The excess death toll in Mexico during the first two years of the Pandemic was twice as high as the official tally.
The official Covid toll was 12 times greater in Egypt.
The figure was eight times higher in Pakistan.
The estimates were calculated by a panel of experts assembled by the World Health Organization. The death counts reported by many governments have overstated the true toll of the epidemic.
The experts estimated that more people died in 2020 and 2021 than would have been expected. They said that most of the victims were victims of Covid, but that a few died because it was more difficult to get medical care for illnesses such as heart attacks. The previous toll was six million.
The death toll from the Pandemic was concentrated in the year 2021, when new and more contagious versions of the virus caused a surge. The W.H.O.-assembled experts estimated that the number of people who died globally in 2021 was 18 percent larger than it would have been without the Pandemic.
It is absolutely staggering what has happened with this epidemic, including our inability to accurately monitor it, said Dr. Prabhat Jha, an epidemiologist at St. Michael's Hospital and the University of Toronto.
The W.H.O. assembled the expert team in the first months of the Pandemic and was tasked with calculating the number of people who would have been expected to die in normal times. The calculations combined national data on reported deaths with new information from localities and household surveys to account for deaths that were missed.
India objected to the methodology for calculating how many of its citizens died, so the release of the excess death data was delayed.
According to the W.H.O. estimates, nearly a third of the excess deaths worldwide took place in India. Through the end of 2021, the Indian government says it has 481,080 deaths.
India was not the only country where deaths were under reported. The experts said the gap could be a reflection of countries struggling to collect mortality data or their efforts to obscure the toll of the epidemic.
The flaws in government reports were already known in some countries. Russia had reported 310,000 Covid deaths by the end of 2021, but the W.H.O. experts said the death toll was more than one million. The Russian national statistics agency, which is fairly independent of the government, had found excess mortality of more than one million people.
Local authorities were told to make sure that Covid was not registered as the primary cause of death in many cases, according to an independent demographer who quit the Russian state statistics service after complaining of the failure to count Covid deaths properly.
The true picture has been established bycess deaths.
W.H.O. experts used limited data to arrive at estimates that were at odds with previous counts, though they cautioned that some of the calculations were highly uncertain. In Indonesia, the experts relied on monthly death data from Jakarta to estimate that the country had experienced over a million more deaths than normal during the Pandemic. The reported Covid death toll is seven times higher.
Indonesia has suffered more deaths than the government has reported, according to a spokeswoman for the Covid-19 vaccine program. She said the problem was caused by people not reporting the deaths of relatives as a way to avoid complying with government rules.
She said that the W.H.O. estimates were too high.
The W.H.O. estimates illuminated even more shocking figures inside the death counts. The expert estimate of 290,000 excess deaths by the end of the year was less than the Covid death toll. The W.H.O. estimate of 437 excess deaths for every 100,000 people left the country with the highest per capita tolls in the world.
When a health care system isn't prepared to receive patients who are seriously ill with pneumonia, when it can't provide the oxygen they need to live, or even provide beds for them to lay in so they can have some peace.
The W.H.O. estimated that more people had died by the end of the year than had been recorded.
In Mexico, the government has kept a tally of excess deaths during the Pandemic. The estimates were double the country's reported Covid death toll.
We reacted slowly after we responded badly. The most serious of all was to not communicate the seriousness of the situation.
The W.H.O.'s calculations include people who died from Covid, from medical conditions complicated by Covid, or from ailments other than Covid but could not get needed treatment because of the pandemic. Reductions in traffic accidents or isolation that prevented deaths from the flu and other infectious diseases are included in the excess death estimates.
W.H.O experts said calculating excess deaths is complex. Half of the world's countries don't report deaths from all causes. Others only give partial data. In the W.H.O.'s African region, the experts only had data from six countries.
The excess death rates were not indicative of a country's response to the Pandemic. The W.H.O experts did not account for the effects of heat waves.
The statisticians had to rely on modeling where death figures were missing. In those cases, they made predictions based on country specific information like containment measures, historical rates of disease, temperature and demographic to assemble national figures and, from there, regional and global estimates.
W.H.O. officials used the release of their calculations to make a plea for more investment in death reporting.
Dr. Asma is the W.H.O.'s assistant director general for data, analytics and delivery for impact.
The W.H.O. officials found that Britain had recorded more Covid deaths than normal, and that the number was nearly the same as Britain reported.
The disagreement over India's Covid deaths spilled into public this week when the Indian government suddenly released some mortality data from 2020 and reported an 11 percent increase in registered deaths in 2020.
The release was seen as an attempt to force the W.H.O. to reconsider its calculations. According to Indian health officials, the country lost less people to Covid than they thought.
Scientists believe that most of the country's excess mortality occurred in 2021, during a wave caused by the Delta variant. India's 2020 figures gave more credence to the W.H.O. estimates.
He said that the Indian government wanted to downplay the news, but they confirmed it at least for 2020.
India's history of ignoring how data can inform policymaking is what led to the country's refusal to cooperate with the W.H.O. analysis.
It's natural to miss some of the Covid deaths, according to Dr. Bhramar Mukherjee, a professor of biostatistics at the University of Michigan School of Public Health. She said that nobody has been this resistant.
The Ministry of Health in New Delhi did not respond to questions. W.H.O. officials said that India's 2020 death figures were too late to be included in their calculations.
Nations that report Covid deaths more accurately have been at the center of disputes over the reliability of excess death estimates. In Germany, the W.H.O. experts estimated that 195,000 more people than normal had died during the Pandemic.
The W.H.O. analysis may have underestimated the number of people who would have died in Germany because of the country's rapidly aging population, according to a statistician. That could have led to overestimations of deaths.
He said that the W.H.O. experts accounted for trends in mortality, but not for changes in the age structure of the population. He said that the W.H.O. estimate for Germany seems very high.
The W.H.O. calculations were more conservative than other analyses.
Some experts said that the W.H.O. analysis benefited from relying more heavily on actual data than other estimates.
Chris F. Schuetze, Ivan Nechepurenko, Oscar Lopez, and Julie Turkewitz contributed to the report.
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