Estimating the burden of COVID-19 on mortality, life expectancy and lifespan inequality in England and Wales: A population-level study
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, when the first COVID-19 death was registered, to week 47 ending November 20, 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 standard deviation 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 females and males relative to the 2019 levels, respectively. Lifespan inequality also fell over the same period by five months for both sexes. Conclusion: Quantifying excess deaths and their impact on life expectancy at birth provides 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.
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