Countries with a stronger predicted GDP decline in 2020 have also seen a larger number of deaths in excess of official Covid-19 fatalities. Historical data show that recessions are systematically associated with higher mortality, especially in developing economies. Following a recession, death rates remain elevated for several years. The eventual death toll of Covid-19 may be understated if the impact of the pandemic-induced recession is neglected. Limiting the economic fallout of the pandemic could also reduce excess mortality.