Victims of the pandemic: How many people have really died in COVID-19 in Hungary?

There is an ongoing debate about the coronavirus death toll in Hungary. The opposition is pointing to record high mortality rate, while the government states that deaths caused by the virus are actually much lower than recorded, because of the methodology of countig COVID-deaths. Based on the first quarterly data on population trends in Hungary, there is some truth in the latter statement, but it also reveals a phenomenon of which Hungary cannot be proud.

The first coronavirus-related death was registered on 16 March 2020 in Hungary. After that, there were 15 more victims of the virus that month. As the situation got worse only a few months later, the number of deaths in the first quarter of 2020 contains only a small number of coronavirus victims. This means that in the first three months of 2020 there were 34 540 deaths. In the same period in 2021, the database of the Hungarian Central Statistical Office (KSH) shows 42 875 deaths. For the first quarter of the years 2015-2019, there were an average of 37 451 deaths.

Number of deaths in Q1 of 2020, 2021 and of the five year average

The number of deaths in the first quarter of 2021 was 5,424 higher than the average of the first quarter of 2015-2019, and 8,335 higher than the average for the first quarter of 2020. Since the number of registered coronavirus victims in the first quarter of 2021 was 11 738, it can be said that the number of registered covid deaths is indeed much more than the number of people who actually died from the virus. Because if all those registered as victims of the pandemic had died as a consequence of the virus, the death toll should be at least 11 738 higher than last year and the five-year average. Moreover, if we also count in indirect deaths (like deaths caused by delayed hospital treatments), the number should be even higher. However, the growth is smaller than of those dying from covid; by a third compared to the last year, and by a half compared to the average of the previous years.

Excess mortality in 2021 Q1 compared to Q1 of the five year average and to Q1 of 2020, relative to number of Covid deaths in 2021 Q1 

This means that half to third of those who had died during the pandemic, probably would have had a died as a consequence of some other, previously existing disease sooner or later, based on the mortality rates of recent years. But the fact that many of the deceased who had a serious illness were tested positive for coronavirus also shows that those who are hospitalised cannot be protected completely from the infection. In other words, much more people could have survived the epidemic if only they weren’t hospitalised.

There is no unified method

„The success of fighting agaisnt the pandemic in Hungary is measured in human lives. And I see that we won the first battle there.” – stated PM Viktor Orbán in an interview in Kossuth Radio on 4 September 2020.

However, during the third wave of the pandemic, the narrative of the government changed, and began to emphasise that mortality rates cannot be compared, as there are different criteria in every country. There are indeed different methods to define COVID deaths. Most countries follow the recommendation of WHO, i.e. in addition to clinically confirmed cases, deaths probably caused by COVID-19 are also classified as coronavirus deaths. The second method, however, relies on positive laboratory test.

In addition, it also matters whether someone died from or with coronavirus infection. There are countries where all recorded deaths are included in the coronavirus mortality statistics, such as the Czech Republic, Germany or France. The situation is similar in Hungary, which means that people who had died from other existing disease but were infected, are also included in the statistics.

In other countries, however, only deaths where the infection can be shown as the cause of death are included in the coronavirus mortality statistics. This is the practice followed by Austria, Poland, Slovakia and Serbia.

Excess mortality is better for comparison

Excess mortality – which shows how many people died in a country compared to previous years – is a better basis for comparison. According to Eurostat, there have been two major peaks in excess deaths since the outbreak of the coronavirus epidemic: the first between March and May 2020, reaching 25 percent excess death rate than the average for 2016-2019 in EU countries.

The second peak was a few months ago, in November-December 2020, with an increase of 40 percent. And the third wave of the pandemic already showed a significant surplus in March 2021, with 41.2 percent more deaths in Hungary than the average for 2016-2019. Only Bulgaria (52.6%), Slovakia (57.7%) and the Czech Republic (63%) had higher surpluses. In March 2021, we have produced worse numbers than Poland (37.9%) as well, while they had the worst percentage of excess mortality, 97%, on the peak of the second wave in the EU.

Excess mortality in 2020-2021 compared to average of previous four years in EU countries (%) 

The average number of deaths in the EU in 2016-2019 is 4 million 702 thousand, compared to 5 million 247 thousand in 2020. Based on this, there was an excess of 545 thousand deaths in 2020 compared to the average of the previous four years.

In 2020, 143,139 people died in Hungary, which is an increase of 9.8 percent compared to the average of the previous five years. This is not particularly high for the EU as a whole, with only 8 countries showing a smaller increase. The numbers seem favorable in Hungary compared to the EU 27 average of 14.1%. The worst percentages of excess mortality were in Poland (20.8%) and in Slovenia (20.4%).

Excess mortality in EU member states in 2020 compared to average of previous five years

In terms of excess mortality per 1 million people, we are in 11th place out of 27 Member States. In fact, by 3 January 2021, 1,309 more people per million people had died in Hungary than in previous years. The EU average is 1464 people, with the highest excess death in Bulgaria (2553) and the lowest in Latvia (272).

Weekly mortality trends

We have also looked at the number of deaths on a weekly basis since the second wave of the pandemic. Here we see that at the peak of both the second and third waves, the number of deaths reported in a week was almost identical: 4170 in week 49 of 2020 and 4163 in week 12 of 2021.This is interesting because during the third wave, there were almost one and a half times as many deaths in a week as during the second wave. While during the second wave thousands of deaths were not linked to the coronavirus, the opposite appears to be true in the third wave: weekly death not counting deaths caused by covid appear to be steadily below the five year average, and excess mortality was mostly caused by the victims of the pandemic.

Weekly deaths within population by age groups 

Weekly Covid deaths by age groups 

In addition to weekly deaths, we also examined the weekly excess mortaliy trends. It was the highest in week 48 of 2020, with 1609 more than the five-year average, but of these, only 872 were officially victims of the coronavirus.

Weekly excess mortality compared to the five year average 

Translated by Zita Szopkó. The original Hungarian version of the article was written by András Hont, Krisztián Szabó and Zita Szopkó, and can be found here.

Cover photo: Number of deaths per week in the total population in Hungary.