It has been known for some time that the official numbers of COVID-19 cases and mortality are an undercount, due in part to the lack of an active national surveillance program.

For example, reports indicate there still are refrigerator trucks full of 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 CDC, estimated at one point there probably were eight times as many cases as were actually reported nationally. He did not comment on the mortality data. Although it has remained something of a mystery, the consensus was there are more deaths than what has been reported.

With many COVID-19 deaths unreported in the United States, researchers estimate 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’s Institute for Health Metrics and Evaluation (IHME) calculated 905,289 COVID-19 deaths occurred in the U.S. during that period. That is 58% higher than the official numbers. Moreover, they estimate 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,” IHME Director Chris Murray, MD, DPhil, said in statement.

IHME estimated total COVID-19 mortality by calculating anticipated deaths from all causes in pre-pandemic data. They compared the number to all-cause deaths in the pandemic and determined excess mortality. That figure was analyzed to remove deaths indirectly attributable to the pandemic (i.e., people who experienced heart attacks because they could not or would not see their cardiologist during the pandemic). Another factor to sort out is deaths averted by the pandemic, like fewer traffic accidents and other incidents related to decline in mobility.

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

The analysis shows the United States recorded more COVID-19 deaths in the period studied than any other country. India followed with an estimated 654,395 deaths for the period, as opposed to the country’s official count of 221,181. Third was Mexico with 617,127 calculated deaths for the period, almost threefold the official count of 217,694.

“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,” Murray said.


  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.