The number of people who have died of Covid-19 around the globe is probably about three times the official figures suggest, a new study has claimed.

Researchers at Washington University in the US have come to the conclusion after studying excess mortality figures from 191 countries around the world. The research is published in The Lancet.

It means that, overall, around 18.2 million have died from the virus, rather than the official total of 5.94 million, based on adding up the tallies provided by individual countries.

Lead author Dr Haidong Wang said:  “Understanding the true death toll from the pandemic is vital for effective public health decision-making.”

He added: “Studies from several countries, including Sweden and the Netherlands, suggest Covid was the direct cause of most excess deaths, but we currently don’t have enough evidence for most locations.”

The UK figures tally up at 173,000, which is close to the official estimate of Covid deaths. In other countries, some of which have less robust systems for assessing cause of death, the figures are much more inaccurate.

According to the findings, the five countries with the highest excess mortality rates since the pandemic began are Bolivia, Bulgaria, Eswatini, North Macedonia and Lesotho, while the lowest were in Iceland, Australia, Singapore, New Zealand and Taiwan.

Notably, the first group of countries were either in the developing world or Eastern Europe, with the former having less access to vaccines and the latter high rates of vaccine scepticism. The lowest figures are for island nations that were able to close their borders and keep case numbers very low, particularly in the period before vaccines arrived.

All this indicates that the success of the global pharmaceuticals sector in delivering billions of vaccines has had a major impact and that this may continue to be the case as the pandemic continues.

While lower income countries as a whole suffered the highest rates, these did also apply to some wealthier nations, like Italy – the first European country hit hard by the virus in 2020 – and parts of the US, where political allegiances often determine attitudes to masks and vaccines.

Indeed, the latter point is emphasised by Pew Research, which in its latest survey found only 60 per cent of Republicans had been double-jabbed by January this year, compared with 85 per cent of Democrats.

What this data does clearly emphasise is that the impact of Covid on global mortality has been much more substantial than the official figures show, with some countries not having the means to diagnose the cause of death accurately in every case. Moreover, the positive impact of the availability of vaccines and capacity of a country to isolate itself – especially islands – is also clear.

The researchers were at pains to point out that the pandemic is still far from over, despite the milder Omicron strain being predominant, as more variants with greater potential to cause severe death and disease may yet emerge.

In the UK, all restrictions have now been lifted, but the BA2 Omicron strain has been sweeping across the country, with over 552,000 positive tests returned in the week to March 18, a week-on-week rise of 38.1 per cent. However, over the same period deaths have risen just three per cent.