Far more people have died over the past months than have been officially reported, a review of mortality data in 32 countries shows.
Far more people have died over the past months than have been officially reported, a review of mortality data in 32 countries shows.
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The Pandemic’s Hidden Toll: Half a Million Deaths
ByJin WuAllison McCannJosh KatzElian PeltierandKaran Deep SinghUpdatedFeb. 9, 2021
At least 496,000 more people died last year during the coronavirus pandemic than the official Covid-19 death counts report, a review of mortality data last year in 35 countries shows — providing a clearer, if still incomplete, picture of the toll of the crisis.
Far more people died in most of these countries than in previous years, The New York Times found. The totals include deaths from Covid-19 as well as those from other causes, likely including people whocould not be treatedas hospitals became overwhelmed. These numbers undermine the notion that many people who have died from the virus may soon have died anyway.
How excess deaths compare with reported Covid-19 deaths in 2020
Mortality data in the middle of a pandemic is not perfect. In most places, the disparities between the official death counts and the total rise in deaths reflect limited testing for the virus rather than intentional undercounting. Officially, nearly2 million people have diedof the coronavirus worldwide as of Jan. 12.
But the total death numbers offer a more complete portrait of the pandemic, researchers say, especially because many countries report only those Covid-19 deaths that occur in hospitals.
“Whatever number is reported on a given day is going to be a gross underestimate,” said Tim Riffe, a demographer at the Max Planck Institute for Demographic Research in Germany.
Excess deaths spiked across Europe
After large surges in excess mortality in the spring, most countries across Europe returned to normal levels in the summer. But asecond wave of serious illnessreturned in the fall and continued through the winter, leading to an uptick in mortality once again.
In Belgium and Switzerland, the peaks in mortality in the second half of the year were even greater than in the spring.
These estimates were made for each country by comparing the total number of people who died this year to the number of deaths that would be expected given local mortality trends, adjusted to account for changes over time. The Economist is alsotracking these deaths, known as excess deaths, in a similar way.
It is unusual for mortality data to be released so quickly, demographers say, but many countries are working to provide more comprehensive and timely information because of the urgency of the coronavirus outbreak. The data is limited and, if anything, excess deaths are underestimated because not all deaths have been reported.
“At this stage, it’s a partial snapshot,” said Patrick Gerland, a demographer at the United Nations. “It’s one view of the problem that reflects that most acute side of the situation, primarily through the hospital-based system.”
Where excess deaths never returned to normal
The virus was last to hit Latin America, and excess deaths still had not returned to normal levels by the end of the year. Mexico recorded at least 230,800 more deaths than usual compared to the same period in previous years — about two times higher than the reported number of Covid-19 deaths during that time.
Not all countries saw excess deaths
In a handful of countries, however, there was no clear sign of increased mortality in 2020. The reasons for this are varied and will become clearer in the months ahead as countries process and certify deaths.
In Norway, Denmark and Finland, demographers say the low mortality is due in part to a less severe flu season last winter — but also because these countries were quick to implement severe restrictions to slow the spread of the virus when their outbreaks were smaller and easier to contain.
Age breakdowns in mortality data will also provide a clearer picture of the role of Covid-19 in excess deaths. Using relative age-standardized mortality rates, Britain’s Office for National Statisticsfoundthat Spain had the highest rate of all European countries during the peak of the pandemic.
Even taking into account differences in mortality by age, experts say the death toll to date could have been much worse.
“Today’s rise in all-cause mortality takes place under conditions of extraordinary measures, such as social distancing, lockdowns, closed borders and increased medical care, at least some which have positive impacts,” said Vladimir Shkolnikov, a demographer at the Max Planck Institute for Demographic Research. “It is likely that without these measures, the current death toll would be even higher.”
Read more about the methodology anddownload datafor excess mortality from The New York Times on GitHub.
To estimate expected deaths, we fit a linear model to reported deaths in each country from 2015 to January 2020. The model has two components — a linear time trend to account for demographic changes and a smoothing spline to account for seasonal variation. For countries limited to monthly data, the model includes month as a fixed effect rather than using a smoothing spline.
Some countries have less historical data available. For countries with three or fewer years of data, the model uses a simple average of deaths in the observed years. For the United Kingdom, the model accounts for the number of bank holidays in a given week, since deaths are not registered during bank holidays.
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Muktita Suhartono contributed reporting from Bangkok, Carlotta Gall from Istanbul, Anatoly Kurmanaev from Caracas, Venezuela, Monika Pronczuk from Brussels, José María León Cabrera from Quito, Ecuador, Irit Pazner from Jerusalem, John Bartlett from Santiago, Mirelis Morales from Lima, Manuela Andreoni from Rio de Janeiro, Choe Sang-hun from Seoul, María Silvia Trigo from Santa Cruz, Bolivia, Julie Turkewitz and Jenny Carolina Gonzalez Camacho from Bogotá.About the data:The all-cause mortality data obtained from each country varies: Some countries publish daily death totals dating back decades, and others only for the last few years. Places with less historical data, such as Istanbul, make for rougher historical comparisons. Historical baselines used to calculate excess deaths do not adjust for any expected reduction in recent deaths from non-Covid-19 causes or for two deadly flu epidemics in Europe during the winters of 2014-15 and 2017-18. The data in Italy includes towns accounting for 94 percent of the population.
Sources:Stephane Helleringer, Johns Hopkins University; Tim Riffe, Max Planck Institute for Demographic Research; Lasse Skafte Vestergaard, EuroMOMO; Vladimir Shkolnikov, Max Planck Institute for Demographic Research; Tom Moultrie, University of Cape Town; Isaac Sasson, Tel Aviv University; Patrick Gerland, United Nations; S V Subramanian, Harvard University; Paulo Lotufo, University of São Paulo; Marcelo Oliveira; Patama Vapattanawong, Mahidol University; Ryohei Mogi, Autonomous University of Barcelona; Fumiya Uchikoshi, Princeton University; Fatima Marinho, Vital Strategies; Ana Torrens, Vital Strategies; Renato Teixeira, Vital Strategies;  Elizabeth França, Federal University of Minas Gerais; Ana Maria Nogales, University of Brasília; Daisy Xavier, Federal University of Minas Gerais; Thomas Fujiwara, Princeton University; Istanbul Metropolitan Municipality; Jakarta Department of Parks and Cemeteries; Daily Mortality Surveillance System (Spain); National Institute of Statistics and Economic Studies (France); Federal Statistical Office (Switzerland); Belgium Statbel; Statistics Netherlands; Statistics Norway; Statistics Denmark; Statistics Sweden; Public Health Authority (Sweden); Office for National Statistics (England & Wales); National Records of Scotland; Northern Ireland Statistics and Research Agency; Centers for Disease Control and Prevention; NYC Department of Health and Mental Hygiene (New York City); General Direction of Civil Registry (Ecuador); National Institute of Statistics (Ecuador); Federal Statistical Office (Germany); Italian National Institute of Statistics; South African Medical Research Council; Central Bureau of Statistics (Israel); Moscow Department of Health; Federal State Statistics Service (Russia); Peru's Mortality Information System (Sinadef); The Ministry of Health of Peru; The Civil Registry and Identification Service (Chile); Statistics Division, Bureau of General Affairs (Tokyo, Japan); National Institute of Statistics, Geography and Informatics (INEGI); Statistics Korea; Health Information and Quality Authority (Ireland); Municipal Corporation of Greater Mumbai (Mumbai, India); Government of Mexico; Hungarian Central Statistics Office; Ministry of Digital Affairs (Poland); Czech Statistical Office
Correction:An earlier version of a chart with this article misstated the average historical number of deaths in France during the first week of April. More complete historical data has since been added. The average for the week was about 11,000, not 9,400.