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Average lifetime lost (ALL): a descriptive statistic for assessing disease fatality with a COVID-19 example
  1. Elizabeth D Hathaway
  1. Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
  1. Correspondence to Elizabeth D Hathaway, Department of Health & Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, USA; Elizabeth-hathaway{at}

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An opportunity exists for the addition of statistical measures to aid in Center for Disease Control & Prevention’s fulfilment of its goals for COVID-19 surveillance. The average lifetime lost (ALL) statistic attempts to measure the loss caused by a disease. This statistic will give another way to judge how deadly or benign, in an average sense, a disease is. This statistic may lower population anxiety by objectively demonstrating that the actual lifetime shortening effect of a disease is quite small. It will also give a way to make meaningful comparisons between different groups, diseases and treatment strategies.

Below the ALL statistic is defined and an example calculation is given for the COVID-19 data for Georgia, USA, using the official data from the Georgia Department of Public Health as of May 22, 2020 at 19:00.1

Assume the existence of a population p= {I1,I2,…,In} of n infected individuals who have contracted the disease of interest. For the ith individual Ii, we define the average lifetime lost value ALLi as follows: Embedded Image 1aEmbedded Image 1b

and Embedded Image 1c

Then, the ALL statistic is defined as the mean: Embedded Image 2

The conditional expected lifespan Ei in (1b) gives the opportunity to consider current age, race, sex and comorbidity information, whenever it is available.

According to the Georgia Department of Health’s Daily Status Report from May 22, 2020, positive COVID-19 cases for Georgians equalled 42 049, of which, 1806 had resulted in death.1 Of the 1806 individuals who died of COVID, age and sex were given for all but one individual. Therefore, using National Center for Health Statistics 2017 life expectancy tables, ALLi was calculated for 1805 deceased and 40 243 surviving Georgians.2 As an example, ALLi for myself, a 34-year-old woman, equals 48.3 years. Georgia ALL was computed as follows: Embedded Image 3

ALL on May 22, 2020 rounds to 0.60 years, meaning the average actual lifetime shortening effect for Georgians who contracted COVID-19 was slightly above half a year.

The ALL statistic is a simple and helpful statistic for public health officials and decision-makers to use as they decide when to issue the ‘ALL clear’ for their communities.



  • Contributors EDH is the sole author of this work.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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