Per Our World in Data, the term ‘excess mortality’ refers to the number of deaths from all causes during a crisis above and beyond what would have been expected under ‘normal’ conditions. Over the the past year or so, excess mortality figures have captured not only confirmed Covid-19 deaths, but additional Covid-19 deaths that were not correctly diagnosed and reported as well as deaths from other causes that may be attributable to the overall crisis conditions.
In most countries, excess mortality numbers have been higher than recorded Covid-19 deaths during the pandemic. But some countries have more Covid-19 deaths than excess deaths. That’s partly because social distancing and lockdowns reduced the risk of dying from other contagious diseases such as influenza. A few countries have actually experienced fewer deaths than normal during the last year, such as Denmark and Australia, thanks to relatively low Covid-19 mortality rates combined with social distancing and lockdowns that provided protection from other causes of death.
Countries that have way more excess deaths than Covid-19 deaths are almost assuredly undercounting Covid deaths. For example, excess deaths in Peru, Mexico, Russia, and South Africa are 2-5 times higher than recorded Covid deaths during the same time period. On the other hand, excess deaths have been just somewhat higher in the US and lower than Covid deaths in Belgium, France, and Chile. Here are the actual numbers, care of The Economist:
One way to tell if excess deaths are mostly from Covid-19 is whether they track Covid mortality trends, as appears to be the case in most of the countries below*:
Why do so many Covid deaths go unreported? One reason is that most people die at home in developing countries and out-of-hospital deaths are rarely medically certified. For example, only around a fifth of all deaths are medically certified in India. Even in countries with substantial hospital data, cause-of-death is often misclassified, often a result of insufficient physician training. Sometimes, though, misclassification is deliberate, as in some hospitals in India, where officials have directed doctors to list cause-of-death as “sickness” and not Covid, possibly to avoid a panic. And then there’s Russia, which has acknowledged massive undercounting of Covid deaths but has not shed much light on why this happened. I suspect domestic and global politics have something to do with it.
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* Chart cobbled together from Economist images
References:
As Covid-19 Devastates India, Deaths Go Undercounted Jeffrey Gettleman, Sameer Yasir, Hari Kumar and Suhasini Raj/New York Times. April 24, 2021 https://www.nytimes.com/2021/04/24/world/asia/india-coronavirus-deaths.html
Data: How many Deaths are recorded in India every year? Bharath Kancharla/Factly. June 15, 2020 https://factly.in/data-how-many-deaths-are-recorded-in-india-every-year/
Max Roser, Hannah Ritchie, Esteban Ortiz-Ospina and Joe Hasell (2020) - "Coronavirus Pandemic (COVID-19)". Published online at OurWorldInData.org. https://ourworldindata.org/excess-mortality-covid Retrieved from: https://ourworldindata.org/coronavirus
Rampatige et al, (2014) Systematic review of statistics on causes of deaths in hospitals: strengthening the evidence for policy-makers. Bulletin of the World Health Organization; 92:807-816. doi: http://dx.doi.org/10.2471/BLT.14.137935
The Economist. Tracking covid-19 excess deaths across countries. Last updated on April 16th https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker