Measuring the COVID-19 Mortality Burden in the United States : A Microsimulation Study

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• Assessing the full mortality impact of COVID-19 requires quantifying years of life lost (YLLs) and quality-adjusted life-years (QALYs).
• Previous estimates focused primarily on excess deaths, potentially underestimating the pandemic's true burden.

Purpose of the Study:

• To measure YLLs and QALYs lost due to the COVID-19 pandemic.
• To analyze these losses by age, sex, race/ethnicity, and comorbidity status.

Main Methods:

• A state-transition microsimulation model was employed.
• Data sources included the Health and Retirement Study, Panel Study of Income Dynamics, CDC excess death data, and CMS nursing home data.
• The model simulated the U.S. population aged 25 and older over a lifetime horizon.

Main Results:

• The pandemic resulted in 6.62 million QALYs lost and 9.08 million YLLs by March 13, 2021.
• Over half of these losses (3.6 million QALYs) were among individuals aged 25-64.
• Black and Hispanic communities, particularly men aged 65+, experienced the highest QALY losses per capita.

Conclusions:

• The COVID-19 pandemic imposed a substantial life expectancy burden beyond excess deaths.
• This burden was disproportionately borne by younger adults (25-64) and minority communities.
• The findings highlight the need for comprehensive metrics to understand pandemic-related health disparities.