Tracking covid-19 excess deaths across countries
In many parts of the world, official death tolls undercount the total number of fatalities
AS COVID-19 has spread around the world, people have become grimly familiar with the death tolls that their governments publish each day. Unfortunately, the total number of fatalities caused by the pandemic may be even higher, for several reasons. First, the official statistics in many countries exclude victims who did not test positive for coronavirus before dying—which can be a substantial majority in places with little capacity for testing. Second, hospitals and civil registries may not process death certificates for several days, or even weeks, which creates lags in the data. And third, the pandemic has made it harder for doctors to treat other conditions and discouraged people from going to hospital, which may have indirectly caused an increase in fatalities from diseases other than covid-19.
One way to account for these methodological problems is to use a simpler measure, known as “excess deaths”: take the number of people who die from any cause in a given region and period, and then compare it with a historical baseline from recent years. We have used statistical models to create our baselines, by predicting the number of deaths each region would normally have recorded in 2020 and 2021.
Many Western countries, and some nations and regions elsewhere, regularly publish data on mortality from all causes. The table below shows that, in most places, the number of excess deaths (compared with our baseline) is greater than the number of covid-19 fatalities officially recorded by the government. The full data for each country, as well as our underlying code, can be downloaded from our GitHub repository. Our sources also include the Human Mortality Database, a collaboration between UC Berkeley and the Max Planck Institute in Germany, and the World Mortality Dataset, created by Ariel Karlinsky and Dmitry Kobak.
The chart below uses data from EuroMOMO, a network of epidemiologists who collect weekly reports on deaths from all causes in 23 European countries. These figures show that, compared with a historical baseline of the previous five years, Europe has suffered some deadly flu seasons since 2016—but that the death toll from covid-19 has been far greater. Though most of those victims have been older than 65, the number of deaths among Europeans aged 45-64 was 40% higher than usual in early April 2020.
Below are a set of charts that compare the number of excess deaths and official covid-19 deaths over time in each country. The lines on each chart represent excess deaths, and the shaded area represents the number of fatalities officially attributed to coronavirus by the government.
In March 2020 America’s east coast was hit hard by the pandemic. States elsewhere locked down quickly enough to prevent major outbreaks at that point, but a second wave in November and December surged through most of the country. Excess mortality was low from March 2021 onwards, as a rapid vaccination campaign allowed the country to open up again.
While covid-19 was devastating New York in March 2020, cities in western Europe were also suffering severe outbreaks. Britain, Spain, Italy, Belgium and Portugal have some of the highest national excess-mortality rates in the world, after adjusting for the size of their populations. These countries also suffered a second wave of deaths in the autumn and winter of 2020. Some western European countries were slow to vaccinate their citizens in early 2021, as shown by our covid-19 data tracker. But by June mortality rates had returned to normal across the region.
Countries in northern Europe have generally experienced much lower mortality rates throughout the pandemic. Some Nordic nations have experienced almost no excess deaths at all. The exception is Sweden, which imposed some of the continent’s least restrictive social-distancing measures during the first wave.
In central Europe only the Netherlands and Switzerland suffered large numbers of excess deaths in early 2020. After international travel resumed, the entire region was ravaged in the autumn. Poland, Hungary and the Czech Republic all endured additional spikes of mortality in March and April 2021.
South-eastern Europe has followed a similar pattern. November and December 2020 were particularly lethal, with Bulgaria recording the highest weekly excess-mortality rates of any country in our tracker. Several countries have since experienced further deadly outbreaks.
Among former republics of the Soviet Union, only Belarus suffered substantial excess mortality in early 2020, after introducing almost no constraints on daily life. A second wave in late 2020 affected the entire region. Russia now has one of the world’s largest excess-mortality gaps. It recorded about 580,000 more deaths than expected between April 2020 and June 2021, compared with an official covid-19 toll of only 130,000.
Much of Latin America experienced a devastating first wave from April to July 2020, with Bolivia and Ecuador hit particularly hard. A second wave surged through the region in late 2020, as Mexico, Peru and Brazil all recorded higher peaks of excess mortality than at any previous point during the pandemic. The virus has continued to circulate throughout the continent since then, with Colombia and Paraguay suffering their worst death tolls in April and May 2021.
Outside Europe and the Americas, few places release data about excess deaths. No such information exists for large swathes of Africa and Asia, where some countries only issue death certificates for a small fraction of people. For these places without national mortality data, The Economist has produced estimates of excess deaths using statistical models trained on the data in this tracker (as explained in our methodology post). In India, for example, our estimates suggest that perhaps 2.3m people had died from covid-19 by the start of May 2021, compared with about 200,000 official deaths.
Among developing countries that do produce regular mortality statistics, South Africa shows the grimmest picture, after recording three large spikes of fatalities. In contrast, Malaysia and the Philippines had “negative” excess mortality—fewer deaths than they would normally have recorded, perhaps because of social distancing.
A handful of rich countries elsewhere publish regular mortality data. They tend to have negative excess mortality. Australia and New Zealand managed to eradicate local transmission after severe lockdowns. Taiwan and South Korea achieved the same outcome through highly effective contact-tracing systems. Israel has experienced some excess deaths, but has also outpaced the rest of the world in vaccinating its population, with promising results.
Update (October 14th 2020): A previous version of this page used a five-year average of deaths in a given region to calculate a baseline for excess deaths. The page now uses a statistical model for each region, which predicts the number of deaths we might normally have expected in 2020. The model fits a linear trend to years, to adjust from long-term increases or decreases in deaths, and a fixed effect for each week or month.
Correction: The data for deaths officially attributed to covid-19 in Chile were corrected on September 9th 2020. Apologies for this error.
Sources: The Economist; Our World In Data; Johns Hopkins University; Human Mortality Database; World Mortality Dataset; Registro Civil (Bolivia); Vital Strategies; Office for National Statistics; Northern Ireland Statistics and Research Agency; National Records of Scotland; Registro Civil (Chile); Registro Civil (Ecuador); Institut National de la Statistique et des Études Économiques; Santé Publique France; Provinsi DKI Jakarta; Istituto Nazionale di Statistica; Dipartimento della Protezione Civile; Secretaría de Salud (Mexico); Ministerio de Salud (Peru); Data Science Research Peru; Departamento Administrativo Nacional de Estadística (Colombia); South African Medical Research Council; Instituto de Salud Carlos III; Ministerio de Sanidad (Spain); Datadista; Istanbul Buyuksehir Belediyesi; Centres for Disease Control and Prevention; USA Facts; New York City Health. Get the data on GitHub
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