It’s a throwaway comment that’s been made by those accusing governments of overreacting to the coronavirus crisis, that most COVID-19 deaths are occurring in people who would have soon died anyway.
So Dr. David McAllister and colleagues decided to measure the estimated number of years of life lost as a result of COVID-19.
According to their analysis, men are losing, on average, 13 years of their lives, and women, 11 years.
Even after accounting for high blood pressure, diabetes and other common chronic conditions found in people dying of the pandemic virus, death from COVID-19 resulted in more than a decade of life lost per person, the analysis shows, similar to the years of life lost from heart disease.
As societies move to return to some kind of normal, “we need to be honest with people and tell them regardless of what decisions are made that there are going to be people dying who sadly might not have otherwise died,” said McAllister, of the University of Glasgow and a consultant in public health medicine at Public Health Scotland.
As of Friday morning, there were 192,125 confirmed deaths from COVID-19 globally, according to Johns Hopkins University. When severe, COVID-19 causes acute respiratory failure.
But the raw counts of deaths give a distorted picture of the true death toll, because raw counts don’t consider how long someone who died from COVID-19 might otherwise have been expected to live, McAllister and his co-authors wrote.
In their paper published in Wellcome Open Research, that’s still awaiting peer review, the researchers estimated years of life lost from COVID-19 using published data from 6,801 deaths in Italy. They looked at what proportion had one or more of 11 common chronic conditions, including heart failure, stroke, hypertension, diabetes and chronic obstructive pulmonary disease.
Then, using World Health Organization life tables and health-care data from Wales, “we looked at how long people with those 11 different conditions, and in different combinations of those conditions would be expected to live. Then we basically subtracted one from the other,” McAllister said.
Medical staff applaud as a woman greets her mother (C), who was healed from the coronavirus (COVID-19) after having spend more than a month in a coma, upon her discharge from the hospital in the city of Ariana near the capital Tunis on April 24, 2020.
FETHI BELAID/AFP via Getty Images
“So, from Wales we could find out that an 80-year-old person who had high blood pressure and diabetes, but who didn’t have kidney disease might be expected to live seven years,” he said. “That means an 80-year-old with COVID-19 who had that same set of conditions had lost seven years of life.”
The researchers focused on deaths in the 50-plus age group, mainly because there were so few deaths in people younger, and also because there isn’t the same commentary when people under 50 die, McAllister said. “Nobody is suggesting they only had a short time to live,” McAllister said.
The estimated years of life lost, or YLL, was over a decade for the COVID-19 deaths, and factoring in underlying diseases didn’t drastically change it — meaning most people “lost considerably more than the ‘1-2’ years suggested by some commentators,” the researchers wrote.
Undoubtedly there are people who are having worse outcomes following things like heart attacks and strokes as a consequence of the fact they're frightened to go to hospital
In Canada, about half of COVID-19 deaths have occurred in nursing homes. McAllister said his group’s analysis shouldn’t be applied to nursing home residents, “because it’s really a very special population.” However, of confirmed cases in Canada, about one third (38 per cent) are in people 60 and older.
McAllister called the years of life lost in the Italian deaths “substantial,” though perhaps not so surprising, because among older people, having a chronic condition like diabetes doesn’t, in and of itself, affect life expectancy that much.
But as countries move to reopen, “this is one half of a balancing judgement that needs to be made.”
Policymakers need to weigh the effects of COVID-19 on life and death, and the effects of the lockdowns on life and death, he said. “It’s not an easy decision.”
Already, there are serious concerns about the impact forced joblessness and social isolation are having on people’s physical and mental health, as well as unnervingly quiet emergency rooms.
“Undoubtedly there are people who are having worse outcomes following things like heart attacks and strokes as a consequence of the fact they’re frightened to go to hospital,” McAllister said.
“We need to do a similar exercise for these indirect effects of COVID-19 in order to make sensible decisions.”
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