Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset
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Abstract
Comparing the impact of the COVID-19 pandemic between countries or across time is difficult because the reported numbers of cases and deaths can be strongly affected by testing capacity and reporting policy. Excess mortality, defined as the increase in all-cause mortality relative to the expected mortality, is widely considered as a more objective indicator of the COVID-19 death toll. However, there has been no global, frequently updated repository of the all-cause mortality data across countries. To fill this gap, we have collected weekly, monthly, or quarterly all-cause mortality data from 103 countries and territories, openly available as the regularly updated World Mortality Dataset. We used this dataset to compute the excess mortality in each country during the COVID-19 pandemic. We found that in several worst-affected countries (Peru, Ecuador, Bolivia, Mexico) the excess mortality was above 50% of the expected annual mortality (Peru, Ecuador, Bolivia, Mexico) or above 400 excess deaths per 100,000 population (Peru, Bulgaria, North Macedonia, Serbia). At the same time, in several other countries (e.g. Australia and New Zealand) mortality during the pandemic was below the usual level, presumably due to social distancing measures decreasing the non-COVID infectious mortality. Furthermore, we found that while many countries have been reporting the COVID-19 deaths very accurately, some countries have been substantially underreporting their COVID-19 deaths (e.g. Nicaragua, Russia, Uzbekistan), by up to two orders of magnitude (Tajikistan). Our results highlight the importance of open and rapid all-cause mortality reporting for pandemic monitoring.
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The deficit in excess mortality in many high-quality reporting countries is due to decreases in non-natural and natural deaths during the analysed period and less severe influenza seasons in 2020 and 2021 relative to previous years.
“The greater number of these countries have high-quality reporting systems and this deficit is due to deaths from non-natural and natural causes decreasing during the analysed period13 and there having been less severe influenza seasons in 2020 and 2021 relative to previous years19.”
From The WHO estimates of excess mortality associated with the COVID-19 pandemic (2023) · cites this paper as [13]
The Results (Undercount of COVID deaths; page unavailable) say that accurate COVID-death reporting can coexist with a deficit in excess deaths because non-COVID mortality decreased, mostly through influenza suppression. The Discussion (Contributions to excess mortality; page unavailable) says changes in unnatural deaths varied by country and played only a minor role; it does not support a general decrease in both natural and non-natural deaths as the cause. The separate claim about influenza seasons is attached to citation 19, not this source. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThis study complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) statement.
“This study complies with the Guidelines for Accurate and Transparent Health Estimates Reporting17 statement (appendix pp 3–4).”
From Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21 (2022) · cites this paper as [17]
The Discussion’s Summary identifies this paper as presenting the World Mortality Dataset, and the Materials and methods discuss its data and limitations. Our copy does not address the GATHER statement or whether the citing study complied with it (searched for GATHER, the guideline’s full name, and reporting-guideline compliance). (LLM, conf=0.75)
Experimental — accuracy not yet measuredOther settings with >25% increases in mortality during the pandemic have included Russia and LMICs within Latin America, Eastern Europe, and central Asia.
“Other settings with >25% increases in mortality during the pandemic have included Russia and LMICs within Latin America, Eastern Europe, and central Asia1,4.”
From Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city (2023) · cites this paper as [1]
India is one of many settings where excess all-cause mortality during the pandemic vastly exceeded reported COVID-19 deaths.
“India is one of many settings where excess all-cause mortality during the pandemic vastly exceeded reported COVID-19 deaths1.”
From Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city (2023) · cites this paper as [1]
India is among the countries most severely impacted by the COVID-19 pandemic.
“India is among the countries most severely impacted by the pandemic.”
From Estimates of pandemic excess mortality in India based on civil registration data (2022) · cites this paper as [34]
Using international comparisons of pandemic excess deaths as a percentage of annual deaths, even the lowest estimate places India amongst some of the hardest hit countries in the world.
“Using comparisons with international data on pandemic excess deaths as a percentage of annual deaths [34], even the lowest of these estimates places India amongst some of the hardest hit countries in the world.”
From Estimates of pandemic excess mortality in India based on civil registration data (2022) · cites this paper as [34]
Emerging evidence from low- and middle-income countries (such as Brazil and Mexico) that have been devastated by the pandemic suggests that life-expectancy losses may be even larger in these populations.
“Emerging evidence from low- and middle-income countries (such as Brazil and Mexico) that have been devastated by the pandemic6 suggests that life-expectancy losses may be even larger in these populations.”
From Quantifying impacts of the COVID-19 pandemic through life-expectancy losses: a population-level study of 29 countries (2022) · cites this paper as [6]
In a study of excess mortality in over 100 countries, Karlinsky and Kobak note that the direct mortality consequences of the pandemic typically predominate over the indirect consequences; however, they did not study age patterns.
“In a study of excess mortality in over 100 countries, Karlinsky and Kobak note that the direct mortality consequences of the pandemic typically predominate over the indirect consequences (Karlinsky & Kobak, 2021); however, they did not study age patterns.”
From Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022 (2023) · cites this paper as Karlinsky & Kobak, 2021
More recent analyses have examined excess mortality patterns for specific causes of death by age and socio-demographic groups and have compared the COVID-19 death toll between countries.
“More recent analyses have examined excess mortality patterns for specific causes of death by age and socio-demographic groups and have compared the COVID-19 death toll between countries”
From Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022 (2023) · cites this paper as Karlinsky & Kobak, 2021
The disconnect was primarily attributed to under-detection of COVID-19 rather than indirect effects, although indirect effects were not explicitly modeled.
“The disconnect was primarily attributed to under-detection of COVID-19 rather than indirect effects, although indirect effects were not explicitly modeled.”
From Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022 (2023) · cites this paper as Karlinsky & Kobak, 2021
Pandemic excess mortality patterns have been heterogeneous globally.
“Pandemic excess mortality patterns have been heterogeneous globally (Islam et al., 2021; Karlinsky & Kobak, 2021; Kontis et al., 2020; Nørgaard et al., 2021).”
From Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022 (2023) · cites this paper as Karlinsky & Kobak, 2021
In a study of over 100 countries, the ratio between excess mortality and official deaths was 1.6 on average, but went as high as 50 (e.g. Nicaragua).
“In a study of over 100 countries, the ratio between excess mortality and official deaths was 1.6 on average, but went as high as 50 (e.g. Nicaragua) (Karlinsky & Kobak, 2021).”
From Direct and indirect mortality impacts of the COVID-19 pandemic in the United States, March 1, 2020 to January 1, 2022 (2023) · cites this paper as Karlinsky & Kobak, 2021
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“We were inspired by studies of excess mortality (Islam et al., 2021; Karlinsky and Kobak, 2021; Msemburi et al., 2023) that looked at the excess of fatalities during the Covid pandemic compared to pre-Covid mortality.”
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Progress Stalled? The Uncertain Future of Mortality in High‐Income Countries
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Estimating national excess mortality from subnational data: application to Argentina
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- Authors
- Karlinsky, A., & Kobak, D.
- Affiliations
- Hebrew University of Jerusalem (IL)
- University of Tübingen (DE)
- Corresponding author
- Karlinsky, Ariel
- Venue
- eLife
- Publisher
- eLife Sciences Publications, Ltd
- Published
- 2021-06-30
- Volume
- 10
- ISSN
- 2050-084X (ISSN-L)
- PMC
- PMC8331176
- OpenAlex
- W3173464765
- Cited by
- 772
- References
- 61
- Citations by year
- 2026: 51 · 2025: 74 · 2024: 123 · 2023: 181 · 2022: 242 · 2021: 95 · 2020: 2 · 2016: 1 · 2014: 1
- FWCI
- 61.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- eLife (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Deutsche Forschungsgemeinschaft (390727645 and BE5601/4-1)
- Federal Ministry of Education and Research (FKZ 01GQ1601 and 01IS18039A)
- National Institutes of Health (U19MH114830)
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Medicine › Epidemiology › Data-Driven Disease Surveillance
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Keywords
- excess mortality, COVID-19 pandemic, all-cause mortality, underreporting of deaths, social distancing, pandemic monitoring, cross-national comparison
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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