Our model suggests global deaths are still 5% above pre-covid forecasts

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ohn May 5th The World Health Organization has declared the covid-19 public health emergency. Based on official mortality figures, this looked rather modest. By April 2022, average weekly death tolls had already fallen to March 2020 levels.

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These rates exclude deaths caused by covid but not attributed to it, however. A better measure is excess mortality, the gap between the number of deaths from all causes and the pre-covid trend. For countries that do not publish the total number of deaths, we have built a model to estimate the rest.

This statistic also suggests that covid is killing at a slower, more steady pace than in 2020-21. But endemic covid is still surprisingly deadly. Amidst high uncertainty, our median estimate for the current world total mortality rate exceeds projections from 2019 by 5%, or 3m lives per year.

Last year 16% of projected deaths were officially due to covid, down from 37% in 2021. This gap has grown as deaths from covid have moved from country to country rich to poor countries. In 2020 the virus hit the rich world hardest, where relatively old populations travel often and go indoors in cold weather. Places like this also raised trials, increasing the proportion of victims counted in official data.

But in 2021 wealthy states began to turn the tide. Because many of the vulnerable died early, and those who survived covid acquired natural immunity, their numbers became more stable. They designed and distributed effective vaccines and treatments, from steroids to new drugs such as Paxlovid.

At the same time, the disease worked around the world. Highly infectious variants reached rural areas and countries with strict border controls, such as Vietnam. Even China, which often locked down entire cities, realized that it could not control the virus and scrapped its “zero-covid” policy in 2022. In most in some poor countries vaccination uptake remains low, and weak health care systems increase death rates for those who are ill.

Because data on total mortality is scarce outside the rich world, our model’s estimates have become less precise over time. His confidence interval for the current world excess mortality rate extends from near zero all the way up to the estimated levels in the mid-2020s. However, without the recent surge in China, the best estimate for the past year is around one in every 1m people per day. As a proportion of people aged at least 65, excess death rates in rich countries are three times lower than elsewhere. But because such places have older populations, their overall mortality rate is similar.

Covid is not the only reason for this change. Health care systems in many countries are still under pressure, meaning people are missing out on care. Cases of other untreated diseases in 2020-21 are increasing death rates today. But if covid was indeed responsible for the surge, it would be tied for the fourth leading cause of death in the world. At current rates, it will kill more people in the next eight years than in the last three.

Chart sources: WHO; UN; The Economist. Read our methodology here, and explore all our code, data, and modules on GitHub

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