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EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329072

ABSTRACT

Background The COVID-19 pandemic triggered an unprecedented rise in mortality that translated into life expectancy losses around the world, with only a few exceptions. In 2021, life expectancy trends globally diverged more due to the unequal impact of the pandemic across countries, variation in the age-patterns of mortality, and differences in vaccination. We estimate life expectancy changes in 29 countries since 2020, attribute them to mortality changes by age group, and compare them to historic life expectancy shocks. Data Total death counts by age and sex came from the Short-term Mortality Fluctuations and Human Mortality databases. Registered COVID-19 deaths and vaccination counts by age and sex were sourced from the COVerAGE-DB database. Midyear population counts were extracted from the UN World Population Prospects database. Methods Life expectancy for females, males, and the total population were calculated for 29 countries for 2020 and 2021. Additionally, we calculated life expectancy deficits for 2020 and 2021 based on pre-pandemic Lee-Carter forecasts of short-term life expectancy trends. Using demographic decomposition techniques, age- and COVID-19 specific contributions to changes and deficits in life expectancy were calculated. Deficits in life expectancy in 2021 across countries were compared to country vaccination rates. 95% uncertainty intervals were derived from Poisson replications of death counts. Findings Out of 29 countries, 14 countries lost life expectancy in both 2020 and 2021, 12 recovered losses in 2020 but not all of them back to 2019 levels, 2 exceeded pre-pandemic life expectancy, and 1 dropped below 2019 levels only in 2021. All 29 countries had lower life expectancy in 2021 than expected had pre-pandemic trends continued. The female life expectancy advantage increased for most countries, consistent with hypotheses that females are more resilient to mortality crises than men. Life expectancy losses were moderately correlated with measures of vaccination uptake. One notable change from 2020 was that mortality at younger ages contributed more to life expectancy losses in 2021. Registered COVID-19 deaths accounted for most losses of life expectancy. Interpretation In 2021 we saw divergence in the impact of the pandemic on population health. While some countries saw bounce-backs from stark life expectancy losses, others experienced sustained and substantial life expectancy deficits. While COVID-19 has been the most severe global mortality shock since the Second World War, this observed heterogeneity in 2021 indicates that pathways to long-term recovery of life expectancy trends remain unclear. Funding British Academy’s Newton International Fellowship grant NIFBA19/190679 (J.M.A., R.K.);ROCK-WOOL Foundation’s Excess Deaths grant (J.M.A., I.K.);Leverhulme Trust Large Centre Grant (J.M.A., L.Z., R.K., J.B.D.);European Research Council grant ERC-2021-CoG-101002587 (MOR-TAL) (J.B.D.);University of Oxford John Fell Fund (J.M.A., L.Z., R.K., J.B.D.);Estonian Research Council grant PSG 669 (H.J.). Research in context Evidence before this study The COVID-19 pandemic disrupted mortality trends around the world. Most high-income countries experienced life expectancy declines in 2020, and emerging evidence from low-to-middle income shows substantial losses in life expectancy with large regional variation. These analyses emphasise the impact of COVID-19 deaths and also highlight the effect of excess mortality at older ages as the main contributor to life expectancy losses, although in some countries working-age mortality also contributed substantially to life expectancy reductions. Only a few countries including Denmark, Norway, Finland, Australia, South Korea, Iceland and New Zealand did not experience life expectancy losses. Added value of this study We estimate life expectancy for 29 countries in 2020/21 and assess bounce-backs versus mounting losses. We determine which age groups contributed most to life expec ancy changes in 2021, and analyze how age patterns of excess mortality changed between 2020 and 2021. By projecting pre-pandemic mortality trends into 2020/21 we calculate the life expectancy deficit induced by the pandemic. We compare age-specific life expectancy deficits in 2021 against vaccination uptake by age group and further decompose the deficit into contributions from COVID-19 versus non-COVID mortality. To contextualize the magnitude of life expectancy loss, we compare the 2020/21 COVID-19 pandemic with historic mortality shocks over the 20th century. We report results for females, males and the total population. Implications of all the available evidence Life expectancy is an important summary measure of population health. Over the past decade, improvements in life expectancy have slowed in several countries. The COVID-19 pandemic has compounded these trends and disrupted life expectancy improvements across the globe. The pandemic increased life expectancy inequalities between countries, as life expectancy losses were higher among countries with lower pre-pandemic life expectancy. COVID-19 may be a short-term mortality shock, but it is unclear whether countries will bounce back to increasing life expectancy trends in the short- or medium-term. New variants continue the spread of SARS-CoV-2 globally. Variation in preventive measures and vaccine uptake has led to disparate mortality burdens across countries. The long-term mortality impacts of social and economic stressors due to the pandemic are not known, neither are the mortality implications of regular re-infection or Long-COVID. Going forward, it is crucial to understand how and why death rates vary across and within countries.

3.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307039

ABSTRACT

Social distancing and isolation have been introduced widely to counter the COVID-19 pandemic. However, more moderate contact reduction policies become desirable owing to adverse social, psychological, and economic consequences of a complete or near-complete lockdown. Adopting a social network approach, we evaluate the effectiveness of three targeted distancing strategies designed to 'keep the curve flat' and aid compliance in a post-lockdown world. These are limiting interaction to a few repeated contacts, seeking similarity across contacts, and strengthening communities via triadic strategies. We simulate stochastic infection curves that incorporate core elements from infection models, ideal-type social network models, and statistical relational event models. We demonstrate that strategic reduction of contact can strongly increase the efficiency of social distancing measures, introducing the possibility of allowing some social contact while keeping risks low. This approach provides nuanced insights to policy makers for effective social distancing that can mitigate negative consequences of social isolation.

4.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-294013

ABSTRACT

Variations in the age patterns and magnitudes of excess deaths, as well as differences in population sizes and age structures make cross-national comparisons of the cumulative mortality impacts of the COVID-19 pandemic challenging. Life expectancy is a widely-used indicator that provides a clear and cross-nationally comparable picture of the population-level impacts of the pandemic on mortality. Life tables by sex were calculated for 29 countries, including most European countries, Chile, and the USA for 2015-2020. Life expectancy at birth and at age 60 for 2020 were contextualised against recent trends between 2015-19. Using decomposition techniques, we examined which specific age groups contributed to reductions in life expectancy in 2020 and to what extent reductions were attributable to official COVID-19 deaths. Life expectancy at birth declined from 2019 to 2020 in 27 out of 29 countries. Males in the USA and Lithuania experienced the largest losses in life expectancy at birth during 2020 (2.2 and 1.7 years respectively), but reductions of more than an entire year were documented in eleven countries for males, and eight among females. Reductions were mostly attributable to increased mortality above age 60 and to official COVID-19 deaths. The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since WW-II in Western Europe or the breakup of the Soviet Union in Eastern Europe. Females from 15 countries and males from 10 ended up with lower life expectancy at birth in 2020 than in 2015.

5.
Int J Epidemiol ; 51(1): 63-74, 2022 02 18.
Article in English | MEDLINE | ID: covidwho-1437834

ABSTRACT

BACKGROUND: Variations in the age patterns and magnitudes of excess deaths, as well as differences in population sizes and age structures, make cross-national comparisons of the cumulative mortality impacts of the COVID-19 pandemic challenging. Life expectancy is a widely used indicator that provides a clear and cross-nationally comparable picture of the population-level impacts of the pandemic on mortality. METHODS: Life tables by sex were calculated for 29 countries, including most European countries, Chile and the USA, for 2015-2020. Life expectancy at birth and at age 60 years for 2020 were contextualized against recent trends between 2015 and 2019. Using decomposition techniques, we examined which specific age groups contributed to reductions in life expectancy in 2020 and to what extent reductions were attributable to official COVID-19 deaths. RESULTS: Life expectancy at birth declined from 2019 to 2020 in 27 out of 29 countries. Males in the USA and Lithuania experienced the largest losses in life expectancy at birth during 2020 (2.2 and 1.7 years, respectively), but reductions of more than an entire year were documented in 11 countries for males and 8 among females. Reductions were mostly attributable to increased mortality above age 60 years and to official COVID-19 deaths. CONCLUSIONS: The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since World War II in Western Europe or the breakup of the Soviet Union in Eastern Europe. Females from 15 countries and males from 10 ended up with lower life expectancy at birth in 2020 than in 2015.


Subject(s)
COVID-19 , Europe/epidemiology , Female , Humans , Infant, Newborn , Life Expectancy , Male , Middle Aged , Mortality , Pandemics , Research Design , SARS-CoV-2
6.
J Epidemiol Community Health ; 75(8): 735-740, 2021 08.
Article in English | MEDLINE | ID: covidwho-1038423

ABSTRACT

BACKGROUND: Deaths directly linked to COVID-19 infection may be misclassified, and the pandemic may have indirectly affected other causes of death. To overcome these measurement challenges, we estimate the impact of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality from week 10 of 2020, when the first COVID-19 death was registered, to week 47 ending 20 November 2020 in England and Wales through an analysis of excess mortality. METHODS: We estimated age and sex-specific excess mortality risk and deaths above a baseline adjusted for seasonality with a systematic comparison of four different models using data from the Office for National Statistics. We additionally provide estimates of life expectancy at birth and lifespan inequality defined as the SD in age at death. RESULTS: There have been 57 419 (95% prediction interval: 54 197, 60 752) excess deaths in the first 47 weeks of 2020, 55% of which occurred in men. Excess deaths increased sharply with age and men experienced elevated risks of death in all age groups. Life expectancy at birth dropped 0.9 and 1.2 years for women and men relative to the 2019 levels, respectively. Lifespan inequality also fell over the same period by 5 months for both sexes. CONCLUSION: Quantifying excess deaths and their impact on life expectancy at birth provide a more comprehensive picture of the burden of COVID-19 on mortality. Whether mortality will return to-or even fall below-the baseline level remains to be seen as the pandemic continues to unfold and diverse interventions are put in place.


Subject(s)
COVID-19/psychology , Cost of Illness , Life Expectancy , Longevity , Mortality , Pandemics , Adolescent , COVID-19/epidemiology , Cause of Death , Child , Child, Preschool , England/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , SARS-CoV-2 , Wales/epidemiology
7.
SSM Popul Health ; 13: 100721, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-989265

ABSTRACT

Research suggests trust in experts and authorities are important correlates of compliance with public health measures during infectious disease outbreaks. Empirical evidence on the dynamics of reliance on scientists and public health authorities during the early phases of an epidemic outbreak is limited. We examine these processes during the COVID-19 outbreak in Italy by leveraging data from Twitter and two online surveys, including a survey experiment. We find that reliance on experts followed a curvilinear path. Both Twitter and survey data showed initial increases in information-seeking from expert sources in the three weeks after the detection of the first case. Consistent with these increases, knowledge about health information linked to COVID-19 and support for containment measures was widespread, and better knowledge was associated with stronger support for containment policies. Both knowledge and containment support were positively associated with trust in science and public health authorities. However, in the third week after the outbreak, we detected a slowdown in responsiveness to experts. These processes were corroborated with a survey experiment, which showed that those holding incorrect beliefs about COVID-19 gave no greater - or even lower - importance to information when its source was stated as coming from experts than when the source was unstated. Our results suggest weakened trust in public health authorities with prolonged exposure to the epidemic as a potential mechanism for this effect. Weakened responsiveness to expert sources may increase susceptibility to misinformation and our results call for efforts to sustain trust in adapting public health response.

8.
Nat Hum Behav ; 4(6): 588-596, 2020 06.
Article in English | MEDLINE | ID: covidwho-531316

ABSTRACT

Social distancing and isolation have been widely introduced to counter the COVID-19 pandemic. Adverse social, psychological and economic consequences of a complete or near-complete lockdown demand the development of more moderate contact-reduction policies. Adopting a social network approach, we evaluate the effectiveness of three distancing strategies designed to keep the curve flat and aid compliance in a post-lockdown world. These are: limiting interaction to a few repeated contacts akin to forming social bubbles; seeking similarity across contacts; and strengthening communities via triadic strategies. We simulate stochastic infection curves incorporating core elements from infection models, ideal-type social network models and statistical relational event models. We demonstrate that a strategic social network-based reduction of contact strongly enhances the effectiveness of social distancing measures while keeping risks lower. We provide scientific evidence for effective social distancing that can be applied in public health messaging and that can mitigate negative consequences of social isolation.


Subject(s)
Communicable Disease Control/methods , Coronavirus Infections/prevention & control , Models, Theoretical , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Social Isolation , Social Networking , COVID-19 , Humans
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