evidence: At the end of December 2019, the World Health Organization country office in China was notified of several cases of pneumonia of unknown etiology. These were the first cases of COVID-19. In the three years since, COVID-19 has killed more than 7.3 million people worldwide, including more than one million people in the United States, 800,000 in Russia, 690,000 in Brazil, and 530,000 in India. These tallies could substantially underestimate COVID-19's true death toll. In fact, some estimates suggest the total number of deaths could be more than two times as large as reported globally—nearly eighteen million deaths—and more than ten times greater than reported in some countries. The scale of loss is staggering, but the huge numbers are difficult to understand without context. It can be helpful to consider how COVID-19 ranks as a cause of death around the world, and the factors driving those trends. [...] More people in the United States died of COVID-19 than in any other country (1.1 million). Although this is in part due to the large U.S. population, the country also has a high death rate due to COVID-19. Incredibly, 114,000 more Americans died of COVID-19 in 2021 compared to 2020, despite the federal government purchasing over a billion doses of mRNA vaccine, enough to cover its population several times over. More people in the United States died of COVID-19 than died of seasonal influenza in the last ten years (2010-2020) and COVID-19 is the deadliest disease in U.S. history, surpassing the 1918 influenza pandemic which killed an estimated 675,000 Americans.