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COVID-19's impact on life expectancy is worse than anticipated

Mortality rates increased in most countries due to the global Coronavirus pandemic that began in 2020. This led to changes in life expectancy that were more severe in some countries than in others. Previous global epidemics have seen life expectancies recover fairly rapidly afterwards, but this has not been the case in all countries as the current pandemic has progressed. New research published in the journal Nature Human Behavior.has found that, in some countries, deficits in life expectancy continue to persist more than two years after the start of the pandemic.

Scientists from Oxford’s Leverhulme Centre for Demographic Science and the Max Planck Institute for Demographic Research used data from 29 countries, including those in Europe, as well as Chile and the U.S., to assess whether life expectancy had ‘bounced back’ to pre-pandemic levels. They found that life expectancy in 2021 remained lower than would be predicted across all 29 countries, had pre-pandemic trends continued. They say that COVID-19 has caused a protracted shock to life expectancy levels, leading to global mortality changes that are unprecedented in the last 70 years.

This finding about the magnitude and distribution of mortality due to COVID-19 confounds claims that the disease has had no more impact than a flu-like illness. Life expectancy losses during recurring flu epidemics over the second-half of the 20th century have been much smaller and less widespread than those seen in the current pandemic.

The researchers identified a clear geographical divide between Western and Eastern European countries that appeared in 2021. Those in Western Europe experienced life expectancy bounce backs from the sharp losses in 2020. Sweden, Switzerland, Belgium and France saw complete bounce backs, and returned to pre-pandemic (2019) life expectancy levels. England and Wales, on the other hand, saw partial bounce backs from 2020 levels in 2021. Life expectancy in Scotland and Northern Ireland, however, still remained at the same depressed level as seen in 2020. 

But Eastern Europe and the U.S. witnessed worsening or compounded losses in life expectancy over the same period. The scale of life expectancy losses during the COVID-19 pandemic in Eastern Europe were akin to those last seen at the break-up of the Soviet Union, according to the research. 

The authors state that this East-West difference in life expectancy during COVID-19 generally reflects bigger losses in countries that had lower pre-pandemic life expectancy levels to start with. Bulgaria was the worst-hit of the countries studied, with a decline in life expectancy of nearly 43 months, over two years of the pandemic. Furthermore, the study’s results show that “Bulgaria, Chile, Croatia, Czech Republic, Estonia, Germany, Greece, Hungary, Lithuania, Poland, and Slovakia suffered substantially higher life expectancy deficits in 2021 compared to 2020, indicating a worsening mortality burden over the course of the pandemic.”

There was also an apparent vaccination effect that followed the same East-West divide in Europe. Countries with higher proportions of fully vaccinated people experienced smaller life expectancy deficits. Older people, especially those over 80 who had seen the bulk of deaths in 2020, benefitted from vaccine protection and suffered less excess mortality in 2021.

“A notable shift between 2020 and 2021 was that the age patterns of excess mortality shifted in 2021 towards younger age groups, as vaccines began to protect the old,” said study co-author Dr. Ridhi Kashyap. But there were ‘outliers’ that had surprisingly high life expectancy deficits, in spite of high vaccination rates. 

“Finer-grained details of the age prioritization of vaccine roll-out and the types of vaccines used may account for some of these differences, as well as correlations between vaccine uptake and compliance with non-pharmaceutical interventions or the overall health care system capacity,” explained study co-author Dr. Jonas Schöley. 

“Countries, such as Sweden, Switzerland, Belgium and France, managed a recovery to pre-pandemic levels of life expectancy because they managed to protect both the old and the young.”

The research team expresses concern about the possible wider international impact of the pandemic. “In 2020, losses in life expectancy suffered in Brazil and Mexico exceeded those experienced in the U.S., so it is likely these countries may have continued suffering mortality impacts in 2021 – even potentially exceeding the 43 months we estimated for Bulgaria,” said study co-author Dr. José Manuel Aburto.

‘It is plausible that countries with ineffective public health responses will see a protracted health crisis induced by the pandemic with medium-term stalls in life expectancy improvements, while other regions manage a smoother recovery to return to pre-pandemic trends,” wrote the researchers.

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By Alison Bosman, Staff Writer

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