Despite vaccinations, COVID-19 death toll likely to increase into April

Published December 3, 2020

New IHME pandemic projections

Over next four months, wearing masks, avoiding gatherings, mounting effective response to address hospital overcrowding vital to reduce deaths as winter surge continues

SEATTLE, WA – The Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine released new forecasts today that incorporate expected rollout of a COVID-19 vaccine for all countries. The projections show that even with expected vaccine rollout, the United States is forecast to see 539,000 deaths by April 1. Especially in Northern Hemisphere countries currently experiencing a winter surge, continued vigilance to control the spread of the virus will be necessary for several months.  

“Mass scale-up of vaccination in 2021 means we have a path back to normal life, but there are still a few rough months ahead,” said Dr. Christopher Murray, IHME director. “We must be vigilant in protecting ourselves at least through April, when, as our projections indicate, vaccines will begin to have an impact.”

The forecasts now include scenarios of rapid vaccine rollout, expected rollout, and no vaccine. A rapid vaccine rollout is forecast to reduce the death toll to 528,000 in the US. The forecasts show that if mask-wearing increased to 95%, combined with expected vaccine rollout, approximately 66,000 lives could be saved, compared to a vaccine rollout scenario with current mask-wearing levels remaining the same. Even with a vaccine, if states do not act to bring current surges under control, the death toll could reach 770,000 by April 1.

“Especially in the Northern Hemisphere, it’s crucial for governments to impose or re-impose mandates that limit gatherings and require masks. Where the winter surge is driving spikes in infections, there will be many people who can still become infected and possibly die before the vaccine is fully rolled out,” said Murray.

In the US, the expected vaccine rollout only reduces the death toll by April 1 by 9,000 deaths. Rapid rollout targeting high-risk groups, compared to no vaccination, can reduce the death toll from 548,000 to 524,000 deaths. The increase in warmer temperatures and then rising vaccination rates will lead to steady declines in the daily death toll that will start in February and continue into March and subsequent months.  

The vaccine rollout estimates incorporate vaccine hesitancy, available doses, vaccine effectiveness, and number of vaccinations per day. They are calibrated for each country or region based on pre-purchasing agreements and health care access. In the US, expected rollout assumes a scale-up to full delivery capacity over 90 days, with a maximum of 3 million doses per day, which is the peak level at which influenza vaccines are delivered each year. The rapid rollout halves the scale-up time and doubles the doses to 6 million per day. Full descriptions of all the scenarios are available in the policy briefings accessible via the visualization.

The IHME visualization also includes estimated infections, daily deaths, hospital resource needs (beds, ICU beds, and ventilators), and mobility.

IHME’s projections are based on an epidemiological model that includes data on cases, deaths, and antibody prevalence, as well as location-specific COVID-19 testing rates, mobility, social distancing mandates, mask use, population density and age structure, and pneumonia seasonality, which shows a strong correlation with the trajectory of COVID-19. 

The new projections, including additional forecasts of daily infections, are available at and will be regularly updated moving forward.

Contacts: [email protected]

About the Institute for Health Metrics and Evaluation

The Institute for Health Metrics and Evaluation (IHME) is an independent global health research organization at the University of Washington School of Medicine that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME is committed to transparency and makes this information widely available so that policymakers have the evidence they need to make informed decisions on allocating resources to improve population health.