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Estimating the burden of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality in England and Wales: a population-level analysis
  1. Jose Manuel Aburto1,2,
  2. Ridhi Kashyap1,
  3. Jonas Schöley2,
  4. Colin Angus3,
  5. John Ermisch1,
  6. Melinda C Mills1,
  7. Jennifer Beam Dowd1
  1. 1 Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
  2. 2 Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
  3. 3 ScHARR, University of Sheffield, Sheffield, UK
  1. Correspondence to Dr Jose Manuel Aburto, Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford OX1 1JD, UK; jose-manuel.aburto{at}sociology.ox.ac.uk; Dr Ridhi Kashyap, Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford OX1 1JD, UK; ridhi.kashyap{at}nuffield.ox.ac.uk

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.

  • demography
  • epidemics
  • mortality

Data availability statement

Data are available in a public, open access repository. All data and code used for this article is available in an open access repository (https://github.com/OxfordDemSci/Excess-Deaths). The repository includes aggregated death counts used in this paper retrieved from the ONS form https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales. The data and code are accessible for public use.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Data availability statement

Data are available in a public, open access repository. All data and code used for this article is available in an open access repository (https://github.com/OxfordDemSci/Excess-Deaths). The repository includes aggregated death counts used in this paper retrieved from the ONS form https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales. The data and code are accessible for public use.

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Footnotes

  • Twitter @jm_aburto, @ridhikash07, @victimofmaths, @melindacmills, @drjenndowd

  • Contributors JMA, RK, JS and JBD contributed to the design of the study. JMA, RK and CA drafted the manuscript. JS and JMA performed the statistical analysis. All authors contributed to interpretation of data, revised the article critically for important intellectual content, and approved the final version of the manuscript. JMA and RK, the corresponding authors, attest that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

  • Funding JMA and RK acknowledge support from the British Academy Newton International Fellowship; JMA and JS acknowledge support from the Rockwool Foundation grant on Excess Deaths; JMA, RK, JBD and MCM were supported by Leverhulme Trust, John Fell Fund and H2020 European Research Council Advanced Grant 835 079. CA was supported by the SIPHER Consortium (https://sipher.ac.uk/), part of the UK Prevention Research Partnership (MR/S037578/1), an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities. Weblink: https://ukprp.org/

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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