COVID-19 continued to hit life expectancy in 2021 in unvaccinated populations and Eastern Europe

COVID-19 has caused a protracted shock to life expectancy levels, leading to global mortality changes unprecedented in the last 70 years, according to research published in Nature Human Behaviour from Oxford’s Leverhulme Centre for Demographic Science and the Max Planck Institute for Demographic Research.

Using data from 29 countries in Europe, as well as Chile and the US, the researchers found life expectancy in 2021 remained lower than expected across all 29 countries, had pre-pandemic trends continued.

Previous global epidemics have seen fairly rapid ‘bounce-backs’ to life expectancy levels. But the magnitude and persistence of COVID-19’s impact on mortality has been very different from 'a bad flu'.

Visualisation (left) by study co-author Luyin Zhang, Leverhulme Centre, showing the impact of the COVID-19 pandemic on life expectancy in different countries studied.

A clear geographical divide

The researchers found most countries in Western Europe experienced life expectancy bounce-backs from the sharp losses in 2020. Sweden, Switzerland, Belgium and France saw complete bounce-backs, returning to pre-pandemic 2019 life expectancy levels. England and Wales saw partial bounce-backs, recovering some of the losses from 2020 but not back to 2019 levels. Life expectancy in Scotland and Northern Ireland, however, remained at the same depressed level as 2020.

In contrast, Eastern Europe and the US witnessed worsening losses in life expectancy over the same period. The scale of life expectancy losses during the COVID-19 pandemic in Eastern Europe were akin to those last seen at the break-up of the Soviet Union, according to the research. 

Visualisation (left) by Luyin Zhang, showing the impact of the COVID-19 pandemic on life expectancy across the UK.

Vaccine uptake likely contributed to the East-West mortality divide in Europe

Countries with higher proportions of fully vaccinated people experienced smaller life expectancy deficits. Older ages, especially those over 80 who had seen the bulk of deaths in 2020, benefitted from vaccine protection and a decline in excess mortality in 2021. 

Visualisation (above) by study co-author Jonas Schöley from the Max Planck Institute, showing the effect of mortality shocks on life expectancy.

Dr Ridhi Kashyap, a study co-author from Oxford, points out, ‘A notable shift between 2020 and 2021 was that the age patterns of excess mortality shifted in 2021 towards younger age groups, as vaccines began to protect the old.’

Vaccine coverage at older ages was on average lower in Eastern European countries and the US.  Dr Jonas Schöley, from the Max Planck Institute, adds, ‘Countries, such as Sweden, Switzerland, Belgium and France, managed a recovery to pre-pandemic levels of life expectancy because they managed to protect both the old and the young.’

International impact of COVID-19

The research team voices concern, about the possible wider international impact of the pandemic.

Study co-author Dr José Manuel Aburto, says, ‘In 2020, losses in life expectancy suffered in Brazil and Mexico exceeded those experienced in the US, so it is likely these countries may have continued suffering mortality impacts in 2021 – even potentially exceeding the 43 months we estimated for Bulgaria.' 

The paper concludes by noting the diverging experiences of countries as the pandemic continues.  Countries with low vaccine uptake or poor public health responses will be likely to continue to suffer life expectancy losses while other countries will manage to return to pre-pandemic trends. 

Read the full paper here