Gaps Between Official and Excess Covid-19 Mortality Measures: The Effects of Institutional Quality and Vaccinations

We evaluate quartile rankings of countries during the Covid-19 pandemic using both official (confirmed) and excess mortality data. By December 2021, the quartile rankings of three-fifths of the countries differ when ranked by excess vs. official mortality. Countries that are ‘doing substantially better’ in the excess mortality are characterized by higher urban population shares; higher GDP/Capita; and higher scores on institutional and policy variables. We perform two regressions in which the ratio of Cumulative Excess to Official Covid-19 mortalities (E/O ratio) is regressed on covariates. In a narrow study, controlling for GDP/Capita and vaccination rates, by December 2021 the E/O ratio was smaller in countries with higher vaccination rates. In a broad study, adding institutional and policy variables, the E/O ratio was smaller in countries with higher degree of voice and accountability. The arrival of vaccines in 2021 and voice and accountability had a discernible association on the E/O ratio.