Background
This study estimates the burden of COVID-19 on mortality in Germany. It is expected that many people
have died because of the new COVID-19 virus who otherwise would not have died. Estimating the burden of
the COVID-19 pandemic on mortality by the number of officially reported COVID-19-related deaths has
been proven to be difficult due to several reasons. Because of this, a better approach, which has been used in
many studies, is to estimate the burden of the COVID-19 pandemic by calculating the excess mortality for
the pandemic years. An advantage of such an approach is that additional negative impacts of a pandemic on
mortality are covered as well, such as a possible pandemic-induced strain on the healthcare system.
Methods
To calculate the excess mortality in Germany for the pandemic years 2020 to 2022, we compare the reported
number of all-cause deaths (i.e., the number of deaths independently of underlying causes) with the number
of statistically expected all-cause deaths. For this, the state-of-the-art method of actuarial science, based on
population tables, life tables, and longevity trends, is used to estimate the expected number of all-cause
deaths from 2020 to 2022 if there had been no pandemic.
Results
The results show that the observed number of deaths in 2020 was close to the expected number with respect
to the empirical standard deviation; approximately 4,000 excess deaths occurred. By contrast, in 2021, the
observed number of deaths was two empirical standard deviations above the expected number and even
more than four times the empirical standard deviation in 2022. In total, the number of excess deaths in the
year 2021 is about 34,000 and in 2022 about 66,000 deaths, yielding a cumulated 100,000 excess deaths in
both years. The high excess mortality in 2021 and 2022 was mainly due to an increase in deaths in the age
groups between 15 and 79 years and started to accumulate only from April 2021 onward. A similar mortality
pattern was observed for stillbirths with an increase of about 9.4% in the second quarter and 19.4% in the
fourth quarter of the year 2021 compared to previous years.
Conclusions
These findings indicate that something must have happened in spring 2021 that led to a sudden and
sustained increase in mortality, although no such effects on mortality had been observed during the early
COVID-19 pandemic so far. Possible influencing factors are explored in the discussion.