posts: 33107

{
    "id": "wp-33107",
    "slug": "excess-mortality-covid",
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                        "text": "We update this page every other week with the latest available data on excess mortality.  {{LastUpdated timestampUrl:https://covid.ourworldindata.org/data/internal/timestamp/owid-covid-data-last-updated-timestamp-xm.txt}}",
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                "text": [
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                        "text": "Excess mortality during COVID-19",
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                "text": [
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                        "text": "What is 'excess mortality'?",
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                                "text": "Excess mortality ",
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                        "text": "is a term used in epidemiology and public health that refers to the number of deaths ",
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                        "children": [
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                                "text": "from all causes",
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                        "text": " during a crisis above and beyond what we would have expected to see under \u2018normal\u2019 conditions.{ref}Checchi, F., & Roberts, L. (2005).",
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                    },
                    {
                        "url": "https://odihpn.org/resources/interpreting-and-using-mortality-data-in-humanitarian-emergencies/",
                        "children": [
                            {
                                "text": " Interpreting and using mortality data in humanitarian emergencies",
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                            }
                        ],
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                    {
                        "text": ". ",
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                        "children": [
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                                "text": "Humanitarian Practice Network",
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                            }
                        ],
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                    {
                        "text": ", ",
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                        "children": [
                            {
                                "text": "52",
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                        "text": ".{/ref} In this case, we\u2019re interested in how the number of deaths during the COVID-19 pandemic compares to the deaths we would have expected had the pandemic not occurred \u2014 a crucial quantity that cannot be known but can be ",
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                        "url": "https://ourworldindata.org/excess-mortality-covid#how-is-excess-mortality-measured",
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                                "text": "estimated in several ways",
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                        ],
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                        "text": ".",
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                        "text": "Excess mortality is a more comprehensive measure of the ",
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                    {
                        "children": [
                            {
                                "text": "total",
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                        "text": " impact of the pandemic on deaths than the confirmed COVID-19 death count alone. It captures not only the confirmed deaths, but also COVID-19 deaths that were not correctly diagnosed and reported{ref}For example, because no COVID-19 test was conducted or a country\u2019s death reporting system failed to register the death as from COVID.{/ref} as well as deaths from",
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                    {
                        "url": "https://ourworldindata.org/causes-of-death",
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                                "text": " other causes",
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                        ],
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                    {
                        "text": " that are attributable to the overall crisis conditions.{ref}Conditions such as health systems being overwhelmed, resources being diverted away from other health problems, or fewer people seeking treatment for other health risks.",
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                        "text": "A working paper with data from England estimates that for every 30 COVID deaths there is at least one avoidable non-COVID excess death in hospitals. See Fetzer and Rauh (2022) ",
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                    },
                    {
                        "url": "https://warwick.ac.uk/fac/soc/economics/research/centres/cage/manage/publications/wp607.2022.pdf?link=twitter",
                        "children": [
                            {
                                "text": "Pandemic Pressures and Public Health Care: Evidence from England",
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                    {
                        "text": ".{/ref}",
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                        "text": "We further discuss the relationship between confirmed COVID-19 deaths and excess mortality in the section '",
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                    {
                        "url": "/excess-mortality-covid#excess-mortality-during-covid-19-background",
                        "children": [
                            {
                                "text": "Excess mortality during COVID-19: background",
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                        "text": ".'",
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                "text": [
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                        "text": "How is excess mortality measured?",
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                        "text": "Excess mortality is measured as the difference between the reported number of deaths in a given week or month (depending on the country) in 2020\u20132024 and an estimate of the expected deaths for that period had the COVID-19 pandemic not occurred.",
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                        "text": "[latex]Excess\\ Deaths = Reported\\ Deaths\\ \u2013\\ Expected\\ Deaths[/latex]",
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                        "text": "The baseline of expected deaths can be estimated in several different ways.",
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                        "text": "We use an estimate produced by Ariel Karlinsky and Dmitry Kobak as part of their ",
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                    {
                        "url": "https://ourworldindata.org/excess-mortality-covid#excess-mortality-our-data-sources",
                        "children": [
                            {
                                "text": "World Mortality Dataset (WMD)",
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                        "text": ".{ref}We use this estimate as of 20 September 2021.{/ref} To produce this estimate, they first fit a regression model for each region using historical deaths data from 2015\u20132019.{ref}Or as many years from this period as are available.{/ref} They then use the model to project the number of deaths we might normally have expected in 2020\u20132024.{ref}Before 18 January 2022, WMD published a projection only for 2020 to avoid further extrapolation from the historical data. As of 18 January 2022, they do publish\u2014and we use\u2014separate projections for each year (that is, 2020, 2021, 2022, 2023, and so on).{/ref} Their model can capture both seasonal variation and year-to-year trends in mortality.",
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                        "text": "For more details on this method, see the article Karlinsky and Kobak (2021) ",
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                    {
                        "url": "https://elifesciences.org/articles/69336",
                        "children": [
                            {
                                "text": "Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset",
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                        "text": ".{ref}Karlinsky, A. and Kobak, D. (2021). Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset. ",
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                    {
                        "children": [
                            {
                                "text": "eLife",
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                    {
                        "text": ", DOI: 10.7554/eLife.69336.{/ref}",
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                        "text": "Previously we used a different expected deaths baseline: the average number of deaths over the years 2015\u20132019.{ref}Except for a few countries for which we only have data from the years 2016 or 2017 to 2019; for details see ",
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                        "url": "https://docs.google.com/spreadsheets/d/1JPMtzsx-smO3_K4ReK_HMeuVLEzVZ71qHghSuAfG788/edit?usp=sharing",
                        "children": [
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                                "text": "this spreadsheet",
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                        ],
                        "spanType": "span-link"
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                    {
                        "text": " and the ",
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                    {
                        "url": "https://www.mortality.org/Public/STMF_DOC/STMFmetadata.pdf",
                        "children": [
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                                "text": "Human Mortality Database metadata",
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                        "text": ".{/ref} We made this change because using the five-year average has an important limitation \u2014\u00a0it does not account for year-to-year trends in mortality and thus can misestimate excess mortality.{ref}For instance, for countries that have an increasing trend in mortality like the US and South Korea, the five-year average will ",
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                        "children": [
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                                "text": "over",
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                        "text": "estimate excess deaths; while for countries that have a decreasing trend in mortality like Russia, it will ",
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                    {
                        "children": [
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                                "text": "under",
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                        "text": "estimate excess deaths.{/ref} The WMD projection, on the other hand, does not suffer from this limitation because it accounts for these year-to-year trends. Our charts using the five-year average are still accessible in links in the sections below.",
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                        "text": "For reported deaths, we ",
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                    {
                        "url": "https://ourworldindata.org/excess-mortality-covid#excess-mortality-our-data-sources",
                        "children": [
                            {
                                "text": "source our data",
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                        ],
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                        "text": " from both WMD and the Human Mortality Database.",
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                "text": [
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                        "text": "The P-score: a measure of excess mortality that is more comparable across countries",
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                        "text": "The raw number of excess deaths gives us a sense of scale, but it is less comparable across countries due to large differences in population. To better enable comparisons across countries, we measure excess mortality as the ",
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                    {
                        "children": [
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                                "text": "percentage difference",
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                        "text": " between the reported and projected number of deaths. This metric is called the P-score and we calculate it as:{ref}We calculate P-scores using the reported deaths data for 2020\u20132024 from HMD and WMD \u2014 ",
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                    },
                    {
                        "url": "https://ourworldindata.org/excess-mortality-covid#source-information-country-by-country",
                        "children": [
                            {
                                "text": "see here for country by country source information",
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                        ],
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                        "text": " \u2014 and the projected deaths for 2020\u20132024 from WMD (which we use for all countries and regions, including for deaths broken down by age group).{/ref}",
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                        "text": "[latex]P\\text{-}score = \\frac{Reported\\ Deaths\\ \u2013\\ Projected\\ Deaths}{Projected\\ Deaths} * 100[/latex]",
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                        "text": "For example, if a country had a P-score of 100% in a given week in 2020, that would mean the death count for that week was 100% higher than \u2014 that is, double \u2014 the projected death count for that week.",
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                "url": "https://ourworldindata.org/covid-excess-mortality",
                "type": "prominent-link",
                "title": "A pandemic primer on excess mortality statistics and their comparability across countries",
                "description": "Learn more about measures of excess mortality in our work with John Muellbauer and Janine Aron.",
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                "text": [
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                        "text": "Excess mortality P-scores",
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                                "text": "The chart here shows excess mortality during the pandemic for all ages using the P-score. To see the P-scores for other countries click Add country on the chart.",
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                        "text": [
                            {
                                "text": "Important points about excess mortality figures to keep in mind",
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                                        "text": "The reported number of deaths might not count all deaths that occurred.",
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                            {
                                "text": " This is the case for two reasons:",
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                                        "text": "First, not all countries have the infrastructure and capacity to register and report all deaths. In richer countries with high-quality mortality reporting systems, ",
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                                    },
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                                        "url": "https://ourworldindata.org/grapher/estimated-completeness-of-death-reporting",
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                                                "text": "nearly 100% of deaths are registered",
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                                        "spanType": "span-link"
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                                    {
                                        "text": ". But in many low- and middle-income countries, undercounting of mortality is a serious issue. The ",
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                                    },
                                    {
                                        "url": "https://unstats.un.org/unsd/demographic-social/crvs/#coverage",
                                        "children": [
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                                                "text": "UN estimates",
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                                        "spanType": "span-link"
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                                    {
                                        "text": " that, in \"normal\" times, only two-thirds of countries register at least 90% of all deaths that occur, and some countries register less than 50% \u2014 or ",
                                        "spanType": "span-simple-text"
                                    },
                                    {
                                        "url": "https://www.bbc.com/news/world-africa-55674139",
                                        "children": [
                                            {
                                                "text": "even under 10%",
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                                        ],
                                        "spanType": "span-link"
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                                    {
                                        "text": " \u2014 of deaths. During the pandemic the actual coverage might be even lower.{ref}See ",
                                        "spanType": "span-simple-text"
                                    },
                                    {
                                        "url": "https://docs.google.com/spreadsheets/d/1JPMtzsx-smO3_K4ReK_HMeuVLEzVZ71qHghSuAfG788/edit?usp=sharing",
                                        "children": [
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                                                "text": "this spreadsheet",
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                                        "spanType": "span-link"
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                                    {
                                        "text": " for the UN-estimated death registration coverage of the countries in our dataset. Despite the estimates, the actual coverage might be lower due to the burden of the pandemic. For analysis of this under-reporting see the recent paper by ",
                                        "spanType": "span-simple-text"
                                    },
                                    {
                                        "url": "https://www.bmj.com/content/375/bmj.n2239",
                                        "children": [
                                            {
                                                "text": "Whittaker et al (2021) Under-reporting of deaths limits our understanding of true burden of covid-19",
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                                        "text": ".{/ref}",
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                                        "text": "Second, there are delays in death reporting that make mortality data provisional and incomplete in the weeks, months, and even years after a death occurs \u2014 even in richer countries with high-quality mortality reporting systems.{ref}For instance, a ",
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                                    },
                                    {
                                        "url": "https://www.cdc.gov/nchs/data/vsrr/report001.pdf",
                                        "children": [
                                            {
                                                "text": "2016 CDC study of the delay in the US",
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                                        "spanType": "span-link"
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                                        "text": " found that after four weeks, only 54% of deaths had been registered; by eight weeks the figure was 75%, and it didn't reach 100% until almost a year after the date of death. Though the\u00a0",
                                        "spanType": "span-simple-text"
                                    },
                                    {
                                        "url": "https://www.cdc.gov/nchs/nvss/vsrr/covid19/tech_notes.htm",
                                        "children": [
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                                                "text": "CDC does note",
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                                    {
                                        "text": "\u00a0that \u201cData timeliness has improved in recent years, and current timeliness is likely higher than published rates.\u201d In fact the\u00a0",
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                                    },
                                    {
                                        "url": "https://www.cdc.gov/nchs/nvss/vsrr/covid19/",
                                        "children": [
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                                                "text": "CDC currently estimates",
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                                    {
                                        "text": "\u00a0that \u201c63% of all U.S. deaths are reported within 10 days of the date of death, but there is significant variation between states.\u201d{/ref} The extent of the delay varies by country. For some, the most recent data points are clearly very incomplete and therefore inaccurate \u2014 we ",
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                                    },
                                    {
                                        "children": [
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                                                "text": "do not show ",
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                                        "spanType": "span-italic"
                                    },
                                    {
                                        "text": "these clearly incomplete data points.{ref}Clearly incomplete data is marked by a large, abrupt drop in the death count \u2014 often well below the five-year average \u2014 and a pattern of substantial upward revision to the count from recent periods.{/ref}",
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                                        "text": "The date associated with a death might refer to when the death ",
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                                    {
                                        "children": [
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                                                "text": "occurred ",
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                                        "text": "or to when it was ",
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                                                "text": "registered.",
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                                        "text": " ",
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                                "text": "This varies by country.",
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                                "children": [
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                                        "text": " ",
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                                "text": "Death counts by date of registration can vary significantly irrespectively of any actual variation in deaths, such as from registration delays or the closure of registration offices on weekends and holidays. It can also happen that deaths are registered, but the date of death is unknown \u2014\u00a0this is the case for Sweden.{ref}In 2020, for instance, there were an estimated ~2500 such deaths; see ",
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                            },
                            {
                                "url": "https://twitter.com/HMDatabase/status/1345417758129999872",
                                "children": [
                                    {
                                        "text": "here for details",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
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                                "text": ".",
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                                "text": "Before 27 September 2021, we did not include these deaths in Sweden's data series because our source at the time, the Human Mortality Database, did not include them.",
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                            {
                                "text": "As of 27 September 2021, however, we ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "do",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " include these deaths with unknown date \u2014\u00a0we switched sources for Sweden to the World Mortality Dataset (WMD), which does include these deaths. See here for how WMD does this: ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://github.com/akarlinsky/world_mortality#sweden-weekly",
                                "children": [
                                    {
                                        "text": "https://github.com/akarlinsky/world_mortality#sweden-weekly",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ".{/ref}",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "children": [
                                    {
                                        "text": "The dates of any particular reporting week might differ slightly between countries. ",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-bold"
                            },
                            {
                                "text": "This is because countries that report weekly data define the start and end days of the week differently. Most follow international standard",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://en.wikipedia.org/wiki/ISO_week_date",
                                "children": [
                                    {
                                        "text": " ISO 8601",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ", which defines the week as from Monday to Sunday, but not all countries follow this standard.{ref}For instance, England & Wales define the week as from Saturday to Friday.{/ref} In the charts on this page we use the ISO 8601 week end dates from 2020\u20132024.{ref}This enables easy comparisons of weekly deaths across the years in the chart, but it means we show a date that is slightly incorrect (plus or minus a few days) for the other years. This is because the same numbered week falls on slightly different dates in different years; for example, Week 1 2020 ended on 5 January 2020, while Week 1 2021 ended on 10 January 2021. For more details ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://www.epochconverter.com/weeks/2021",
                                "children": [
                                    {
                                        "text": "see this resource with ISO 8601 week dates across the years",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ".{/ref}",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "children": [
                                    {
                                        "text": "Deaths reported weekly might not be directly comparable to deaths reported monthly.",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-bold"
                            },
                            {
                                "text": " For instance, because excess mortality calculated from monthly data tends to be lower than the excess calculated from weekly data.{ref}The reason for this is that the monthly data smooth the weekly fluctuations, resulting in lower estimates. Source: D. Jdanov, Human Mortality Database, personal communication, 11 February 2021.{/ref}",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "For more discussion and detail on these points, see ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/covid-excess-mortality",
                                "children": [
                                    {
                                        "text": "our article with John Muellbauer and Janine Aron",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " as well as the metadata from the ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://www.mortality.org/Public/STMF_DOC/STMFmetadata.pdf",
                                "children": [
                                    {
                                        "text": "Human Mortality Database",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " and ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://github.com/akarlinsky/world_mortality/",
                                "children": [
                                    {
                                        "text": "World Mortality Dataset",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ".",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    }
                ],
                "type": "sticky-right",
                "right": [
                    {
                        "url": "https://ourworldindata.org/grapher/excess-mortality-p-scores-projected-baseline",
                        "type": "chart",
                        "parseErrors": []
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/cumulative-excess-mortality-p-scores-projected-baseline",
                        "type": "prominent-link",
                        "title": "Cumulative P-scores using projected baseline",
                        "description": "",
                        "parseErrors": []
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/excess-mortality-p-scores-average-baseline",
                        "type": "prominent-link",
                        "title": "P-scores using five-year average baseline",
                        "description": "",
                        "parseErrors": []
                    }
                ],
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Excess mortality P-scores by age group",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "left": [
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "The chart here shows P-scores broken down by age groups: ages 0\u201314, 15\u201364, 65\u201374, 75\u201384, and 85+. The mortality risk from COVID-19 increases with age.{ref}For example, compared to the death rate from COVID-19 for ages 5\u201317, the death rate for ages 65\u201374 is 1100 times higher, for ages 75\u201384 it is 2800 times higher, and for ages 85+ it is ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "7900 times higher.",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " These estimates are based on US data from the CDC:",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html",
                                "children": [
                                    {
                                        "text": " COVID-19 Hospitalization and Death by Age",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ".{/ref}",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "Countries for which the reported deaths data is ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/excess-mortality-covid#source-information-country-by-country",
                                "children": [
                                    {
                                        "text": "sourced from the World Mortality Dataset",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " are not included in this chart because the data is not broken down by age. Though WMD does provide the projected baselines used for calculating P-scores by age in this chart.{ref}These baselines are produced according to the same method described in Karlinsky and Kobak 2021.{/ref}",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "text": [
                            {
                                "text": "Why is it informative to look at P-scores for different age groups?",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "type": "heading",
                        "level": 5,
                        "parseErrors": []
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                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "The chart in the previous section showed P-scores for ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "all ages",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " \u2014 these are impacted by differences in both mortality risk by age and countries\u2019 age distributions. For example, countries with older populations \u2014 which have a higher mortality risk, including from COVID-19 \u2014 will tend to have higher all-age P-scores by default. Looking at the P-scores for ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "different age groups",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " is therefore informative when comparing countries.",
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                            }
                        ],
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                    }
                ],
                "type": "sticky-right",
                "right": [
                    {
                        "url": "https://ourworldindata.org/grapher/excess-mortality-p-scores-projected-baseline-by-age",
                        "type": "chart",
                        "parseErrors": []
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/excess-mortality-p-scores-average-baseline-by-age",
                        "type": "prominent-link",
                        "title": "P-scores by age group using five-year average baseline",
                        "description": "",
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                ],
                "parseErrors": []
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            {
                "text": [
                    {
                        "text": "Excess mortality using raw death counts",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "left": [
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "Besides visualizing excess mortality as a percentage difference as we have with the P-scores, we can also look at the raw death count as shown in the chart here. The raw death count gives us a sense of scale: for example, the US suffered roughly ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/grapher/cumulative-excess-deaths-covid?time=earliest..2021-01-03&country=~USA",
                                "children": [
                                    {
                                        "text": "470,000 excess deaths in 2020",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ", compared to ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=earliest..2020-12-31&facet=none&pickerSort=desc&pickerMetric=total_deaths&Metric=Confirmed+deaths&Interval=Cumulative&Relative+to+Population=false&Align+outbreaks=false&country=~USA",
                                "children": [
                                    {
                                        "text": "352,000 confirmed COVID-19 deaths",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " during that year.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "However, this measure is less comparable across countries due to large differences in populations. You can still see the death counts for other countries by clicking \u201cChange country\u201d on the chart.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    }
                ],
                "type": "sticky-right",
                "right": [
                    {
                        "url": "https://ourworldindata.org/grapher/excess-mortality-raw-death-count-single-series",
                        "type": "chart",
                        "parseErrors": []
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/excess-mortality-raw-death-count",
                        "type": "prominent-link",
                        "title": "Deaths from all causes compared to projection: stacked-years view",
                        "description": "See reported and projected deaths since 2020 separated by year instead of in a single series",
                        "parseErrors": []
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/cumulative-excess-deaths-covid",
                        "type": "prominent-link",
                        "title": "Cumulative excess deaths during COVID-19",
                        "description": "",
                        "parseErrors": []
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/cumulative-excess-deaths-per-million-covid",
                        "type": "prominent-link",
                        "title": "Cumulative excess deaths during COVID-19 per million people",
                        "description": "",
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                ],
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            {
                "text": [
                    {
                        "text": "Estimated excess mortality from ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "The Economist",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    }
                ],
                "type": "heading",
                "level": 3,
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            {
                "left": [
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "Many countries have not reported any data on all-cause mortality during the pandemic. If we want to understand the total ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/excess-mortality-covid#excess-mortality-during-covid-19-background",
                                "children": [
                                    {
                                        "text": "impact of the pandemic",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " on deaths in those countries, as well as globally, we must find a way to estimate this death toll.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "children": [
                                    {
                                        "text": "The Economist",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " built a ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://github.com/TheEconomist/covid-19-the-economist-global-excess-deaths-model",
                                "children": [
                                    {
                                        "text": "machine-learning model",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " to estimate the number of excess deaths during the pandemic for 223 countries and regions.{ref}To read ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "The Economist's",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " article presenting the model estimates, see: ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates",
                                "children": [
                                    {
                                        "text": "https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            }
                        ],
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                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "To read about the model methodology, see: ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://www.economist.com/graphic-detail/2021/05/13/how-we-estimated-the-true-death-toll-of-the-pandemic",
                                "children": [
                                    {
                                        "text": "https://www.economist.com/graphic-detail/2021/05/13/how-we-estimated-the-true-death-toll-of-the-pandemic",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": "{/ref} From these country-level estimates they calculate a global figure.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "Globally, the model estimates that the total number of excess deaths is ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "two to four times higher",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-bold"
                            },
                            {
                                "text": " than the reported number of ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/explorers/coronavirus-data-explorer?facet=none&Metric=Confirmed+deaths&Interval=Cumulative&Relative+to+Population=true&Align+outbreaks=false&country=USA~AUS~ITA~CAN~DEU~GBR~FRA",
                                "children": [
                                    {
                                        "text": "confirmed deaths",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " due to COVID-19.{ref}Similar results were reported in March 2022 by researchers from the Institute for Health Metrics and Evaluation, publishing in the journal ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "The Lancet.",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            }
                        ],
                        "parseErrors": []
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                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "They found that \"Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5.94 million worldwide, we estimate that 18.2 million (95% uncertainty interval 17.1\u201319.6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period.\"",
                                "spanType": "span-simple-text"
                            },
                            {
                                "spanType": "span-newline"
                            },
                            {
                                "spanType": "span-newline"
                            },
                            {
                                "text": "The full citation is: Wang, H., et al. (2022). ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=doi.org%2F10.1016%2FS0140-6736%2821%2902796-3&btnG=",
                                "children": [
                                    {
                                        "text": "Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020\u201321",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ". ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "The Lancet.",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": "{/ref} You can explore the data for any country or region by clicking \u201cChange country\u201d on the chart.",
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                            }
                        ],
                        "parseErrors": []
                    },
                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "How should we think about these estimates?",
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                            }
                        ],
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                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "This work by ",
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                            },
                            {
                                "children": [
                                    {
                                        "text": "The Economist",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " is one of the most comprehensive and rigorous attempts to understand how mortality has changed during the pandemic at the global level. But these estimates come with a great deal of uncertainty given the large amount of data that is missing ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "and",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " the ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/excess-mortality-covid#excess-mortality-p-scores",
                                "children": [
                                    {
                                        "text": "known shortcomings",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " even for data that is available.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "parseErrors": []
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                    {
                        "type": "text",
                        "value": [
                            {
                                "text": "We can think of them as our best, educated \u2014 but still ballpark \u2014 estimates. Some of the specific figures are highly uncertain, as the large uncertainty intervals show. But the overall conclusion remains clear: in many countries and globally, the number of confirmed deaths from COVID-19 is far below the pandemic's full death toll.",
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                            }
                        ],
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                ],
                "type": "sticky-right",
                "right": [
                    {
                        "url": "https://ourworldindata.org/grapher/excess-deaths-cumulative-economist-single-entity",
                        "type": "chart",
                        "parseErrors": []
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/excess-deaths-cumulative-economist",
                        "type": "prominent-link",
                        "title": "Estimated cumulative excess deaths during COVID-19: multiple-country view",
                        "description": "",
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                        "url": "https://ourworldindata.org/grapher/excess-deaths-cumulative-per-100k-economist",
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                        "title": "Estimated cumulative excess deaths during COVID-19 per 100k people",
                        "description": "",
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                        "url": "https://ourworldindata.org/grapher/excess-deaths-daily-economist-single-entity",
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                    },
                    {
                        "url": "https://ourworldindata.org/grapher/excess-deaths-daily-economist",
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                        "title": "Estimated daily excess deaths during COVID-19: multiple-country view",
                        "description": "",
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                        "url": "https://ourworldindata.org/grapher/excess-deaths-daily-per-100k-economist",
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                "text": [
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                        "text": "Estimated excess mortality from the World Health Organization",
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                    }
                ],
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                                "text": "On 5 May 2022, the WHO published estimates of the number of excess deaths for 194 countries and regions, as well as a global total. These estimates cover the period from the start of 2020 to the end of 2021.",
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                                "text": "Similar to ",
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                                        "text": "The Economist",
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                                "text": ", the WHO estimates that the total number of excess deaths is substantially higher than the number of confirmed deaths due to COVID-19.",
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                                "text": "Though broadly similar, the estimates from the WHO and ",
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                                        "text": "The Economist",
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                                "text": " can differ because they use different methods to estimate both the baseline of expected deaths and the missing all-cause mortality data for countries that have not reported any during 2020 and 2021.",
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                                "text": "You can compare the estimates in the chart here, and read in more detail about the methods of the ",
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                            {
                                "url": "https://www.who.int/publications/m/item/methods-for-estimating-the-excess-mortality-associatedwith-the-covid-19-pandemic",
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                                        "text": "WHO",
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                                "text": " and ",
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                            {
                                "url": "https://www.economist.com/graphic-detail/2021/05/13/how-we-estimated-the-true-death-toll-of-the-pandemic",
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                                        "children": [
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                                                "text": "The Economist",
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                        "text": "Our World in Data relies on data from the Human Mortality Database, the World Mortality Dataset, ",
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                        "text": ", and the World Health Organization",
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                        "text": "In our presentation of excess mortality figures we rely on the reported all-cause mortality data from the ",
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                                "text": "Human Mortality Database",
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                        "text": " (HMD) and the ",
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                        "text": " (WMD). We also present model estimates of excess deaths ",
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                                "text": "published by ",
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                        "text": " and ",
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                                "text": "the WHO",
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                        "text": ". We make all of the data used in our charts downloadable as complete and structured .csv files ",
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                        "url": "https://github.com/owid/covid-19-data/tree/master/public/data/excess_mortality",
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                                "text": "here on our GitHub site",
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                        "text": ".",
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                        "text": "We have calculated P-scores from the reported death data provided by HMD and WMD, and from the projections provided by WMD.",
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                        "text": "Human Mortality Database",
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                        "text": "The ",
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                                "text": "Human Mortality Database",
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                        "text": " is maintained by a team of researchers based at the University of California, Berkeley, USA and the Max Planck Institute for Demographic Research in Rostock, Germany. HMD has been publishing updates on all-cause mortality for currently 38 countries as part of its Short-term Mortality Fluctuations (STMF) project since May 2020.{ref}HMD only includes countries with the highest quality and most comprehensive mortality statistics, with breakdowns by age and sex and many years of historical data. Because of this, only select countries with very robust and capable statistical agencies are included.{/ref}",
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                        "text": "HMD updates its data weekly. The data is sourced from ",
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                                "text": "Eurostat",
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                        "text": " and national statistical agencies \u2014 a full list of sources and detailed information for each country\u2019s data series can be found in the ",
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                        "url": "https://www.mortality.org/Public/STMF_DOC/STMFmetadata.pdf",
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                                "text": "HMD metadata file",
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                        "text": ". HMD was our sole source of data until 20 February 2021.",
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                "value": [
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                        "text": "You can read more about HMD's STMF project in the article by N\u00e9meth, Jdanov, and Shkolnikov (2021) ",
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                    },
                    {
                        "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246663",
                        "children": [
                            {
                                "text": "An open-sourced, web-based application to analyze weekly excess mortality based on the Short-term Mortality Fluctuations data series",
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                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".{ref}N\u00e9meth L., Jdanov D.A., Shkolnikov V.M. (2021) An open-sourced, web-based application to analyze weekly excess mortality based on the Short-term Mortality Fluctuations data series. PLoS ONE 16(2): e0246663. https://doi.org/10.1371/journal.pone.0246663{/ref}",
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                        "text": "The ",
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                                "text": "World Mortality Dataset",
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                        "text": " is maintained by the researchers Ariel Karlinsky and Dmitry Kobak. WMD has been publishing updates on all-cause mortality for currently 124 countries and regions since January 2021. The data is not broken down by age so we only include it in our all-age charts.{ref}Though WMD does provide the projected baselines used for calculating P-scores in the by-age chart.{/ref}",
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                        "text": "As of 20 September 2021, we use WMD's projected deaths for 2020\u20132024 as our baseline for the expected deaths had the COVID-19 pandemic not occurred. We use this baseline for all countries and regions, including for deaths broken down by age group.{ref}Before 18 January 2022, WMD published a projection for 2020 only to avoid further extrapolation from the historical data. As of 18 January, they do publish\u2014and we use\u2014separate projections for 2020, 2021, and 2022.{/ref}",
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                        "text": "WMD updates its data weekly. The data is sourced from the Human Mortality Database \u2014 we use the reported deaths data directly from HMD and not WMD \u2014 Eurostat, and national statistical agencies. A full list of sources and information for each country\u2019s data series can be found on ",
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                        "url": "https://github.com/akarlinsky/world_mortality#sources",
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                                "text": "WMD\u2019s GitHub site",
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                        "text": ".",
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                        "text": "You can read more about WMD in the article by Karlinsky and Kobak (2021) ",
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                        "url": "https://elifesciences.org/articles/69336",
                        "children": [
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                                "text": "Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset",
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                        "text": ".{ref}Karlinsky, A. and Kobak, D. (2021). Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset. ",
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                        "children": [
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                                "text": "eLife",
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                        "text": ", DOI:\u00a010.7554/eLife.69336.{/ref}",
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                                "text": "The Economist",
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                        "text": " built a ",
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                        "text": " to estimate the number of excess deaths during the pandemic for 223 countries & regions. From these country-level estimates they calculate a global figure.",
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                        "text": " presents the model estimates and details their sources in the article \"",
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                        "url": "https://www.economist.com/graphic-detail/coronavirus-excess-deaths-estimates",
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                                "text": "The pandemic's true death toll.",
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                        "text": "\" They describe their model methodology in the article \"",
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                        "url": "https://www.economist.com/graphic-detail/2021/05/13/how-we-estimated-the-true-death-toll-of-the-pandemic",
                        "children": [
                            {
                                "text": "How we estimated the true death toll of the pandemic.",
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                        "text": "The WHO published estimates of the number of excess deaths during 2020 and 2021 for 194 countries and regions, as well as a global total.",
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                        "text": "The WHO presents the model estimates in the following reports:",
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                                        "text": "Global excess deaths associated with COVID-19 (modelled estimates)",
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                                "text": "Msemburi et al. (2023). ",
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                                "text": ". ",
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                                        "text": "Nature.",
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                                        "text": "Methods for estimating the excess mortality associated with the COVID-19 pandemic",
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                                "text": "Knutson et al. (2023). ",
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                                        "text": "Estimating global and country-specific excess mortality during the Covid-19 pandemic",
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                                "text": ". ",
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                                        "text": "The Annals of Applied Statistics.",
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                                "value": "<div class=\"raw-html-table__container\"><table><tbody><tr><td><strong>Location</strong></td><td><strong>Source</strong></td></tr><tr><td>Albania</td><td>World Mortality Dataset</td></tr><tr><td>Algeria</td><td>World Mortality Dataset</td></tr><tr><td>Andorra</td><td>World Mortality Dataset</td></tr><tr><td>Antigua and Barbuda</td><td>World Mortality Dataset</td></tr><tr><td>Argentina</td><td>World Mortality Dataset</td></tr><tr><td>Armenia</td><td>World Mortality Dataset</td></tr><tr><td>Aruba</td><td>World Mortality Dataset</td></tr><tr><td>Australia{ref}2 May 2022: Switched source back to Human Mortality Database as they now include total deaths, not just doctor-certified deaths.<br><br>Had previously (on 18 January 2022) switched source from Human Mortality Database to World Mortality Dataset to get an estimate of total deaths and not just the doctor-certified deaths that HMD publishes. For more details see: <a rel=\"noreferrer noopener\" href=\"https://github.com/akarlinsky/world_mortality#australia-weekly\" target=\"_blank\">https://github.com/akarlinsky/world_mortality#australia-weekly</a>.{/ref}</td><td>Human Mortality Database</td></tr><tr><td>Austria</td><td>Human Mortality Database</td></tr><tr><td>Azerbaijan</td><td>World Mortality Dataset</td></tr><tr><td>Bahamas</td><td>World Mortality Dataset</td></tr><tr><td>Barbados</td><td>World Mortality Dataset</td></tr><tr><td>Belarus</td><td>World Mortality Dataset</td></tr><tr><td>Belgium</td><td>Human Mortality Database</td></tr><tr><td>Belize</td><td>World Mortality Dataset</td></tr><tr><td>Bermuda</td><td>World Mortality Dataset</td></tr><tr><td>Bolivia</td><td>World Mortality Dataset</td></tr><tr><td>Bosnia and Herzegovina</td><td>World Mortality Dataset</td></tr><tr><td>Brazil</td><td>World Mortality Dataset</td></tr><tr><td>Brunei</td><td>World Mortality Dataset</td></tr><tr><td>Bulgaria</td><td>Human Mortality Database</td></tr><tr><td>Cape Verde</td><td>World Mortality Dataset</td></tr><tr><td>Canada</td><td>Human Mortality Database</td></tr><tr><td>Chile</td><td>Human Mortality Database</td></tr><tr><td>Colombia</td><td>World Mortality Dataset</td></tr><tr><td>Costa Rica</td><td>World Mortality Dataset</td></tr><tr><td>Croatia</td><td>Human Mortality Database</td></tr><tr><td>Cuba</td><td>World Mortality Dataset</td></tr><tr><td>Cyprus</td><td>World Mortality Dataset</td></tr><tr><td>Czechia</td><td>Human Mortality Database</td></tr><tr><td>Denmark</td><td>Human Mortality Database</td></tr><tr><td>Dominican Republic</td><td>World Mortality Dataset</td></tr><tr><td>Ecuador</td><td>World Mortality Dataset</td></tr><tr><td>Egypt</td><td>World Mortality Dataset</td></tr><tr><td>El Salvador</td><td>World Mortality Dataset</td></tr><tr><td>England &amp; Wales</td><td>Human Mortality Database</td></tr><tr><td>Estonia</td><td>Human Mortality Database</td></tr><tr><td>Faeroe Islands</td><td>World Mortality Dataset</td></tr><tr><td>Finland</td><td>Human Mortality Database</td></tr><tr><td>France</td><td>Human Mortality Database</td></tr><tr><td>French Guiana</td><td>World Mortality Dataset</td></tr><tr><td>French Polynesia</td><td>World Mortality Dataset</td></tr><tr><td>Georgia</td><td>World Mortality Dataset</td></tr><tr><td>Germany</td><td>Human Mortality Database</td></tr><tr><td>Gibraltar</td><td>World Mortality Dataset</td></tr><tr><td>Greece</td><td>Human Mortality Database</td></tr><tr><td>Greenland</td><td>World Mortality Dataset</td></tr><tr><td>Guadeloupe</td><td>World Mortality Dataset</td></tr><tr><td>Guatemala</td><td>World Mortality Dataset</td></tr><tr><td>Hong Kong</td><td>World Mortality Dataset</td></tr><tr><td>Hungary</td><td>Human Mortality Database</td></tr><tr><td>Iceland</td><td>Human Mortality Database</td></tr><tr><td>Iran</td><td>World Mortality Dataset</td></tr><tr><td>Ireland</td><td>World Mortality Dataset</td></tr><tr><td>Israel</td><td>Human Mortality Database</td></tr><tr><td>Italy</td><td>Human Mortality Database</td></tr><tr><td>Jamaica</td><td>World Mortality Dataset</td></tr><tr><td>Japan</td><td>World Mortality Dataset</td></tr><tr><td>Jordan</td><td>World Mortality Dataset</td></tr><tr><td>Kazakhstan</td><td>World Mortality Dataset</td></tr><tr><td>Kosovo</td><td>World Mortality Dataset</td></tr><tr><td>Kuwait</td><td>World Mortality Dataset</td></tr><tr><td>Kyrgyzstan</td><td>World Mortality Dataset</td></tr><tr><td>Latvia</td><td>Human Mortality Database</td></tr><tr><td>Lebanon</td><td>World Mortality Dataset</td></tr><tr><td>Liechtenstein</td><td>World Mortality Dataset</td></tr><tr><td>Lithuania</td><td>Human Mortality Database</td></tr><tr><td>Luxembourg</td><td>Human Mortality Database</td></tr><tr><td>Macao</td><td>World Mortality Dataset</td></tr><tr><td>Malaysia</td><td>World Mortality Dataset</td></tr><tr><td>Maldives</td><td>World Mortality Dataset</td></tr><tr><td>Malta</td><td>World Mortality Dataset</td></tr><tr><td>Martinique</td><td>World Mortality Dataset</td></tr><tr><td>Mauritius</td><td>World Mortality Dataset</td></tr><tr><td>Mayotte</td><td>World Mortality Dataset</td></tr><tr><td>Mexico</td><td>World Mortality Dataset</td></tr><tr><td>Moldova</td><td>World Mortality Dataset</td></tr><tr><td>Monaco</td><td>World Mortality Dataset</td></tr><tr><td>Mongolia</td><td>World Mortality Dataset</td></tr><tr><td>Montenegro</td><td>World Mortality Dataset</td></tr><tr><td>Netherlands</td><td>Human Mortality Database</td></tr><tr><td>New Caledonia</td><td>World Mortality Dataset</td></tr><tr><td>New Zealand</td><td>Human Mortality Database</td></tr><tr><td>Nicaragua</td><td>World Mortality Dataset</td></tr><tr><td>North Macedonia</td><td>World Mortality Dataset</td></tr><tr><td>Northern Ireland</td><td>Human Mortality Database</td></tr><tr><td>Norway</td><td>Human Mortality Database</td></tr><tr><td>Oman</td><td>World Mortality Dataset</td></tr><tr><td>Palestine</td><td>World Mortality Dataset</td></tr><tr><td>Panama</td><td>World Mortality Dataset</td></tr><tr><td>Paraguay</td><td>World Mortality Dataset</td></tr><tr><td>Peru</td><td>World Mortality Dataset</td></tr><tr><td>Philippines</td><td>World Mortality Dataset</td></tr><tr><td>Poland</td><td>Human Mortality Database</td></tr><tr><td>Portugal</td><td>Human Mortality Database</td></tr><tr><td>Puerto Rico</td><td>World Mortality Dataset</td></tr><tr><td>Qatar</td><td>World Mortality Dataset</td></tr><tr><td>Reunion</td><td>World Mortality Dataset</td></tr><tr><td>Romania</td><td>World Mortality Dataset</td></tr><tr><td>Russia</td><td>World Mortality Dataset</td></tr><tr><td>Saint Kitts and Nevis</td><td>World Mortality Dataset</td></tr><tr><td>Saint Vincent and the Grenadines</td><td>World Mortality Dataset</td></tr><tr><td>San Marino</td><td>World Mortality Dataset</td></tr><tr><td>Scotland</td><td>Human Mortality Database</td></tr><tr><td>Serbia</td><td>World Mortality Dataset</td></tr><tr><td>Seychelles</td><td>World Mortality Dataset</td></tr><tr><td>Singapore</td><td>World Mortality Dataset</td></tr><tr><td>Slovakia</td><td>Human Mortality Database</td></tr><tr><td>Slovenia</td><td>Human Mortality Database</td></tr><tr><td>South Africa</td><td>World Mortality Dataset</td></tr><tr><td>South Korea</td><td>Human Mortality Database</td></tr><tr><td>Spain</td><td>Human Mortality Database</td></tr><tr><td>Suriname</td><td>World Mortality Dataset</td></tr><tr><td>Sweden{ref}27 September 2021: Switched source from Human Mortality Database to World Mortality Dataset to account for deaths with unknown date.{/ref}</td><td>World Mortality Dataset</td></tr><tr><td>Switzerland</td><td>Human Mortality Database</td></tr><tr><td>Taiwan</td><td>World Mortality Dataset</td></tr><tr><td>Tajikistan</td><td>World Mortality Dataset</td></tr><tr><td>Thailand</td><td>World Mortality Dataset</td></tr><tr><td>Transnistria</td><td>World Mortality Dataset</td></tr><tr><td>Tunisia</td><td>World Mortality Dataset</td></tr><tr><td>Turkey</td><td>World Mortality Dataset</td></tr><tr><td>Ukraine</td><td>World Mortality Dataset</td></tr><tr><td>United Kingdom</td><td>Human Mortality Database</td></tr><tr><td>United States</td><td>Human Mortality Database</td></tr><tr><td>Uruguay</td><td>World Mortality Dataset</td></tr><tr><td>Uzbekistan</td><td>World Mortality Dataset</td></tr></tbody></table></div>",
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                        ],
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                ],
                "parseErrors": []
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            {
                "text": [
                    {
                        "text": "Other publicly available data on excess mortality",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 4,
                "parseErrors": []
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            {
                "text": [
                    {
                        "text": "International organizations are not publishing an international database on excess mortality",
                        "spanType": "span-simple-text"
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                ],
                "type": "heading",
                "level": 5,
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            {
                "type": "text",
                "value": [
                    {
                        "text": "Unlike statistics on ",
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                    {
                        "url": "https://ourworldindata.org/covid-deaths",
                        "children": [
                            {
                                "text": "confirmed COVID-19 deaths",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": " \u2014 for which several organizations such as the",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://data.who.int/dashboards/covid19/",
                        "children": [
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                                "text": " WHO",
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                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.ecdc.europa.eu/en/coronavirus",
                        "children": [
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                                "text": "ECDC",
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                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ", and ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://coronavirus.jhu.edu/map.html",
                        "children": [
                            {
                                "text": "Johns Hopkins University",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": " have collated data for all countries \u2014 there is no single source of data on excess mortality. And no data source will have data for all countries because ",
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                    },
                    {
                        "url": "https://ourworldindata.org/excess-mortality-covid#excess-mortality-statistics-will-only-be-available-for-a-minority-of-countries",
                        "children": [
                            {
                                "text": "excess mortality statistics will only be available for a minority of countries",
                                "spanType": "span-simple-text"
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                        ],
                        "spanType": "span-link"
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                    {
                        "text": ".",
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                ],
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                "value": [
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                        "text": "This is a major problem for policymakers, researchers, and the general public that have a need to understand the ongoing pandemic.",
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                "text": [
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                        "text": "Several media publications and regional data sources are publishing public databases",
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                        "text": "In addition to the Human Mortality Database and the World Mortality Dataset, several media publications and regional data sources have been publishing excess death data for some countries.",
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                                        "text": "The Economist ",
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                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": "published the first database on excess mortality",
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                                "url": "https://github.com/TheEconomist/covid-19-excess-deaths-tracker",
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                                        "text": " on GitHub",
                                        "spanType": "span-simple-text"
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                                ],
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                            },
                            {
                                "text": ". Its reporting on the topic can be",
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                            },
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                                "url": "https://www.economist.com/graphic-detail/2020/07/15/tracking-covid-19-excess-deaths-across-countries",
                                "children": [
                                    {
                                        "text": " found here",
                                        "spanType": "span-simple-text"
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                            },
                            {
                                "text": ". We show their global estimates of excess mortality in ",
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                                        "text": "the section here",
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                                "text": ".",
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                                "text": " publishes its dataset on excess mortality",
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                                        "text": " on GitHub",
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                            {
                                "text": ". Its reporting on the topic can be",
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                                "url": "https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html",
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                                        "text": " found here",
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                                "text": ".",
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                                "text": " publishes its dataset on excess mortality",
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                            {
                                "text": ". Its reporting on the topic can be",
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                            {
                                "url": "https://www.ft.com/content/a2901ce8-5eb7-4633-b89c-cbdf5b386938",
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                                        "text": " found here",
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                                "text": ".",
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                                "text": " publishes its dataset on excess mortality in the US",
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                                "text": ". The GitHub page also contains links to the Post's reporting on the topic.",
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                                "text": " publishes downloadable data for European countries",
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                            {
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                                        "text": " on its website",
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                        "text": "Excess mortality during COVID-19: background",
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                        "text": "What is the relationship between confirmed COVID-19 deaths and excess mortality?",
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                        "text": ", we visualize the data on the",
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                        "text": " for all countries. We update this data weekly based on figures published by",
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                                "text": ",",
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                            {
                                "text": ",",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/grapher/tuberculosis-death-rates",
                                "children": [
                                    {
                                        "text": " tuberculosis",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ");{ref}A working paper with data from England estimates that for every 30 COVID deaths there is at least one avoidable non-COVID excess death in hospitals. See Fetzer and Rauh (2022) ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://warwick.ac.uk/fac/soc/economics/research/centres/cage/manage/publications/wp607.2022.pdf?link=twitter",
                                "children": [
                                    {
                                        "text": "Pandemic Pressures and Public Health Care: Evidence from England",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ".{/ref}",
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                            }
                        ],
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                        "value": [
                            {
                                "text": "The pandemic may also result in ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "fewer",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " deaths from other causes. For example, the mobility restrictions during the pandemic might lead to fewer deaths from",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "https://ourworldindata.org/grapher/death-rates-road-incidents",
                                "children": [
                                    {
                                        "text": " road accidents",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": ". Or there might be fewer deaths from the flu because of interventions to stop the spread of COVID-19, or because COVID-19 now causes deaths that would have otherwise been caused by the flu.",
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                            }
                        ],
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                "value": [
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                        "text": "Because COVID-19 \"competes\" with other causes of death like the flu, this means that COVID-19 deaths are not by default excess deaths. It is possible for there to be more confirmed COVID-19 deaths than excess deaths, and in fact for there to be confirmed COVID-19 deaths without ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "any",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    },
                    {
                        "text": " excess deaths.",
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                    }
                ],
                "parseErrors": []
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            {
                "type": "text",
                "value": [
                    {
                        "text": "This all makes clear that the two statistics \u2014 confirmed deaths due to COVID-19 and excess mortality \u2014 can be related in ways that are not straightforward. This is because they are giving a perspective on different questions:",
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                    }
                ],
                "parseErrors": []
            },
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                "type": "list",
                "items": [
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                        "value": [
                            {
                                "text": "The confirmed deaths often undercount the total impact of the pandemic on deaths, but in contrast to excess mortality they contain information about the ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
                                    {
                                        "text": "cause of death",
                                        "spanType": "span-simple-text"
                                    }
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                            },
                            {
                                "text": ".",
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                        "type": "text",
                        "value": [
                            {
                                "text": "The excess mortality includes not only those who have died from COVID-19, but also those from all other causes \u2014 and these numbers may also be changing due to the overall pandemic conditions.",
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                            }
                        ],
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                    }
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            {
                "type": "text",
                "value": [
                    {
                        "text": "This means both metrics are needed to understand the total impact of the pandemic on deaths.",
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                    }
                ],
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            {
                "text": [
                    {
                        "text": "Excess mortality statistics will only be available for a minority of countries",
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                    }
                ],
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                "level": 4,
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                    {
                        "text": "Excess mortality data is unfortunately not available for many countries, and because the required data from previous years is lacking this will continue to be the case. When the goal is to monitor a global pandemic, this is a major limitation of this metric.",
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                    }
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                    {
                        "text": "Excess mortality can only be calculated on the basis of accurate, high-frequency data on mortality from previous years. But few countries have statistical agencies with the capacity and infrastructure to report the number of people that died in a given month, week or even day-to-day. For most low- and middle-income countries, such data is not available for previous years.",
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                    }
                ],
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                "value": [
                    {
                        "text": "As we saw from the available excess mortality estimates discussed previously, this data is most often only available for richer countries that can afford high-quality data reporting systems.",
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                    }
                ],
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                    {
                        "text": "Researchers can draw on some other sources to estimate excess mortality \u2014 such as funeral or burial records \u2014 or on data from subnational regions of poorer countries (often the capital). But in many cases no information at all can be obtained.",
                        "spanType": "span-simple-text"
                    }
                ],
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            }
        ],
        "type": "article",
        "title": "Excess mortality during the Coronavirus pandemic (COVID-19)",
        "authors": [
            "Charlie Giattino",
            "Hannah Ritchie",
            "Esteban Ortiz-Ospina",
            "Joe Hasell",
            "Lucas Rod\u00e9s-Guirao",
            "Max Roser"
        ],
        "dateline": "May 11, 2020",
        "sidebar-toc": false,
        "featured-image": "covid-excess-mortality.png"
    },
    "createdAt": "2022-07-21T11:12:29.000Z",
    "published": false,
    "updatedAt": "2024-01-16T12:59:49.000Z",
    "revisionId": null,
    "publishedAt": "2020-05-11T14:05:51.000Z",
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