Governments have undercounted the COVID-19 death toll by millions, the WHO says

The COVID-19 pandemic directly or indirectly caused 14.9 million deaths in 2020 and 2021, the World Health Organization said on Thursday, in its newest attempt to quantify the outbreak's terrible toll.

That's around 2.7 times more than the 5.42 million COVID-19 deaths the WHO says were previously reported through official channels in the same 2-year period.

Here's a rundown of four main points in WHO's report:

Overall, deaths are far higher than those in official reports

In its tally, WHO aims to quantify "excess mortality," accounting for people who lost their lives either directly, because of contracting COVID-19, or indirectly, because they weren't able to get treatment or preventive care for other health conditions. The figure also takes into account the deaths that analysts say were prevented because of the pandemic's wide-ranging effects, such as curtailing traffic and travel.

The pandemic's current reported death toll is 6.2 million, according to Johns Hopkins University's COVID-19 tracker.

India is seen suffering a much deeper loss than reported — a finding that India disputes

In some cases, WHO's figures depict a shockingly wide gulf between official figures and its experts' findings. That's particularly true for India, where WHO says millions more people died because of the pandemic than has been officially reported.

India reported 481,000 COVID-19 deaths in 2020 and 2021. But William Msemburi, technical officer for WHO's department of data and analytics, said on Thursday that the toll is vastly higher, with 4.74 million deaths either directly or indirectly attributable to the pandemic — although Msemburi said that figure has a wide "uncertainty interval," ranging from as low as 3.3 million to as high as 6.5 million.

The data behind the staggering figures promise to expand the understanding of the pandemic's true effects. But the findings are also a flashpoint in debates over how to account for unreported coronavirus deaths. India, for instance, is rejecting WHO's findings.

India "strongly objects to use of mathematical models for projecting excess mortality estimates," the country's health ministry said on Thursday, insisting that WHO should instead rely on "authentic data" it has provided.

10 countries accounted for a large share of deaths

Deaths were not evenly distributed around the world. The WHO says about 84% of the excess deaths were concentrated in three regions: Southeast Asia, Europe and the Americas.

And about 68% of the excess deaths were identified in just 10 countries. WHO listed them in alphabetical order: Brazil, Egypt, India, Indonesia, Mexico, Russia, South Africa, Turkey and the United States.

Overall, WHO found the number of excess deaths was much closer to reported COVID-19 deaths in high-income countries than in lower income countries.

Many countries still lack reliable health statistics

The WHO says it relied on statistical models to derive its estimates, looking to fill in gaps in official data.

"Prior to the pandemic, we estimate that 6 out of every 10 deaths were unregistered" worldwide, said Stephen MacFeely, director of WHO's department of data and analytics. "In fact, more than 70 countries do not produce any cause of death statistics. In the 21st century, this is a shocking statistic."

By creating its report on excess mortality, WHO is pursuing several goals, such as urging governments to improve their health-care interventions for vulnerable populations and to adopt more rigorous and transparent reporting standards.

"Knowing how many people died due to the pandemic will help us to be better prepared for the next," said Samira Asma, WHO's assistant director-general for data and analytics.

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