Globally, COVID-19 has caused approximately 6.9 million deaths, more than double what official numbers show, according to a new analysis by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine. IHME found that COVID-19 deaths are significantly underreported in almost every country.

The IHME’s estimates of actual Covid-19 deaths were tenfold higher than reported counts for some countries. The analysis estimates that by May 3, 2021, the total number of COVID-19 deaths was 6.93 million, a figure that is more than two times higher than the reported number of deaths of 3.24 million.

Global reported and total COVID-19 deaths, 2020–2021

Predicted ratios of total COVID-19 deaths to reported COVID-19 deaths (March 2020 - April 2021)

The U.S., India and Mexico top the list of 20 countries with the highest numbers of total COVID-19 deaths (March 2020 to May 2021). 

While, in the list of 20 countries with the highest death rates due to COVID-19 i.e. deaths per 100,000 (March 2020 to May 2021), Azerbaijan tops the unfortunate list followed by Bosnia-Herzegovina and Bulgaria.

These reported figures only includes deaths caused directly by the SARS-CoV-2 virus, not deaths caused by the pandemic’s disruption to health care systems and communities.

Many deaths from COVID-19 go unreported because countries only report deaths that occur in hospitals or in patients with a confirmed infection. In many places, weak health reporting systems and low access to health care magnify this challenge.

The United States alone is estimated to have had 905,000 Covid-19 fatalities, vastly more than the 579,000 deaths officially reported, and more than any other country.  Similarly, India, the country with the most recent severe wave of cases and deaths, is estimated to have an overall ratio of 2.96, which implies that the total COVID-19 death toll to date is much higher than what has been reported.

As per IHME analysis, India has 221,18 officially reported deaths while total number of deaths, as per IHME analysis, is 654,395 so a remaining 4,33,214 COVID-19 related deaths, which is about 66% of total, were under-counted.

The Table below shows the 20 countries with the highest number of total COVID-19 deaths

CountryTotal COVID-19 deathsReported COVID-19 deaths
United States of America905,289574,043
Russian Federation593,610109,334
United Kingdom209,661150,519
South Africa160,45254,390

IHME’s modeling is updated weekly and can be accessed at

Dr. Christopher J.L. Murray, IHME Director, said --
Many countries have devoted exceptional effort to measuring the pandemic’s toll, but our analysis shows how difficult it is to accurately track a new and rapidly spreading infectious disease. We hope that today’s report will encourage governments to identify and address gaps in their COVID-19 mortality reporting, so that they can more accurately direct pandemic resources.” Moving forward, IHME’s COVID-19 modeling, which forecasts the potential course of the pandemic over the next several months, will be based on these estimates of total COVID-19 deaths.
The Table below shows 20 countries with the highest death rates due to COVID-19 (deaths per 100,000), March 2020 to May 2021-

CountryTotal COVID-19 death rateReported COVID-19 death rate
Bosnia and Herzegovina587.2262.1
North Macedonia467.9230.0
Russian Federation404.674.5
Republic of Moldova377.6158.4

Read more about this report's methodology here 

IHME's Forecasts for India's COVID-19 Days Ahead

Dr. Murray, who's also the lead modeler of this report, also shares insights IHME's latest COVID-19 model run. He said --

COVID-19 is the number one cause of death in the world this week, and the number of deaths that we are observing so far – up until present – is about 30,000 deaths per day from COVID-19. Now if we look around the world, the main area driving the epidemic is in India. 

There also seems to be an epidemic unfurling in Nepal, spreading perhaps into other countries in Southeast Asia, but primarily the global epidemic is being driven by what’s happening in India. Our model suggests that infections may be at a peak in India this week. Because there are so few people left in many states that have not been infected, we’re starting to observe some breaks in transmission due to the small fraction of the population that remains susceptible. That means, unfortunately, we expect the death toll in India to continue rising probably for the next two to three weeks, and we expect that death toll to get much higher. So the epidemic, as it unfolds in India, is the primary global concern. 


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