The COVID pandemic caused 22.1 million excess deaths worldwide, more than three times the number of official deaths reported

The COVID pandemic had a much greater impact than official figures reflect. According to the 2026 World Health Statistics Report of the World Health Organization (WHO), between 2020 and 2023 there were 22.1 million excess deaths from all causes globally, compared with 7 million officially reported covid deaths.

"Excess all-cause mortality - defined as the number of deaths above those expected based on historical trends - is a key measure for assessing the full impact of crises such as the COVID pandemic," the report explains.

In contrast to COVID-certified deaths, excess deaths represent both deaths caused by the virus and indirect deaths caused by the collapse of health systems, as well as economic and social disruptions.

The data show that for every death reported due to COVID, there were about two additional pandemic-related deaths. The peak was in 2021, with 10.4 million excess deaths, a year marked by the so-called Delta variant and the saturation of healthcare systems. By 2023, the figure dropped to 3.3 million, although it still remained above pandemic levels.

Differences by sex and age

Of the total excess deaths between 2020 and 2023, 57% corresponded to men and 43% to women. The gap points to a real excess risk affecting male individuals.

On the other hand, during the 2021 peak, "men consistently recorded higher excess mortality than women, with age-adjusted mortality rates approximately 50% higher."

Likewise, the age distribution of excess deaths globally between 2020 and 2023 was largely concentrated in elderly people, the report states.

"Nearly two-thirds (65%) of all excess deaths occurred in people aged 65 years and older, while 23% were in people aged 45-64 years. In contrast, younger age groups accounted for a comparatively small proportion (10%) among those aged 25 to 44 years and 3% among those aged 0 to 24 years."

Regional and economic inequalities

Between 2020 and 2023, excess deaths were very unevenly distributed. The region of Southeast Asia made up 27% of the global total followed by the Americas, Europe and the Western Pacific (about 20% each). Middle-income countries were the most affected, accounting for nearly three-quarters of global excess deaths.

However, in 2021, ”the Southeast Asia region stood out most prominently," recording the highest age-standardized excess mortality. The African region and the Eastern Mediterranean region also showed "substantially higher excess mortality after age-standardization, particularly between 2020 and 2021."

On the other hand, after adjusting for age structure, low- and lower-middle-income countries showed higher-than-expected excess mortality rates, "which could reflect more limited capacity of their health systems and later public health intervention."

Decline in life expectancy

The pandemic also reversed years of health progress. Global life expectancy, which had risen from 67 in 2000 to 73 in 2019, fell to 71 in 2021, returning to 2011 levels. Healthy life expectancy (HALE) followed a similar pattern. Although there was a partial recovery between 2022 and 2023, by 2023 life expectancy in women was the only one to return to pre-pandemic levels.

Significant data gaps

The document cautions that these figures are based on statistical models because many countries, especially low- and lower-middle-income countries, lack reliable death registration systems. "Many countries, especially those with weaker health information systems, face difficulties in registering and reporting deaths," WHO notes.