The two teamed up to try to set the record straight, not relying on countries’ published COVID-19 death rates. (Kristina Flour/ Unsplash)

Bolivia, Ecuador, Mexico and Peru grossly under-reported their COVID-19 deaths by about 50 percent.

Nicaragua’s true number of pandemic deaths is 50 times higher than reported — 7,000 coronavirus deaths instead of the 137 reported.

And Russia likely sustained four times more pandemic deaths than reported — 551,000 instead of 135,000.

These figures come from the World Mortality Dataset created by researchers Ariel Karlinsky, a graduate student at Hebrew University of Jerusalem’s economics department, and Dmitry Kobak from Germany’s Tübingen University.

“Our results present a comprehensive picture of the impact of COVID-19,” Kobak said. “We hope these findings — and their methodology — will lead to a better understanding of the pandemic and highlight the importance of open-source and fast mortality reporting.”

The numbers influence policy, such as which countries are not safe for visitors. And they give the public a sense of how successful each country has been at containing the spread of the SARS-CoV-2 coronavirus and its variants.

Karlinsky and Kobak teamed up to try to set the record straight, not relying on countries’ published COVID-19 death rates.

“Measuring and monitoring excess mortality across different countries requires, first and foremost, a comprehensive and regularly updated dataset on all-cause mortality,” they wrote in the journal eLife.

“However, there has been no single resource where such data would be collected from all over the world. The World Mortality Dataset presented here aims to fill this gap by combining publicly available information on country-level mortality, culled and harmonized from various sources.”

This largest existing collection of overall mortality data provides information for 104 countries and territories.

The data on deaths across time in various countries. (World Mortality Dataset/Karlinsky & Kobak, 2021)

In any given period, a certain number of people die “expected deaths” due to old age, illness, violence, traffic accidents and more. Pandemics, wars and natural and manmade disasters cause “excess deaths” beyond the expected deaths.

“We wanted to find out whether the pandemic caused excess deaths in the countries we covered and, if so, to what extent,” said Karlinsky, “Even though the number of excess deaths does not exactly equal the mortality rate from COVID-19 infections, for many countries it is the most objective indicator of their pandemic death toll.”

Under-reporting and over-reporting

Karlinsky and Kobak found that some countries have under-reported COVID-19 deaths consistently, whether intentionally or mistakenly.

According to their World Mortality Dataset, Bolivia’s true number of COVID deaths is likely 2.5 times higher than they reported — 36,000 deaths instead of 15,000. In Ecuador, it’s 2.9 times higher — 64,000 deaths instead of the 22,000 reported. In Mexico, the figure is 2.1 times higher — 471,000 instead of the 221,000 pandemic deaths reported.

Peru originally claimed only 69,000 deaths when the actual figure was closer to 185,000. After an outcry by public health officials, Peru’s health ministry audited all deaths during the pandemic period and resubmitted COVID-19 death stats to the World Health Organization.

Several countries of the former Soviet Union habitually under-report COVID-19 deaths. Russia claims 135,000 while the true number looks closer to 551,000. Belarus reported 392 rather than the more likely 700. Uzbekistan reported 740 instead of the probable 21,500 deaths.

Tajikistan reported 90 deaths when the real number is about 9,000, according to the research.

Egypt’s excess deaths were 13 times higher than reported — 196,000 instead of 15,000. Iran’s were 2.15 times higher, and Lebanon’s were 1.23 times higher than reported.

For Australia and New Zealand, the death rates during the pandemic were lower than in previous periods. This may be due to virus-containment efforts such as border closures, social distancing and mask-wearing, which decreased their overall number of deaths.

The researchers found that many countries did faithfully report their pandemic deaths. Per 100,000 people, the United States had 194 excess deaths; United Kingdom 159; France 110; Switzerland 100; the Czech Republic 320; and Poland 310.

Denmark and Norway uniquely experienced no excess mortality during the pandemic.

At 58 excess deaths per 100,000 persons, Israel fared better than its neighboring countries. The researchers say Israel’s excess deaths during the coronavirus pandemic were fewer than reported — 5,000 instead of 6,400. This is likely due to a decrease in the overall number of deaths from non-COVID-19 respiratory infections during the winter months.

Karlinsky said he and Kobak “are constantly expanding our dataset and will continue to track excess mortality around the world for the remainder of the COVID-19 pandemic. We hope that our dataset will be a valuable asset for public health officials looking to assess the risks and benefits of a given pandemic-containment measure.”

Their research paper was reviewed before publication by Marc Lipsitch of Harvard’s T.H. Chan School of Public Health.

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