More Than 28 Million Excess Years of Life Lost During Pandemic

Megan Brooks

November 04, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

During the pandemic year of 2020, life expectancy dropped and more than 28 million extra years of life were lost in 31 countries. Men were hit much harder than women, a new analysis shows.

Excess years of life lost (YLL) in 2020 were more than five times higher than YLL as a result of seasonal influenza in 2015, the researchers write.

The study was published online November 3 in The BMJ.

Nazrul Islam, MBBS, PhD, with the University of Oxford, Oxford, United Kingdom, and colleagues estimated changes in life expectancy and excess YLL in 2020 in association with the COVID-19 pandemic in 37 upper-middle and high-income countries or regions for which there were reliable and complete mortality data.

In all 37 countries, life expectancy at birth increased among men and women between 2005 and 2019.

In 2020, however, life expectancy declined among both men and women in 31 of the countries studied. The exceptions were New Zealand, Taiwan, and Norway, where a gain in life expectancy was noted; and Denmark, Iceland, and South Korea, where no change in life expectancy occurred.

The biggest drop in life expectancy (in years) that was related to the pandemic occurred in Russia (-2.33 among men and -2.14 among women), the United States (-2.27 and -1.61, respectively), Bulgaria (-1.96 and -1.37, respectively), Lithuania (-1.83 and -1.21, respectively), Chile (-1.64 in men), and Spain (-1.11 in women).

In 2020, YLL topped expectations in all countries expect Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea.

In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million more than expected (17.3 million in men and 10.8 million in women), they report.

The most YLL (per 100,000) were in Bulgaria (7260 in men and 3730 in women), Russia (7020 in men and 4760 in women), Lithuania (5430 in men and 2640 in women), the United States (4350 in men and 2430 in women), Poland (3830 in men and 1830 in women), and Hungary (2770 in men and 1920 in women).

Excess YLL were relatively low among people younger than 65 years except in Russia, Bulgaria, Lithuania, and the United States, where the excess YLL were more than 2000 per 100,000.

Resiliency of Health Systems

The researchers say comparable or lower than expected YLL in Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea "underscore the importance of successful viral suppression and elimination policies, including targeted and population based public health policy interventions.

"A comprehensive pandemic preparedness aimed at more resilient health systems could be key to tackling the impact of future pandemics," they write.

Owing to a lack of mortality data, the analyses did not include most countries from Asia, Africa, and Latin America, the authors note. They were also unable account for some "critically important" factors, such as socioeconomic status and race or ethnicity.

They also were not able determine whether these excess deaths were directly caused by SARS-CoV-2 or were related to other causes.

Given that the COVID-19 pandemic is not over, future studies are needed to estimate the long-term burden of the pandemic, including direct and indirect effects, the researchers say.

The study had no specific funding. The original article includes a complete list of the authors' relevant financial relationships.

BMJ. Published online November 3, 2021. Full text

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