The number of Palestinians killed in the first eight months of the Israeli war on Gaza is estimated to exceed 64,000, nearly 40 percent higher than the official death toll, a new study has found.

The report, published by The Lancet medical journal on Thursday, draws on data from the Palestinian Ministry of Health, its online survey and social media obituaries.

The study estimates that between 7 October 2023 and 30 June 2024, between 55,298 and 78,525 Palestinians died from “traumatic injuries”.

By 30 June, the ministry had reported a death toll of 37,877.

The study’s best estimate puts the number of deaths at 64,260 by that date, representing nearly 3 percent of Gaza’s pre-war population.

It also found that 59 percent of those killed were women, children and elderly people.

However, The Lancet figures do not account for deaths caused by lack of medical care, food shortages or those believed to be buried under rubble.

Earlier this week, the Palestinian health ministry reported that the death toll had surpassed 46,000 since the war began on 7 October.

Potential death toll could exceed 186,000  

A letter published in The Lancet last year by a group of experts estimated that the actual death toll of Palestinians in Gaza could exceed 186,000.

At that time, the official death toll, according to the Palestinian health ministry, was 38,153.

The letter stressed that this figure was likely a significant underestimate, as it excluded thousands of people believed to be buried under rubble and the growing number of “indirect” deaths caused by the destruction of Gaza’s food distribution, healthcare and sanitation systems.

“The total death toll is expected to be large given the intensity of this conflict; destroyed healthcare infrastructure; severe shortages of food, water, and shelter; the population’s inability to flee to safe places; and the loss of funding to Unrwa, one of the very few humanitarian organisations still active in the Gaza Strip,” the letter said.

The experts estimated that the number of bodies still buried under rubble likely exceeds 10,000.