaths between 2019 and 2021 was due to non-COVID causes 4
- Among ages 15-64, nearly half (48.0%) of all U.S. deaths in 2021 were excess deaths 4
Critical Caveats About Mortality Data
Mortality statistics substantially underestimate the true pandemic death toll 1:
- Official COVID-19 death counts capture only approximately one-third of actual pandemic-related deaths 1
- Incomplete death registration systems worldwide, particularly in low- and middle-income countries, contribute to underreporting 1
- Excess mortality includes both direct deaths from SARS-CoV-2 infection and indirect deaths from pandemic consequences (delayed medical care, economic disruption, mental health crises) 1
- The proportion of excess mortality directly caused by SARS-CoV-2 infection versus indirect pandemic effects remains incompletely distinguished 1
As of May 30,2020, early pandemic data showed 5: