By the end of May, an estimated 385,000 people had died as a direct result of the coronavirus as the deadly infection swept across the globe.

But researchers have found the total loss of life was much higher.

New research from the Imperial College London reveals there have been 206,000 previously unreported deaths in 19 European countries as well as Australia and New Zealand.

Spain, England and Wales were the worst-hit nations with nearly 100 excess deaths per 100,000 people. It’s an increase of 37% for England and Wales and 38% for Spain, relative to levels without a pandemic.

Hundreds voice their opposition to lockdown rules in Melbourne earlier in October. Photo: AAP

Professor Hamish McCallum from Griffith University says the important paper helps clear the controversy surrounding whether people die “from coronavirus” or “with coronavirus” and instead captures overall impact.

“Using ‘excess deaths’ to estimate the impact of the pandemic gets around this problem,” he says.

“The idea is to compare the number of deaths from all causes this year with the number of deaths over the same months in the last few years. The difference between the two numbers is the ‘excess deaths’.”

“If COVID is causing lots of deaths, even if it is undiagnosed or death is attributed to other factors, it will appear as excess deaths.”

While the study doesn’t determine why there are such significant differences between similar countries, the authors speculate it is linked to three broad areas which urgently require further research.

The authors of the report published in Nature Medicine wrote the timing, duration, and severity of lockdown periods played a central role.

“This is mostly due to the fact that delayed or ineffective partial lockdown measures failed to limit the spread of the virus, which resulted in exponentially increasing number of people getting infected, ultimately resulting in higher mortality.”

“Also, extent and availability of testing as well as the effectiveness of tracing and isolation of contacts likely contributed significantly to the overall mortality.

Secondly, the differences between public health effectiveness vary wildly country to country despite similar funding levels.

And finally, authors suggested that lockdowns, timely initiated, reduced mortality from COVID-19 as they limited the number of infected individuals.

However, other experts said the study’s findings came with a caveat.

“Lockdowns undoubtedly have significant negative short- and long-term consequences, including adverse psychological and economic effects,” Dr Alex Polyakov, an epidemiologist at the University of Melbourne said.

“A lockdown strategy should be the mechanism of last resort and can largely be avoided, or significantly shortened, if effective testing, tracing, and isolation measures are in place,” Dr Polyakov warned.