Life-expectancy loss during the COVID-19 pandemic: decomposition using individual-level mortality data

We study life-expectancy loss (LEL) from the COVID-19 pandemic in the U.S. from March 2020 through April 2023. We use individual-level death-certificate data and the cohort-based approach to life expectancy. We also examine how LEL varies with age, gender, race/ethnicity, county-level socio-economic status (county-SES). The U.S. recorded 983 000 COVID-19 deaths. The COVID-19 Mortality Rate (COVID-MR, the fraction of the population who died of COVID-19) was 0.30%. An upper bound estimate of years of life lost per person (YLL) is 14.6 years (thus population loss of 14.32 million life-years). Estimated LEL based on this YLL estimate was 0.043 years (16 days). However, LEL rose rapidly with age averaging 8 weeks for ages 75+. LEL was substantially higher for Native Americans, Blacks, and Hispanics than for Whites at all ages. LEL also increased as county-SES decreased. Our cohort-based LEL estimates are a small fraction of period-based estimates during the pandemic, which were based on mortality in a particular year and assumed the pandemic would continue indefinitely with no change in severity. Using current life expectancies, cohort-based LEL for the COVI|D-19 pandemic was a fraction of LEL for the 1918 influenza pandemic (14 weeks), but well above three recent, severe influenza seasons (average of 0.12 weeks).