For some time, it has been known that the official numbers of COVID-19 cases and deaths are an undercount, in part caused by the lack of an active national surveillance.

For example, it was reported recently that there still are refrigerator trucks full of about 750 COVID-19 dead in New York City.1 Maybe these have been counted, but there are many more who have not been.

Robert Redfield, immediate past director of the Centers for Disease Control and Prevention (CDC), estimated at one point that there probably were eight times as many cases as were actually reported nationally. He did not comment on the morality data. Although the number of deaths has remained something of a mystery, there was general consensus that the number was more than was being reported. Now we know. With many COVID-19 deaths unreported in the United States, researchers estimate that the actual death toll of the pandemic is closer to 1 million than the 574,043 reported from March 1, 2020, to May 3, 2021.2

Looking at excess mortality data, researchers at the University of Washington Medical School’s Institute for Health Metrics and Evaluation (IHME) calculated that 905,289 COVID-19 deaths occurred in the United States during that time period. That is 58% higher than the official numbers. Moreover, they estimate that COVID-19 has caused 6.9 million deaths globally, more than double the official count. “Understanding the true number of COVID-19 deaths not only helps us appreciate the magnitude of this global crisis, but also provides valuable information to policymakers developing response and recovery plans,” Chris Murray, MD, DPhil, IHME’s director, said in a statement.

IHME estimated the total COVID-19 deaths by calculating anticipated deaths from all causes in pre-pandemic data. They compared that to all-cause deaths in the pandemic and determined excess mortality. That figure then was analyzed to remove deaths indirectly attributable to the pandemic — for example, people who had a heart attack because they could not or would not see their cardiologist during the pandemic. Another factor to sort out is deaths averted by the pandemic, such as fewer traffic accidents and other incidents related to the decline in mobility.

“The resulting adjusted estimates include only deaths directly due to the SARS-CoV-2 virus,” the researchers concluded.


  1. Shammas B. Hundreds of bodies of covid-19 victims are still in New York’s refrigerated trucks more than a year into the pandemic. The Washington Post. May 9, 2021.
  2. Institute for Health Metrics and Evaluation. COVID-19 has caused 6.9 million deaths globally, more than double what official reports show. May 6, 2021.