18m excess deaths attributed to pandemic (not counting 2022 it seems)

The paper doesn't say (because we don't yet have research with any conclusions it seems) what happened. Was it that the virus in its various strains was stronger than thought, or was it people not able to access health care, or was it due to preventative measures, or what?

It's expected there will be repercussions going forward as well, as people who avoided or weren't able to get diagnoses for things didn't know or weren't able to be treated in a timely manner.

Paper in the Lancet