The actual death toll of the pandemic is estimated to be over 18 million, far more than the global tallies report, indicating the true aftermath of devastating surges since 2020.

A group of COVID-19 modeling experts at the Institute for Health Metrics and Evaluation at the University of Washington projects in the first peer-reviewed global estimates that the reported global death toll of roughly 6 million is an undercount.

“Our estimates of COVID-19 excess mortality suggest the mortality impact from the COVID-19 pandemic has been more devastating than the situation documented by official statistics,” the researchers wrote in the medical journal the Lancet.


They arrived at their estimate — as many as 18.2 million people could have died from COVID-19 between January 2020 and December 2021 — by calculating excess deaths, or the difference between the observed number of deaths during a specific time frame and the expected number of deaths during that same period. Fewer than 40 countries have reported cause-of-death data from 2020. Therefore, the researchers tracked weekly and monthly mortality rates due to all causes in 2020 and 2021 and up to 11 prior years for 74 countries and 266 states and provinces.

India accounted for the most excess deaths (22%) due in part to its sizable population. The United States and Russia came in second and third, respectively, with about a million cumulative excess deaths due to COVID-19 each.

Estimates of excess deaths help scientists and policy experts in determining the full scope of COVID-19’s destruction. They attributed the discrepancy between reported and estimated true death toll to uneven testing access globally and flawed data reporting from governments. Excess deaths also consider the deaths likely linked to the disease but not designated as such on death certificates.

“Gaps exist between reported and excess deaths related to the COVID-19 pandemic for a number of reasons,” they said. “Health-care reporting systems generally do not list COVID-19 as the cause of death without a positive SARS-CoV-2 test, and thus deaths due to COVID-19 will be missed in official counts in locations with low testing capacity.”

Excess mortality rates exceeded 300 deaths per 100,000 in 21 countries, mostly in South American countries connected by the Andes mountains, eastern Europe, central Europe, southern sub-Saharan Africa, and central Latin America, they reported.


In the U.S., federal authorities have put the true death toll linked to COVID-19 at more than 1,045,000. Meanwhile, nearly 966,000 deaths have been reported, by comparison. The vast majority of the excess deaths were due to COVID-19, but the Centers for Disease Control and Prevention pointed to several other health conditions that contributed to the high mortality, such as hypertension, ischemic heart disease, Alzheimer’s, and diabetes.

Health experts have also pointed to an increase in substance abuse and overdose rates due to stresses that come with living through a global pandemic. The CDC has estimated that 100,306 people died of drug overdoses between May 2020 and April 2021, surpassing the number of deaths from car crashes, guns, and pneumonia.