The WHO has specified its estimates of excess mortality during the Corona years 2020 and 2021. It is doing a new calculation for Germany.

According to an evaluation, the excess mortality worldwide in the first two years of the corona pandemic in 2020 and 2021 was significantly higher than the officially reported Covid 19 death toll. The discrepancy was particularly large in middle-income countries, as the World Health Organization (WHO) reports in the journal Nature.

According to this, around 14.83 million more people died worldwide in the two years than would have been expected without the pandemic. The WHO had already reported 14.9 million additional deaths in May. She has now refined the analysis for publication in Nature.

For Germany, the WHO data analysis team recalculated the original estimate and concluded that there was an excess mortality of 122,000 – rather than 195,000 – over the two years. A study by the University of Duisburg-Essen also took demographic developments into account for 2020 and came to the conclusion that some of the additional deaths were due to the growing number of over-80s.

The reason for the different results between the calculations of the WHO and the Federal Statistical Office lies in the different calculation methods. “The Federal Statistical Office uses the median of the monthly death figures of the four previous years as a reference to calculate the monthly excess mortality. This was probably chosen because it is explained in one sentence and is therefore transparent,” explains Jonas Schöley, an expert at the Max Planck Institute for Demographic Research.

“But there are more precise, albeit complicated, methods, for example those of the WHO, to calculate the expected deaths in the absence of the Covid 19 pandemic,” explains the expert. According to Schöley, the WHO indicates uncertainty intervals around the estimated excess mortality. This is useful in order not to draw wrong conclusions based on random fluctuations.

Middle-income countries in South America were particularly affected by high excess mortality, as the WHO reports in “Nature”. Peru had almost twice as many deaths as would have been expected. In Mexico, Bolivia and Ecuador the number was 50 percent higher.

In poorer countries, the excess mortality was not as high because the population there is usually younger and therefore fewer people died of Covid-19, the analysis also says.

Schöley notes that in large parts of Africa, parts of Asia and South America, deaths are only registered very unreliably. According to Schöley, excess mortality cannot therefore be estimated on the basis of reported deaths, it is estimated indirectly on the basis of correlations between excess mortality and existing variables such as gross domestic product.

“The WHO deals transparently with these uncertainties in the estimate and publishes uncertainty intervals around the estimated excess mortality and in the ranking of different countries,” Schöley continues.

Globally, the excess mortality was therefore more than two and a half times as high as the reported Covid 19 deaths alone would have suggested: At the end of 2021, the WHO statistics showed 5.4 million Covid 19 deaths. “The excess mortality caused by COVID-19 is unique in its level and global scale in the last 70 years. We can also see this in the declines in period life expectancy for the years 2020/21, which has not been observed in the post-war period to such an extent as since February 2020, at least for Western Europe and the USA,” emphasizes Schöley.

However, the now published figure of 14.83 million also includes deaths where the cause of death was not correctly stated, those from patients who were suspected to be infected but not tested, and deaths from people with illnesses or injuries that were not treated in time due to the overload of the health systems could become.

A comment in Nature by Enrique Acosta of the Max Planck Institute for Demographic Research (MPIDR) said the numbers should be viewed with caution because only 37 percent of countries had monthly statistics of all deaths . 43 percent of the countries did not present any figures at all. The statisticians therefore had to make assumptions that Acosta believes are sometimes problematic.

Hanno Ulmer, a statistics expert at the Medical University of Innsbruck, is also critical of the results: “The WHO’s desire to be able to classify the Covid 19 pandemic with a few numbers on excess mortality is understandable,” says Ulmer However, it is a very rough estimate that does not have to be correct for individual countries. It also seems necessary to examine the situation in the individual countries separately so that the excess mortality from Covid-19 can be correctly estimated.”