evidence: Msemburi and colleagues set out to estimate excess deaths from COVID-19 for every country in the world. The authors report that there were between 13.2 million and 16.6 million more deaths than expected in 2020 and 2021. This death toll was between 2.4 and 3.1 times higher than the officially reported number of COVID-19-related deaths. Four out of five excess deaths occurred in middle-income countries (Fig. 1), with some of the worst affected in Latin America. In both years combined, the observed mortality in Peru was double the expected level, and it was between 41% and 51% higher than expected in Mexico, Bolivia and Ecuador. Low-income countries had fewer deaths, mostly because they account for only 9% of the global population, and have younger populations, on average, than do higher-income countries. Compared with the published data, Msemburi etal. present more-detailed methods and more-refined estimates, by adjusting the way in which underlying mortality trends were forecast for several countries6.