The COVID-19 Report
While COVID-19 as an event has driven headline reductions in life expectancy of 1.3 years in men and 0.9 year in women, this over-simplifies. The most pronounced effects are in vulnerable groups where inequality has widened, while broader trend changes will depend far more on little-understood factors like variants, long COVID and socio-economic impacts on longevity.
The report is a comprehensive review of COVID-19 effects and responses up to October 2021, bearing in mind that the pandemic is still evolving. It is intended as a resource for professional users of longevity data including actuaries, risk managers, public health professionals, epidemiologists and researchers. It asks ‘what do we know?’, ‘what have we learned?’ and ‘what are the uncertainties’ over a range of issues that could potentially drive the pandemic and longevity going forward.
Some key learnings and future challenges include:
- The pandemic has cost an estimated 155,000 lives in the UK and more than 4.5m lives globally, and while its impact has been profound, the data suggests that approximately 76% of total COVID deaths were in patients in the top 5% for highest predicted risk. These risk factors are varied, including everything from heart disease to obesity. By far the most substantial of these is age, with the risk of death increasing about 10% for each year of age.
- The emergence of variants of the SARS-CoV-2, such as the Alpha and Delta variants, have led to rapid spreads in parts of the world notably in India, the UK and US. The potential emergence of faster-spreading, more fatal or vaccine-evading variants is a risk going forward. However, effective vaccination programmes could also mean that COVID-19 would become less harmful and like the ‘common cold’.
- At least 20 vaccines have been approved globally against the SARS-CoV-2, with more in the pipeline. In general, they markedly reduce hospitalisation and death rates, but may not fully prevent future infection and transmission. This ‘leakiness’ when combined with the risk of waning immunity and massive global inequalities in vaccine availability and rollout could lead to continued circulation of the virus in all countries in the near future.
- There is a backlog in diagnosis and treatment in the NHS for other conditions which will take many years to catch up. It may impact death rates as late diagnosis of major killers like cancer and heart disease lead to earlier death.
- Gap in life expectancy between people in different socio-economic circumstances had been wide even before the pandemic. The more deprived have suffered higher rates of infection, hospitalisation and mortality during the pandemic. An endemic COVID-19 scenario might continue to disadvantage them, widening the life expectancy gap.
- Improved hygiene, work from home and mask-wearing would have suppressed influenza infection in the UK and globally in 2020. Success in managing influenza would contribute to more stable rise in longevity trends. However, there is a risk of ‘rebound’ of influenza cases due to reduced immunity from a lack of exposure to the virus and increased social interactions in the population.
- Mortality improvements in many higher income countries had slowed since the 2008 recession before the pandemic. The aftershock of the pandemic on health care system, society and economy may continue to suppress mortality improvements in the near future.
- The pandemic has spurred scientific innovation and collaboration from immunology and vaccine science through new approaches to collection and processing of health data and organisation of health care.
Dame Karen Dunnell, Chair of Longevity Science Panel concluded: “The pandemic has had a devastating impact on us. On the other hand, it has unleashed many untapped resources of energy, flexibility, innovation and “can do” approach to challenges. However, potential emergence of faster-spreading or more virulent variants could still cause problems, requiring continual surveillance. Success in managing the pandemic will require effective global efforts in immunisation, monitoring, healthcare, public behaviour and scientific developments.”
Professor Debora Price, Professor of Social Gerontology at the University of Manchester said: “The pandemic has plainly exposed the many structural and systemic inequalities in our societies that people live with from day to day and that have become a matter of life and death. Health inequalities have worsened, and for women, the pandemic has exacerbated existing inequalities in almost all areas of life, setting the equality agenda back decades. If we are to learn anything from this experience, it must surely be that we critically examine the unequal distribution of power and resources from the local to the global, and work out how to create a more equal society through social investment and social protection.”
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