The Covid-19 pandemic may have caused significantly more deaths than officially reported, with the World Health Organization (WHO) estimating around 22.1 million excess deaths worldwide between 2020 and 2023 nearly three times higher than the roughly seven million Covid deaths officially recorded globally.
In its World Health Statistics 2026 report, WHO said the pandemic reversed nearly a decade of progress in global life expectancy and healthy life expectancy by 2021, describing the impact as a historic setback for healthcare systems across the world.
According to the report, global life expectancy declined by 1.8 years between 2019 and 2021, while healthy life expectancy dropped by 1.5 years during the same period, marking the sharpest fall seen in recent decades.
WHO stated that excess mortality peaked in 2021 with 10.4 million additional deaths as health systems faced immense pressure. Excess deaths later fell to 4.9 million in 2022 and 3.3 million in 2023, although the agency noted that recovery remains uneven and several countries are yet to return to pre-pandemic health trends.
The organisation defines excess deaths as fatalities exceeding expected levels during a specific time period. These include both direct Covid-19 deaths and indirect deaths caused by disrupted healthcare services and delayed treatment.
The report also found that men were more severely affected, with age-standardised excess mortality nearly 50% higher among men than women during the peak of the pandemic in 2021. Older adults, particularly those above 85 years, faced the highest mortality burden.
WHO further highlighted major weaknesses in global death reporting systems exposed during the pandemic. Of the estimated 61 million deaths worldwide in 2023, only around 21 million were officially reported to WHO with cause-of-death information, while just 12 million had medically certified ICD-coded mortality data.
The agency said the pandemic disrupted essential healthcare services globally, including vaccination programmes, tuberculosis and HIV treatment, and care for non-communicable diseases, contributing significantly to indirect deaths.
WHO had earlier estimated in a separate 2022 analysis that India recorded nearly 4.74 million excess deaths during 2020-21, a figure disputed by the Indian government.
The report also warned about slowing progress toward universal health coverage, rising healthcare-related poverty and declining global health funding in the years following the pandemic.