The number of people who died as a result of the coronavirus pandemic by the end of last year may be nearly three times higher than thought, according to estimates by the World Health Organization.

The WHO calculation is based on an analysis of excess mortality, an approach used by demographers to measure the real impact of the health crisis that compares average death rates with those recorded during the pandemic.

By the close of 2021, 14-9mn excess deaths “associated directly or indirectly” with the pandemic were recorded globally, according to the health body. About 5-4mn were officially confirmed Covid-19 deaths in 2020 and 2021, according to research project Our World in Data.

Dr William Msemburi, an official in the department of data and analytics, told a news conference that the majority of the excess deaths — 84 percent — were concentrated in south-east Asia, Europe and the Americas. A total of 52 per cent of the deaths occurred in lower middle-income countries and 28 per cent in upper middle-income countries. Just 10 countries — including India, the US and Russia — accounted for 68 percent of the total excess deaths across the two-year period.

Msemburi added: “We have found that the global death toll is higher for men than for women”, splitting 57 per cent to 43 percent. The excess deaths were also concentrated in older people: 82 percent were estimated to have occurred in the over-60s.

WHO director-general Tedros Adhanom Ghebreyesus said: “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. ”

Tedros said the WHO was working with “all countries to strengthen their health information systems to generate better data for better decisions and better outcomes”.

The excess mortality calculations captured deaths “due to the disease” and those “due to the pandemic’s impact on health systems and society”, the WHO added.

A similar estimate from researchers at the University of Washington’s Institute for Health Metrics and Evaluation, published in the Lancet in March, put the