More than 28 million extra years of life were lost in 2020 in 31 high- and upper-middle income countries, an international study reports today.
All countries examined – except for Taiwan, New Zealand, Denmark, Iceland, Norway, and South Korea – reported more premature deaths than expected, particularly among men.
Writing in the latest edition of The BMJ, the study said the highest rates of excess premature deaths were in Russia, Bulgaria, Lithuania, and the USA.
An international team of researchers, led by Dr Nazrul Islam from the Nuffield Department of Population Health, University of Oxford, compared the observed life expectancy and years of life lost in 2020 with those that would be expected, based on historical trends from 2005-2019 in 37 upper-middle and high-income countries.
Between 2005 and 2019, life expectancy at birth increased in both men and women in all the countries studied, but in 2020, there was a decline in life expectancy in all countries except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy.
There was no evidence of a change in life expectancy in Denmark, Iceland, and South Korea.
The most marked decline in life expectancy was in Russia, which recorded 2.33 years loss in men and 2.14 years in women. This was followed by the USA, which saw a decline of 2.27 years in men and 1.61 years in women.
Years of life lost declined in most countries in both men and women between 2005 and 2019, except Canada, Greece, Scotland, Taiwan, and the USA.
In 2020, years of life lost were higher than expected in all countries except Taiwan and New Zealand, where there was a reduction in years of life lost, and Iceland, South Korea, Denmark, and Norway, where there was no evidence of a change in years of life lost.
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.
The highest excess years of life lost per 100,000 were in Russia, where it was 7,020 per 100,000 in men and 4,760 in women, Bulgaria (7,260 in men and 3,730 in women), Lithuania (5,430 in men and 2,640 in women), and the USA (4,350 in men and 2,430 in women).
The report adds that excess years of life lost to the COVID-19 pandemic in 2020 were more than five times higher at 2,510 per 100,000 than those associated with the seasonal influenza epidemic in 2015, which was 458 per 100,000.
“Our findings of a comparable or lower than expected YLL in Taiwan, New Zealand, Denmark, Iceland, Norway, and South Korea underscore the importance of successful viral suppression and elimination policies, including targeted and population based public health policy interventions,” they write.
“As many of the effects of the pandemic might take a longer time frame to have a measurable effect on human lives, continuous and timely monitoring of excess YLL would help identify the sources of excess mortality and excess YLL in population subgroups.”
A debate published in The BMJ today asks if COVID passes and vaccine passports should be introduced to avoid further lockdowns in the UK.
Researchers from the Tony Blair Institute for Global Change in London argue that COVID passes are a useful tool for people to prove they are either fully vaccinated against coronavirus, have immunity from a previous infection or have recently tested negative for COVID-19.
They highlight the first phase of the government’s Events Research Programme pilot as a success as it detected 28 cases of COVID-19 in 7,764 participants who completed the full testing requirements.
When they looked at a June 2021 model of the virus’s spread, created by researchers at Imperial College London for the UK’s Scientific Advisory Group for Emergencies (SAGE), their analysis showed that if the government had made COVID passes mandatory for crowded indoor and mass attendance settings in England after restrictions were lifted on 19 July, cases and deaths could have been reduced by as much as 30%.
However, Imogen Parker, associate director at Ada Lovelace Institute, London, and policy fellow at Centre for Science and Policy, University of Cambridge, disagrees, saying the passes reduce risk but do not guarantee safety.
She pointed to the Boardmasters Festival, which took place in Cornwall in August, which used vaccine passports with additional testing, but became a “super-spreader” event, incubating almost 5,000 cases.
Although the Ada Lovelace Institute did not rule out passports as a valid tool to help transition from lockdowns, it called for models on their public health effects to compare with other tools and technical design standards.
Parker writes that passports introduce “profound risks” into society such as the risk through segregation of introducing barriers to economic and social participation as some people might not want to or be unable to be vaccinated.
There was also a risk of creating “enduring surveillance technology”, she added.
Islam N, Jdanov DA, Shkolnikov VM et al. Effects of COVID-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries. BMJ 4 November 2021
Sleat D, Innes K, Parker I. Are vaccine passports and COVID passes a valid alternative to lockdown? BMJ 4 November 2021
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