Our model suggests that global deaths remain 5% above pre-covid forecasts

On May 5th the World Health Organisation declared an end to the covid-19 public-health emergency. Based on official mortality counts, this looked tardy. By April 2022, average weekly death tolls had already fallen to the level of March 2020.

Such tallies 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 amount pre-covid trends would imply. For countries that do not publish their total number of deaths, we have built a model to estimate the excess.

This statistic also suggests that covid is killing at a slower, steadier pace than in 2020-21. Yet endemic covid remains surprisingly deadly. Amid high uncertainty, our central estimate for the world’s current total mortality rate exceeds projections from 2019 by 5%, or 3m lives per year.

In the past year 16% of estimated excess deaths were officially attributed to covid, down from 37% in 2021. This gap has grown as deaths from covid have shifted from rich countries to poor ones. In 2020 the virus hit hardest in the rich world, where relatively old populations travel often and huddle indoors in cold weather. Such places also ramped up testing, raising the share of victims counted in official data.

But in 2021 wealthy states began to turn the tide. Because many of the vulnerable died early on, and covid survivors gained natural immunity, their populations became more resilient. They devised and distributed effective vaccines and treatments, from steroids to new drugs like Paxlovid.

Meanwhile, the disease worked its way around the world. Ultra-contagious variants reached rural areas and countries with tight border controls, like Vietnam. Even China, which often locked down entire cities, realised it could not control the virus and scrapped its “zero-covid” policy in 2022. In most poor countries vaccine take-up remains low, and weak health-care systems raise death rates for those who fall ill.

Because data on total mortality is scant outside the rich world, our model’s estimates have become less precise over time. Its confidence interval for the world’s current excess-death rate stretches from near zero all the way up to the estimated levels of mid-2020. However, excluding the recent surge in China, its best guess for the past year is around one of every 1m people per day. As a share 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 sole cause of this change. Many countries’ health-care systems remain strained, meaning people miss out on care. Cases of other diseases that went untreated in 2020-21 are raising death rates today. But if covid were indeed responsible for the full increase, it would be tied for the world’s fourth-leading cause of death. At current rates, it would kill more people in the next eight years than in the past three.■

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