Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21
The global all-age rate of excess mortality due to the COVID-19 pandemic was 120·3 deaths per 100000 of the population, and excess mortality rate exceeded 300 deaths per 100 000 of the population in 21 countries.
The number of excess deaths due to COVID-19 was largest in the regions of south Asia, north Africa and the Middle East, and eastern Europe.
At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India, the USA, Russia, Mexico, Brazil, Indonesia, and Pakistan. Among these countries, the excess mortality rate was highest in Russia (374 deaths per 100, 000) and Mexico (325 per 100,000), and was similar in Brazil (186 per 100,000).
Note: Arizona’s per capita COVID death rate is 415 per 100,000, making Arizona the worst in the entire globe in this study if we were a country, thanks mostly to the decisions made by Governor Ducey and former ADHS Director Christ.
Interpretation: The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics.
In addition, further research is warranted to help distinguish the proportion of excess mortality that was directly caused by SARS-CoV-2 infection and the changes in causes of death as an indirect consequence of the pandemic.