Excess Mortality and COVID-19 in MENA

Infographic, May 2023
Nonresident Fellow

May 22, 2023

Throughout the COVID-19 pandemic, public health specialists across the globe struggled with efforts to accurately count the number of COVID-19 cases and associated deaths. This was driven by the initial lack of accurate tests and institutional weaknesses within the health system, as well as differences over how to count deaths among those with comorbidities like cancer, heart disease, and diabetes. With hindsight, however, we can accurately estimate the number of deaths associated with the COVID-19 pandemic using excess mortality analysis, which allows us to contrast total deaths within a country with a predicted number of deaths modeled on past mortality outcomes: for the pandemic period, the difference between total deaths and the number of deaths one would expect under normal circumstances—excess mortality—provides an estimate of total deaths associated with the pandemic.1  

Assessing mortality data from Middle East and North Africa (MENA) countries for 2020-2021, we find that the official death toll associated with COVID-19 was fairly accurate, with excess mortality exceeding official COVID-19 deaths marginally in most countries.2 Excess mortality exceeds official COVID-19 deaths marginally in most assessed countries. In contrast, excess mortality analysis suggests that official counts of deaths associated with COVID-19 in Algeria and Egypt greatly underestimated the real number of pandemic-related deaths. For example, Egypt officially reported only 21,752 COVID-19 deaths for the 2020-2021 period, during which excess mortality reached nearly 280,000 (See Dyer 2023 for a deeper analysis of excess mortality in Egypt.)


Excess Mortality vs. Official COVID-19 Deaths in Select MENA Countries, 2020-2021 

1 For more details on the methodology, see Ariel Karlinsky and Dmitry Kobak, Tracking excess mortality across countries during the COVID-19 pandemic with the World Mortality Dataset,” eLife 10 no. 69336 (2021), https://doi.org/10.7554/eLife.69336.  
2 The analysis only includes countries for which we have periodic mortality data for 2015 to 2019, used to model predicted mortality for the 2020-2021 period.