Albania Ranked Fourth with Over 400 Deaths per 100,000 Population/Total COVID-19 Deaths Could Be 7m Worldwide

A new analysis from the Institute for Health Metrics and Evaluation (IHME), which independently researches health at the University of Washington School of Medicine, shows that the total global toll due to coronavirus disease 2019 (COVID-19) could be more than twice the officially reported number of deaths, at almost 7 million.

The highest proportion of the population to be infected was in 12 countries, with over 400 deaths per 100,000 population. These include Azerbaijan at 650, Bosnia and Herzegovina at 590, Bulgaria at 540, and Albania at 525 per 100,000, said the analysis released by

This should serve as a timely warning that the outbreak is more extensive than assumed and shape preventive strategies accordingly.

The highest ratio of excess mortality to officially reported statistics is in Central Asia, Eastern Europe, and Central Europe, where deaths are over ten times the official death.

This astounding conclusion is the result of looking at the excess mortality of countries around the world and adjusting for drivers of mortality changes other than COVID-19.

Many deaths due to the virus go unrecorded as such because they are attributed to other causes. This is either because they occur at home or other residential facilities or in patients who have not received a positive polymerase chain reaction (PCR) indicating the presence of the virus, as shown by the presence of viral ribonucleic acid, the genetic material.

In countries with poor health records or a weak healthcare system and infrastructure, still higher disparities are likely to occur between officially reported and actual deaths. Even in high-income countries, many deaths in nursing homes went unnoticed by the authorities. Thus, the excess mortality suggests an actual COVID-19 mortality that is many times higher than official reports indicate.

“As terrible as the COVID-19 pandemic appears, this analysis shows that the actual toll is significantly worse,” said Dr. Chris Murray, director of IHME. “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.”

This analysis put the USA, which has been the hardest hit by the pandemic, in top place. The IHME estimate pegs U.S. deaths at over 900,000, rather than the reported 574,000. It is followed by India, with officially reported deaths of 221,000 but an actual estimated total of 654,000.

For India, this is harder to bear at a stage where 4,000 deaths are being reported daily and new case numbers are going through the roof every single day.

While the countries with the highest outbreaks are likely to also have the most significant number of unrecorded COVID-19 deaths, the analysis also finds that countries like Japan, which would seem to have suffered relatively less, also have a ten-fold higher total COVID-19 mortality compared to reported deaths.