Nearly 15 million people have died worldwide from COVID-19 and other causes related to the pandemic crisis, according to new figures released Thursday from the World Health Organization (WHO) that far exceed reported death tolls. 

The WHO confirmed that 14.91 million excess deaths occurred between 1 January 2020 and 31 December 2021, representing 9.49 million deaths more than those globally reported as directly attributed to COVID-19.

“These sobering data not only point to the impact of the pandemic but also to the need for all countries to invest in more resilient health systems that can sustain essential health services during crises, including stronger health information systems,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus in a statement. “WHO is committed to working with all countries to strengthen their health information systems to generate better data for better decisions and better outcomes.”

Most of the excess deaths were concentrated in Southeast Asia, Europe, and the Americas. The global death toll was also higher for men than for women, and higher among older adults. Twenty countries that make up 50 percent of the world’s population accounted for 80 percent of the estimated global excess mortality rate during this timeframe, including Brazil, Germany, Mexico, the United Kingdom, and the United States.

“The monitoring of excess mortality provides us with a more comprehensive understanding of the impact of COVID-19 beyond the number of COVID-19 deaths reported by countries,” according to the WHO report, which is tracking “global excess mortality as the pandemic evolves over time to reveal a picture of its full impact and burden on countries, health systems, and individuals.”

Generally, reported death numbers due to COVID-19 are underestimated because individuals die without being tested for the disease, the country the person died in has a different definition for COVID-19 cause of death than others, or health systems may have been overwhelmed and the individual did not seek care. 

Calculating the number of excess deaths is important for understanding how to “combat future pandemics and continue to respond to this one,” said Dr. Albert Ko, an infectious disease specialist at the Yale School of Public Health, in an interview with the Associated Press (AP). 

“For example, Ko said South Korea’s decision to invest heavily in public health after it suffered a severe outbreak of MERS allowed it to escape COVID-19 with a per-capita death rate around a 20th of the one in the United States,” the AP reports.

The United States has faired the worst of high-income countries in terms of excess deaths caused by COVID-19, said Steven H. Woolf, director emeritus and senior adviser to the Center on Society and Health at Virginia Commonwealth University School of Medicine, in an interview with The Washington Post. 

“Looking at excess deaths allows public health experts and political leaders to gain a better understanding of the true toll of the pandemic,” the Post reports. “It counts people who died because they did not get treatment for acute emergencies, chronic illness, and behavioral health conditions such as depression, anxiety, or addiction that were exacerbated by the stresses of the pandemic.”

The total number of deaths associated with #COVID19 worldwide from 2020-2021 may be closer to 14.9 million: New estimates by WHO & @UNDESA.

That’s 9.5 million more deaths than reported https://t.co/qDvaA6t5KZ #HealthData pic.twitter.com/ZjABJzlgiZ

— World Health Organization (WHO) (@WHO) May 5, 2022

The United States reached a grim milestone on 4 May when confirmed COVID-19 deaths reached 1 million, 27 months after the first confirmed case of COVID-19 in the country.

“While deaths from COVID have slowed in recent weeks, about 360 people have still been dying every day,” NBC News reports on the status of U.S. deaths. “The casualty count is far higher than what most people could have imagined in the early days of the pandemic, particularly because then-President Donald Trump repeatedly downplayed the virus while in office.”

The political willpower to fund COVID-19 mitigation and treatment efforts could also have an impact on the pandemic and preparation for future ones. On Thursday, the AP reported that U.S. federal funding for uninsured COVID-19 patients may run out soon. 

"Recently an urgent White House request for $22.5 billion for COVID priorities failed to advance in Congress," according to the AP. "Even a pared-back version is stuck. Part of the Biden administration’s request involves $1.5 billion to replenish the Uninsured Program, which paid for testing, treatment, and vaccine-related bills for uninsured patients. The program has now stopped accepting claims due to lack of money."