New analysis from IHME highlights the true toll of the pandemic
SEATTLE, May 6, 2021 /PRNewswire/ — Globally, COVID-19 has caused approximately 6.9 million deaths, more than double what official numbers show, according to a new analysis by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine. IHME found that COVID-19 deaths are significantly underreported in almost every country. The updated analysis shows that the United States has had more COVID-19 deaths to-date than any other country, a total of more than 905,000. By region, Latin America and the Caribbean and Central Europe, Eastern Europe and Central Asia were hardest hit in terms of total deaths. This figure only includes deaths caused directly by the SARS-CoV-2 virus, not deaths caused by the pandemic’s disruption to health care systems and communities.
“As terrible as the COVID-19 pandemic appears, this analysis shows that the actual toll is significantly worse,” said Dr. Chris Murray, IHME’s director. “Understanding the true number of COVID-19 deaths not only helps us appreciate the magnitude of this global crisis, but also provides valuable information to policymakers developing response and recovery plans.”
The 20 countries with the highest number of total COVID-19 deaths, March 2020–May 2021
| Country | Total COVID-19 deaths | Reported COVID-19 deaths |
| United States of America | 905,289 | 574,043 |
| India | 654,395 | 221,181 |
| Mexico | 617,127 | 217,694 |
| Brazil | 595,903 | 408,680 |
| Russian Federation | 593,610 | 109,334 |
| United Kingdom | 209,661 | 150,519 |
| Italy | 175,832 | 121,257 |
| Iran | 174,177 | 72,906 |
| Egypt | 170,041 | 13,529 |
| South Africa | 160,452 | 54,390 |
| Poland | 149,855 | 68,237 |
| Peru | 147,765 | 62,739 |
| Ukraine | 138,507 | 46,737 |
| France | 132,680 | 105,506 |
| Spain | 123,786 | 85,365 |
| Germany | 120,729 | 83,256 |
| Indonesia | 115,743 | 45,938 |
| Japan | 108,320 | 10,390 |
| Romania | 87,649 | 28,382 |
| Kazakhstan | 81,696 | 5,620 |
Many deaths from COVID-19 go unreported because countries only report deaths that occur in hospitals or in patients with a confirmed infection. In many places, weak health reporting systems and low access to health care magnify this challenge.
IHME’s analysis found that the largest number of unreported deaths occurred in countries that have had the largest epidemics to-date. However, some countries with relatively smaller epidemics saw a large increase in the death rate when accounting for unreported deaths. This analysis shows that they may be at greater risk for a wider epidemic than previously thought.
“Many countries have devoted exceptional effort to measuring the pandemic’s toll, but our analysis shows how difficult it is to accurately track a new and rapidly spreading infectious disease,” Murray said. “We hope that today’s report will encourage governments to identify and address gaps in their COVID-19 mortality reporting, so that they can more accurately direct pandemic resources.” Moving forward, IHME’s COVID-19 modeling, which forecasts the potential course of the pandemic over the next several months, will be based on these estimates of total COVID-19 deaths. IHME’s modeling is updated weekly and can be accessed at covid19.healthdata.org.
Methodology
These estimates are based on IHME’s long-standing methodology for measuring the burden of diseases on a global scale. Since 1990, the Global Burden of Disease study has measured the total human cost of diseases.
IHME estimated total COVID-19 deaths by comparing anticipated deaths from all causes based on pre-pandemic trends with the actual number of all-cause deaths during the pandemic. This “excess mortality” figure was then adjusted to remove deaths indirectly attributable to the pandemic (for example, due to people with non-COVID conditions avoiding health care facilities) as well as deaths averted by the pandemic (for example, declines in traffic deaths due to lower mobility). The resulting adjusted estimates include only deaths directly due to the SARS-CoV-2 virus, which causes COVID-19. A detailed write-up on methodology is available on IHME’s website.
About the Institute for Health Metrics and Evaluation
The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington School of Medicine that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME is committed to transparency and makes this information widely available so that policymakers have the evidence they need to make informed decisions on allocating resources to improve population health.
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