COVID-19 caused a 12% increase in worldwide deaths last year.

Examining excess deaths is one of the most touted methods to estimate the impact of COVID-19 on health. A major advantage of evaluating excess deaths is that it gets around the problem of whether or not the death was appropriately attributed to COVID-19. Many have argued that COVID-19 deaths were overstated because deaths from other illnesses were being attributed to COVID-19. A new article in the Wall Street Journal actually suggests the opposite — that COVID-19 death numbers underestimate health impact.    

More than 2.8 million people have lost their lives due to the pandemic, according to the Journal report on data from 59 countries. These countries account for roughly one-quarter of the world’s population, but about three-quarters of all reported deaths from Covid-19 through late last year. This analysis suggests that world deaths surged more than 12% above average levels last year.

The most interesting point is that less than two-thirds of that increase has been attributed directly to Covid-19. Experts believe that many of the additional deaths were directly the result of the disease, particularly early in the pandemic. Later last year, after shutdowns increased, deaths also increased due to health-care disruptions.

Despite this, the Journal’s assessment found more than 821,000 additional deaths were not accounted for in the world’s governments’ official Covid-19 death counts. Tracking all of these deaths, and doing it quickly, is vital to help understand the breadth of the crisis, public-health experts say.

“Measuring total deaths gives you a readout if things are getting better or worse,” said Colin Mathers, a retired coordinator of the World Health Organization’s Mortality and Health Analysis Unit. “If you see a sudden rise in heart disease, it may be linked to Covid-19, but if there’s a rise in cancer it may be because of people fearing to go to the hospital.”

Some countries, including New Zealand and Norway, actually showed lower-than-expected deaths. These countries controlled their COVID-19 infections well, and the reductions may be the effect of behavior changes that reduce other causes of death, such as increased hygiene and reduced social interactions that spread other diseases, researchers say.

Much has been made of the concept that the elderly who died from COVID-19 were simply individuals who would have died at the same time from other causes. Still, researchers who examined the impact early in the pandemic found even the oldest victims were losing almost a year of life on average.

In the U.S. alone, Centers for Disease Control and Prevention data show more than 475,000 excess deaths through early December, a time frame that also included about 281,000 deaths directly linked to Covid-19, according to Johns Hopkins University.

This summary shows that the deaths from COVID-19 were the major cause of excess deaths in 2010.