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Mortality impact from the COVID-19 pandemic has been more devastating than the situation documented by official statistics. A study published by the Lancet on 10th March 2022 estimates excess mortality from the pandemic in 191 countries, from Jan 1, 2020, to Dec 31, 2021. Although the reported COVID-19 deaths during this period totaled 5.94 million worldwide, the study estimates that 18.2 million people died because of the pandemic, as measured by excess mortality, over that period.
Excess mortality due to the COVID-19 pandemic is defined as the net difference between the number of deaths during the pandemic (measured by observed or estimated all-cause mortality) and the number of deaths that would be expected based on past trends in all-cause mortality.
The global all-age rate of excess mortality due to the pandemic was 120.3 deaths per 100,000 of the population. At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India, 4.07 million against 489,000 deaths reported. India had an estimated 152.5 excess deaths per 100,000 of the population over the study period. This was much higher than its reported COVID-19 mortality rate of 18.3 per 100,000 over the same period. India accounted for 22.3% of global excess deaths as of Dec 31, 2021.
The ratio between excess mortality rate and reported COVID-19 mortality rate in India was 8.33. Among the states, this ratio was the lowest in Goa (0.9) followed by Kerala (1.86), Sikkim (2.42) and Delhi (2.44). The ratio was the highest in Bihar (26.68) followed by Uttar Pradesh (22.58) and Madhya Pradesh (21.2). To put this in context, the actual death toll in Bihar could be around 320,000 against the reported 12,000 deaths. Eight Indian states had excess mortality rates higher than 200 per 100,000 population: Uttarakhand, Manipur, Maharashtra, Chhattisgarh, Haryana, Himachal Pradesh, Punjab, and Karnataka.