Europeans Have Lost Millions of Years of Life to COVID

As the COVID-19 pandemic paralyzed much of the world in 2020-2022, 289 million people in Europe lost nearly 17 million years of life, according to a new study in PLOS Medicine.

The study distinguished years lost from the direct and indirect impacts of COVID and estimated disability-free years of lost life. Its findings reflect how the pandemic worsened socioeconomic inequalities and overburdened healthcare systems, highlighting the need to prepare policies and allocate resources to deal with future pandemics.

The research team, from the United Kingdom, Poland, Finland, and the United States, built a computational model in which people older than 35 years could switch between eight states of health, from being disease-free to combinations of cardiovascular disease, cognitive impairment, dementia, disability, and ultimately, death. They fed the model with population and mortality data from several sources and used it to predict how much longer people would have lived if the pandemic had not happened. In total, the populations of 18 European countries lost 16.8 million years to the pandemic, nearly two thirds of which would have been lived without disability and independently.

“This is an important analysis,” said Martin McKee, MD, DSc , professor in European public health at the London School of Hygiene and Tropical Medicine, London, England, who wasn’t involved in the study. “We are seeing systematic attempts to downplay the effects of the pandemic, with many of those most active now being appointed to leadership positions in the United States. This study shows that death rates substantially underestimate the harms caused by the pandemic and that vaccines don’t just save lives — they reduce disability.”

Unequal Burdens

The number of years lost in each country varied with gross domestic product (GDP), with poorer countries seeing more years lost. There were also more years lost to men than to women, as well as to older people. In fact, 90% of the nearly 17 million lost years were among people aged 65 years or older. This finding highlights the benefit of targeting vaccination efforts towards the elderly, who are most vulnerable to COVID-19.

“Despite the notion that most of lost lives related to the pandemic were in poor health, a large proportion of the years of life lost would have been without disability,” said the study’s lead author, Sara Ahmadi-Abhari, MD, PhD, lecturer in the epidemiology of ageing at Imperial College London, London, England.

Vaccination rates reduced the number of years lost, and the effect was independent of GDP, somewhat counterbalancing socioeconomic inequalities. For instance, despite having a relatively low GDP per capita, Portugal lost roughly as many years per capita as Germany thanks to a very high per capita vaccine dosage.

Healthcare Disruption and Long-Term Impact

The number of years lost from COVID dropped from 2021 to 2022 as vaccines became available. However, years lost due to non-COVID deaths continued to rise even as vaccines were rolled out. Nearly half of the years lost in 2022 were because of non-COVID deaths.

The continuing increase in years lost to non-COVID deaths reflects the indirect impact of the pandemic and its longer-term effects. As healthcare systems became overburdened, care for conditions other than COVID was reduced or delayed. In addition, lockdowns and other containment measures led to lifestyle changes that could negatively affect health, such as reduced physical activity or social interaction.

“The early phase of the pandemic had profound consequences for healthcare. Health workers experienced burnout, and some died. There was huge disruption, and this continued after the vaccine became available, to some extent because of inadequate uptake,” said McKee.

More research is needed to understand the impact of different policies and the resulting disruptions. Likewise, mitigating the effects of socioeconomic inequalities in a future pandemic is a major challenge. “The substantial loss in years of life, particularly given more than half would have been lived without disability, underscores the critical need for a comprehensive pandemic preparedness program, which could provide both immediate and long-term public health benefits,” said Ahmadi-Abhari.

The study was independently funded by Imperial College London and the European Institute of Innovation and Technology. Ahmadi-Abhari reported no relevant financial relationships.