The World Health Organization says nearly 15 million people were killed either by the coronavirus or by its impact on overwhelmed health systems in the past two years, more than double the official death toll of 6 million.

There were 14.9 million excess deaths associated with COVID-19 by the end of 2021, the UN body said on Thursday.

The official count of deaths directly attributable to COVID-19 and reported to WHO in that period, from January 2020 to the end of December 2021, was slightly more than 5.4 million.

The WHO's excess mortality figures reflect people who died of COVID-19 as well as those who died as an indirect result of the outbreak, including people who could not access healthcare for other conditions when systems were overwhelmed during huge waves of infection.

It also accounts for deaths averted during the pandemic, for example, because of the lower risk of traffic accidents during lockdowns.

The figures are based on country-reported data and statistical modelling.

The UN agency's chief, Tedros Adhanom Ghebreyesus described the figure as "sobering," saying it should prompt countries to invest more in their capacities to quell future health emergencies.

WHO did not immediately break down the figures to distinguish between direct deaths from COVID-19 and others caused by the pandemic.

For example, Mr 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 that of the US.

Disputed figures throughout the pandemic

Accurate numbers on COVID-19 deaths have been problematic throughout the pandemic, as the figures were only a fraction of the devastation wrought by the virus, largely because of limited testing and differences in how countries counted COVID-19 deaths.

According to government figures reported to WHO and to a separate count kept by Johns Hopkins University, there have been more than 6 million reported coronavirus deaths to date.

Scientists at the Institute of Health Metrics and Evaluation at the University of Washington calculated there were likely more than 18 million COVID deaths from January 2020 to December 2021, in a recent study published in the journal Lancet, while a team led by Canadian researchers estimated there were more than 3 million uncounted coronavirus deaths in India alone.

Some countries, including India, have disputed WHO's methodology for calculating COVID deaths, resisting the idea that there were many more deaths than officially counted.

Earlier this week, the Indian government released new figures showing there were 474,806 more deaths in 2020 compared to the previous year but did not say how many were tied to the pandemic.

India did not release any death estimates for 2021, when the highly infectious delta variant swept through the country, killing many thousands.

Mr Ko said better figures from WHO might also explain some lingering mysteries about the pandemic, like why Africa appears to have been one of the least affected by the virus despite its low vaccination rates.

"Were the mortality rates so low because we couldn't count the deaths or was there some other factor to explain that?" he said, adding that the crush of deaths in rich countries like Britain and the US proved that resources alone were insufficient to contain a global outbreak.

True death toll will probably never be known

Dr Bharat Pankhania, a public health specialist at Britain's University of Exeter, said we may never get close to the true toll of COVID-19, particularly in poor countries.

"When you have a massive outbreak where people are dying in the streets because of a lack of oxygen, bodies were abandoned or people had to be cremated quickly because of cultural beliefs, we end up never knowing just how many people died," he explained.

Although Dr Pankhania said the currently estimated COVID-19 death toll still paled in comparison to the 1918 Spanish flu pandemic — when experts estimate up to 100 million people died — he said the fact that so many people died despite the advances of modern medicine, including vaccines, is shameful.

He also warned the cost of COVID-19 could be far more damaging in the long term, given the increasing burden of long COVID.

"With the Spanish flu, there was the flu and then there were some [lung] illnesses people suffered, but that was it," he said.

"There was not an enduring immunological condition that we're seeing right now with COVID," he said.

AP/Reuters

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