This file contains COVID-19 death counts and rates by month and year of death, jurisdiction of residence (U.S., HHS Region) and demographic characteristics (sex, age, race and Hispanic origin, and age/race and Hispanic origin). United States death counts and rates include the 50 states, plus the District of Columbia. Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1. Number of deaths reported in this file are the total number of COVID-19 deaths received and coded as of the date of analysis and may not represent all deaths that occurred in that period. Counts of deaths occurring before or after the reporting period are not included in the file. Data during recent periods are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction and cause of death. Death counts should not be compared across jurisdictions. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly. The ten (10) United States Department of Health and Human Services (HHS) regions include the following jurisdictions. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada; Region 10: Alaska, Idaho, Oregon, Washington. Rates were calculated using the population estimates for 2021, which are estimated as of July 1, 2021 based on the Blended Base produced by the US Census Bureau in lieu of the April 1, 2020 decennial population count. The Blended Base consists of the blend of Vintage 2020 postcensal population estimates, 2020 Demographic Analysis Estimates, and 2020 Census PL 94-171 Redistricting File (see https://www2.census.gov/programs-surveys/popest/technical-documentation/methodology/2020-2021/methods-statement-v2021.pdf). Rate are based on deaths occurring in the specified week and are age-adjusted to the 2000 standard population using the direct method (see https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-08-508.pdf). These rates differ from annual age-adjusted rates, typically presented in NCHS publications based on a full year of data and annualized weekly age-adjusted rates which have been adjusted to allow comparison with annual rates. Annualization rates presents deaths per year per 100,000 population that would be expected in a year if the observed period specific (weekly) rate prevailed for a full year. Sub-national death counts between 1-9 are suppressed in accordance with NCHS data confidentiality standards. Rates based on death counts less than 20 are suppressed in accordance with NCHS standards of reliability as specified in NCHS Data Presentation Standards for Proportions (available from: https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf.).

This file contains COVID-19 death counts, death rates, and percent of total deaths by jurisdiction of residence. The data is grouped by different time periods including 3-month period, weekly, and total (cumulative since January 1, 2020). United States death counts and rates include the 50 states, plus the District of Columbia and New York City. New York state estimates exclude New York City. Puerto Rico is included in HHS Region 2 estimates.

Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1. Number of deaths reported in this file are the total number of COVID-19 deaths received and coded as of the date of analysis and may not represent all deaths that occurred in that period. Counts of deaths occurring before or after the reporting period are not included in the file.

Data during recent periods are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction and cause of death.

Death counts should not be compared across states. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly.

The ten (10) United States Department of Health and Human Services (HHS) regions include the following jurisdictions. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York, New York City, Puerto Rico; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada; Region 10: Alaska, Idaho, Oregon, Washington.

Rates were calculated using the population estimates for 2021, which are estimated as of July 1, 2021 based on the Blended Base produced by the US Census Bureau in lieu of the April 1, 2020 decennial population count. The Blended Base consists of the blend of Vintage 2020 postcensal population estimates, 2020 Demographic Analysis Estimates, and 2020 Census PL 94-171 Redistricting File (see https://www2.census.gov/programs-surveys/popest/technical-documentation/methodology/2020-2021/methods-statement-v2021.pdf).

Rates are based on deaths occurring in the specified week/month and are age-adjusted to the 2000 standard population using the direct method (see https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-08-508.pdf). These rates differ from annual age-adjusted rates, typically presented in NCHS publications based on a full year of data and annualized weekly/monthly age-adjusted rates which have been adjusted to allow comparison with annual rates. Annualization rates presents deaths per year per 100,000 population that would be expected in a year if the observed period specific (weekly/monthly) rate prevailed for a full year.

Sub-national death counts between 1-9 are suppressed in accordance with NCHS data confidentiality standards. Rates based on death counts less than 20 are suppressed in accordance with NCHS standards of reliability as specified in NCHS Data Presentation Standards for Proportions (available from: https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf.).

In 2021, the death rate in the United States stood at **** deaths per 1,000 of the population. This is a slight increase from the previous year, when the death rate stood at **** deaths per 1,000 of the population.

In 2023, about **** million deaths were reported in the United States. This figure is an increase from **** million deaths reported in 1990, and from **** in 2019. This sudden increase can be attributed to the COVID-19 pandemic.

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

The graph displays the number of deaths per year in the United States from 1950 to 2025. The x-axis represents the years, abbreviated from '50 to '25, while the y-axis indicates the annual number of deaths. Over this 75-year period, the number of deaths ranges from a low of 1,479,684 in 1950 to a high of 3,492,879 in 2021. Notable figures include 2,430,923 deaths in 2001 and 3,090,000 projected deaths in 2024. The data exhibits a general upward trend in annual deaths over the decades, with significant increases in recent years. This information is presented in a line graph format, effectively highlighting the long-term trends and yearly variations in deaths across the United States.

Estimates of excess deaths can provide information about the burden of mortality potentially related to the COVID-19 pandemic, including deaths that are directly or indirectly attributed to COVID-19. Excess deaths are typically defined as the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods. This visualization provides weekly estimates of excess deaths by the jurisdiction in which the death occurred. Weekly counts of deaths are compared with historical trends to determine whether the number of deaths is significantly higher than expected.Counts of deaths from all causes of death, including COVID-19, are presented. As some deaths due to COVID-19 may be assigned to other causes of deaths (for example, if COVID-19 was not diagnosed or not mentioned on the death certificate), tracking all-cause mortality can provide information about whether an excess number of deaths is observed, even when COVID-19 mortality may be undercounted. Additionally, deaths from all causes excluding COVID-19 were also estimated. Comparing these two sets of estimates — excess deaths with and without COVID-19 — can provide insight about how many excess deaths are identified as due to COVID-19, and how many excess deaths are reported as due to other causes of death. These deaths could represent misclassified COVID-19 deaths, or potentially could be indirectly related to the COVID-19 pandemic (e.g., deaths from other causes occurring in the context of health care shortages or overburdened health care systems).Estimates of excess deaths can be calculated in a variety of ways, and will vary depending on the methodology and assumptions about how many deaths are expected to occur. Estimates of excess deaths presented in this webpage were calculated using Farrington surveillance algorithms (1). A range of values for the number of excess deaths was calculated as the difference between the observed count and one of two thresholds (either the average expected count or the upper bound of the 95% prediction interval), by week and jurisdiction.Provisional death counts are weighted to account for incomplete data. However, data for the most recent week(s) are still likely to be incomplete. Weights are based on completeness of provisional data in prior years, but the timeliness of data may have changed in 2020 relative to prior years, so the resulting weighted estimates may be too high in some jurisdictions and too low in others. As more information about the accuracy of the weighted estimates is obtained, further refinements to the weights may be made, which will impact the estimates. Any changes to the methods or weighting algorithm will be noted in the Technical Notes when they occur. More detail about the methods, weighting, data, and limitations can be found in the Technical Notes.This visualization includes several different estimates:Number of excess deaths: A range of estimates for the number of excess deaths was calculated as the difference between the observed count and one of two thresholds (either the average expected count or the upper bound threshold), by week and jurisdiction. Negative values, where the observed count fell below the threshold, were set to zero.Percent excess: The percent excess was defined as the number of excess deaths divided by the threshold.Total number of excess deaths: The total number of excess deaths in each jurisdiction was calculated by summing the excess deaths in each week, from February 1, 2020 to present. Similarly, the total number of excess deaths for the US overall was computed as a sum of jurisdiction-specific numbers of excess deaths (with negative values set to zero), and not directly estimated using the Farrington surveillance algorithms.Select a dashboard from the menu, then click on “Update Dashboard” to navigate through the different graphics.The first dashboard shows the weekly predicted counts of deaths from all causes, and the threshold for the expected number of deaths. Select a jurisdiction from the drop-down menu to show data for that jurisdiction.The second dashboard shows the weekly predicted counts of deaths from all causes and the weekly count of deaths from all causes excluding COVID-19. Select a jurisdiction from the drop-down menu to show data for that jurisdiction.The th

This dataset of U.S. mortality trends since 1900 highlights the differences in age-adjusted death rates and life expectancy at birth by race and sex. Age-adjusted death rates (deaths per 100,000) after 1998 are calculated based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years between 2000 and 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Data on age-adjusted death rates prior to 1999 are taken from historical data (see References below). Life expectancy data are available up to 2017. Due to changes in categories of race used in publications, data are not available for the black population consistently before 1968, and not at all before 1960. More information on historical data on age-adjusted death rates is available at https://www.cdc.gov/nchs/nvss/mortality/hist293.htm. SOURCES CDC/NCHS, National Vital Statistics System, historical data, 1900-1998 (see https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm); CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES National Center for Health Statistics, Data Warehouse. Comparability of cause-of-death between ICD revisions. 2008. Available from: http://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm. National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf. Arias E, Xu JQ. United States life tables, 2017. National Vital Statistics Reports; vol 68 no 7. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf. National Center for Health Statistics. Historical Data, 1900-1998. 2009. Available from: https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm.

Provisional estimates of excess mortality, adjusted numbers of deaths, and expected numbers of deaths to monitor weekly death trends in Canada. Given the delays in receiving the data from the provincial and territorial vital statistics offices, death data have been adjusted to account for undercoverage. Data in this table will be available by province and territory.

As of April 26, 2023, around 27 percent of total COVID-19 deaths in the United States have been among adults 85 years and older, despite this age group only accounting for two percent of the U.S. population. This statistic depicts the distribution of total COVID-19 deaths in the United States as of April 26, 2023, by age group.

Provisional deaths registration data for single year of age and average age of death (median and mean) of persons whose death involved coronavirus (COVID-19), England and Wales. Includes deaths due to COVID-19 and breakdowns by sex.

Effective September 27, 2023, this dataset will no longer be updated. Similar data are accessible from wonder.cdc.gov.

Estimates of excess deaths can provide information about the burden of mortality potentially related to COVID-19, beyond the number of deaths that are directly attributed to COVID-19. Excess deaths are typically defined as the difference between observed numbers of deaths and expected numbers. This visualization provides weekly data on excess deaths by jurisdiction of occurrence. Counts of deaths in more recent weeks are compared with historical trends to determine whether the number of deaths is significantly higher than expected.

Estimates of excess deaths can be calculated in a variety of ways, and will vary depending on the methodology and assumptions about how many deaths are expected to occur. Estimates of excess deaths presented in this webpage were calculated using Farrington surveillance algorithms (1). For each jurisdiction, a model is used to generate a set of expected counts, and the upper bound of the 95% Confidence Intervals (95% CI) of these expected counts is used as a threshold to estimate excess deaths. Observed counts are compared to these upper bound estimates to determine whether a significant increase in deaths has occurred. Provisional counts are weighted to account for potential underreporting in the most recent weeks. However, data for the most recent week(s) are still likely to be incomplete. Only about 60% of deaths are reported within 10 days of the date of death, and there is considerable variation by jurisdiction. More detail about the methods, weighting, data, and limitations can be found in the Technical Notes.

The Plague of Justinian was an outbreak of bubonic plague that ravaged the Mediterranean and its surrounding area, between 541 and 767CE. It was likely the first major outbreak of bubonic plague in Europe, and possibly the earliest pandemic to have been recorded reliably and with relative accuracy. Contemporary scholars described the symptoms and effects of the disease in detail, and these matched descriptions of the Black Death and Third Pandemic, leading most historians to believe that this was bubonic plague. It was also assumed that the plague originated in sub-Saharan Africa, before making its way along the Nile to Egypt, and then across the Mediterranean to Constantinople. In 2013, scientists were able to confirm that Justinian's Plague was in fact Yersinia pestis (the bacteria which causes bubonic plague), and recent theories suggest that the plague originated in the Eurasian Steppes, where the Black Death and Third Pandemic are also thought to have originated from, and that it was brought to Europe by the Hunnic Tribes of the sixth century. Plague of Justinian The pandemic itself takes its name from Emperor Justinian I, who ruled the Byzantine Empire (or Eastern Roman Empire) at the time of the outbreak, and who actually contracted the disease (although he survived). Reports suggest that Constantinople was the hardest hit city during the pandemic, and saw upwards of five thousand deaths per day during the most severe months. There are a multitude of sources with differing estimates for the plague's death toll, with most ranging between 25 and 100 million. Until recently, scholars assumed that the plague killed between one third and 40 percent of the world's population, with populations in infected regions declining by up to 25 percent in early years, and up to 60 percent over two centuries. The plague was felt strongest during the initial outbreak in Constantinople, however it remained in Europe for over two centuries, with the last reported cases in 767. Pre-2019 sources vary in their estimates, with some suggesting that up to half of the world's population died in the pandemic, while others state that it was just a quarter of the Mediterranean or European population; however most of them agree that the death toll was in the tens of millions. Historians have also argued about the plague's role in the fall of the Roman Empire, with opinions ranging from "fundamental" to "coincidental", although new evidence is more aligned with the latter theories. Challenging theories As with the recent studies which propose a different origin for the disease, one study conducted by researchers in Princeton and Jerusalem calls into question the accuracy of the death tolls estimated by historians in the 19th and 20th centuries. In 2019, L. Mordechai and M. Eisenberg published a series of papers suggesting that, although the plague devastated Constantinople, it did not have the same impact as the Black Death. The researchers argue that modern historians have taken a maximalist approach to the death tolls of the pandemic, and have applied the same models of distribution to Justinian's Plague as they believe occurred during the Black Death; however there is little evidence to support this. They examine the content and number of contemporary texts, as well archaeological, agricultural and genetic evidence which shows that the plague did spread across Europe, but did not seem to cause the same societal upheaval as the Black Death. It is likely that there will be further investigation into this outbreak in the following years, which may shed more light on the scale of this pandemic.

The graph illustrates the number of deaths per day in the United States from 1950 to 2025. The x-axis represents the years, abbreviated from '50 to '24, while the y-axis indicates the daily number of deaths. Over this 75-year period, the number of deaths per day ranges from a low of 4,054 in 1950 to a high of 9,570 in 2021. Notable figures include 6,855 deaths in 2010 and 8,333 in 2024. The data shows a general upward trend in daily deaths over the decades, with recent years experiencing some fluctuations. This information is presented in a line graph format, effectively highlighting the long-term trends and yearly variations in daily deaths across the United States.

United States Excess Death excl COVID: Predicted: Total Estimate: South Dakota data was reported at 600.000 Number in 16 Sep 2023. This stayed constant from the previous number of 600.000 Number for 09 Sep 2023. United States Excess Death excl COVID: Predicted: Total Estimate: South Dakota data is updated weekly, averaging 600.000 Number from Jan 2017 (Median) to 16 Sep 2023, with 350 observations. The data reached an all-time high of 600.000 Number in 16 Sep 2023 and a record low of 600.000 Number in 16 Sep 2023. United States Excess Death excl COVID: Predicted: Total Estimate: South Dakota data remains active status in CEIC and is reported by Centers for Disease Control and Prevention. The data is categorized under Global Database’s United States – Table US.G012: Number of Excess Deaths: by States: All Causes excluding COVID-19: Predicted (Discontinued).

This dataset presents the age-adjusted death rates for the 10 leading causes of death in the United States beginning in 1999. Data are based on information from all resident death certificates filed in the 50 states and the District of Columbia using demographic and medical characteristics. Age-adjusted death rates (per 100,000 population) are based on the 2000 U.S. standard population. Populations used for computing death rates after 2010 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for non-census years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause of death statistics are based on the underlying cause of death. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. Murphy SL, Xu JQ, Kochanek KD, Curtin SC, and Arias E. Deaths: Final data for 2015. National vital statistics reports; vol 66. no. 6. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_06.pdf.

This dataset describes drug poisoning deaths at the county level by selected demographic characteristics and includes age-adjusted death rates for drug poisoning from 1999 to 2015. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2015 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Estimate does not meet standards of reliability or precision. Death rates are flagged as “Unreliable” in the chart when the rate is calculated with a numerator of 20 or less. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Estimates should be interpreted with caution. Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year during 1999–2015. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates are unavailable for Broomfield County, Colo., and Denali County, Alaska, before 2003 (6,7). Additionally, Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. County boundaries are consistent with the vintage 2005-2007 bridged-race population file geographies (6).

Excess Death excl COVID: Predicted: Total Estimate: Hawaii data was reported at 1,382.000 Number in 16 Sep 2023. This stayed constant from the previous number of 1,382.000 Number for 09 Sep 2023. Excess Death excl COVID: Predicted: Total Estimate: Hawaii data is updated weekly, averaging 1,382.000 Number from Jan 2017 (Median) to 16 Sep 2023, with 350 observations. The data reached an all-time high of 1,382.000 Number in 16 Sep 2023 and a record low of 1,382.000 Number in 16 Sep 2023. Excess Death excl COVID: Predicted: Total Estimate: Hawaii data remains active status in CEIC and is reported by Centers for Disease Control and Prevention. The data is categorized under Global Database’s United States – Table US.G012: Number of Excess Deaths: by States: All Causes excluding COVID-19: Predicted (Discontinued).

The data shows the year, state and region wise estimated birth rates, death rates, infant mortality rates by residence

Note: Infant Mortality Rate for smaller States & Union Territories are based on three-years period 2013-15.

The Black Death was the largest and deadliest pandemic of Yersinia pestis recorded in human history, and likely the most infamous individual pandemic ever documented. The plague originated in the Eurasian Steppes, before moving with Mongol hordes to the Black Sea, where it was then brought by Italian merchants to the Mediterranean. From here, the Black Death then spread to almost all corners of Europe, the Middle East, and North Africa. While it was never endemic to these regions, it was constantly re-introduced via trade routes from Asia (such as the Silk Road), and plague was present in Western Europe until the seventeenth century, and the other regions until the nineteenth century. Impact on Europe In Europe, the major port cities and metropolitan areas were hit the hardest. The plague spread through south-western Europe, following the arrival of Italian galleys in Sicily, Genoa, Venice, and Marseilles, at the beginning of 1347. It is claimed that Venice, Florence, and Siena lost up to two thirds of their total population during epidemic's peak, while London, which was hit in 1348, is said to have lost at least half of its population. The plague then made its way around the west of Europe, and arrived in Germany and Scandinavia in 1348, before travelling along the Baltic coast to Russia by 1351 (although data relating to the death tolls east of Germany is scarce). Some areas of Europe remained untouched by the plague for decades; for example, plague did not arrive in Iceland until 1402, however it swept across the island with devastating effect, causing the population to drop from 120,000 to 40,000 within two years. Reliability While the Black Death affected three continents, there is little recorded evidence of its impact outside of Southern or Western Europe. In Europe, however, many sources conflict and contrast with one another, often giving death tolls exceeding the estimated population at the time (such as London, where the death toll is said to be three times larger than the total population). Therefore, the precise death tolls remain uncertain, and any figures given should be treated tentatively.