Mandates and “excess deaths”

David Wallace-Wells:

There is one data point that might serve as an exceptional interpretative tool, one that blinks bright through all that narrative fog: excess mortality. The idea is simple: You look at the recent past to find an average for how many people die in a given country in a typical year, count the number of people who died during the pandemic years, and subtract one from the other. The basic math yields some striking results, as shown by a recent paper in The Lancet finding that 18.2 million people may have died globally from COVID, three times the official total. As skeptical epidemiologists were quick to point out, the paper employed some strange methodology — modeling excess deaths even for countries that offered actual excess-death data and often distorting what we knew to be true as a result. A remarkable excess-mortality database maintained by The Economist does not have this problem, and, like the Lancet paper, the Economist database estimates global excess mortality; it puts the figure above 20 million.

As a measure of pandemic brutality, excess mortality has its limitations — but probably fewer than the conventional data we’ve used for the last two years. That’s because it isn’t biased by testing levels — in places like the U.S. and the U.K., a much higher percentage of COVID deaths were identified as such than in places like Belarus or Djibouti, making our pandemics appear considerably worse by comparison. By measuring against a baseline of expected death, excess mortality helps account for huge differences in the age structures of different countries, some of which may have many times more mortality risk than others because their populations are much older. And to the extent that the ultimate impact of the pandemic isn’t just a story about COVID-19 but also one about our responses to it — lockdowns and unemployment, suspended medical care and higher rates of alcoholism and automobile accidents — excess mortality accounts for all that, too. In some places, like the U.S., excess-mortality figures are close to the official COVID data — among other things, a tribute to our medical surveillance systems. In other places, the numbers are so different that accounting for them entirely changes the picture of not just the experience of individual nations but the whole world, scrambling everything we think we know about who did best and who did worst, which countries were hit hardest and which managed to evade catastrophe. If you had to pick a single metric by which to measure the ultimate impact of the pandemic, excess mortality is as good as we’re probably going to get.