In the first two years of the Covid-19 pandemic, countries reported that 5.4 million people died of Covid-19. Tragic as this was, it is almost certainly an underestimate. At WHO we estimate during those same 2 years when we include indirect effects, or what we call excess mortality associated with Covid-19, the death toll was closer to 14.9 million deaths. In 2022 an additional 1.5 million deaths were reported. But for the exchange of scientific data, it could have been much worse.