Asian Demographic Research Institute, Shanghai University, Shanghai, China.
Wittgenstein Centre for Demography and Global Human Capital (Univ. Vienna, IIASA, VID/ÖAW), International Institute for Applied Systems Analysis (IIASA), Laxenburg, Austria.
PLoS One. 2020 Sep 17;15(9):e0238678. doi: 10.1371/journal.pone.0238678. eCollection 2020.
The COVID-19 virus pandemic has caused a significant number of deaths worldwide. If the prevalence of the infection continues to grow, this could impact life expectancy. This paper provides first estimates of the potential direct impact of the COVID-19 pandemic on period life expectancy.
From the estimates of bias-adjusted age-specific infection fatality rates in Hubei (China) and a range of six prevalence rate assumptions ranging from 1% to 70%, we built a discrete-time microsimulation model that simulates the number of people infected by COVID-19, the number dying from it, and the number of deaths from all causes week by week for a period of one year. We applied our simulation to four broad regions: North America and Europe; Latin America and the Caribbean; Southeastern Asia; and sub-Saharan African. For each region, 100,000 individuals per each 5-year age group are simulated.
At a 10% COVID-19 prevalence rate, the loss in life expectancy at birth is likely above 1 year in North America and Europe and in Latin America and the Caribbean. In Southeastern Asia and sub-Saharan Africa, one year lost in life expectancy corresponds to an infection prevalence of about 15% and 25%, respectively. Given the uncertainty in fatality rates, with a 50% prevalence of COVID-19 infections under 95% prediction intervals, life expectancy would drop by 3 to 9 years in North America and Europe, by 3 to 8 years in Latin America and the Caribbean, by 2 to 7 years in Southeastern Asia, and by 1 to 4 years in sub-Saharan Africa. In all prevalence scenarios, as long as the COVID-19 infection prevalence rate remains below 1 or 2%, COVID-19 would not affect life expectancy in a substantial manner.
In regions with relatively high life expectancy, if the infection prevalence threshold exceeds 1 or 2%, the COVID-19 pandemic will break the secular trend of increasing life expectancy, resulting in a decline in period life expectancy. With life expectancy being a key indicator of human development, mortality increase, especially among the vulnerable subgroups of populations, would set a country back on its path of human development.
新冠病毒大流行在全球范围内造成了大量死亡。如果感染的流行率继续增长，这可能会影响预期寿命。本文首次估算了新冠大流行对期间预期寿命的潜在直接影响。
我们根据中国湖北省校正后偏倚的年龄特异性感染病死率估计数和 1%至 70%的六个流行率假设范围，建立了一个离散时间微观模拟模型，该模型每周模拟一次新冠感染人数、死于该病的人数和所有原因死亡人数，为期一年。我们将模拟应用于四个广泛的地区：北美洲和欧洲；拉丁美洲和加勒比；东南亚；以及撒哈拉以南非洲。每个地区模拟 10 万名 5 岁年龄组的个体。
在 10%的新冠流行率假设下，在北美洲和欧洲以及拉丁美洲和加勒比，出生时预期寿命的损失可能超过 1 年。在东南亚和撒哈拉以南非洲，预期寿命损失 1 年对应于感染率约为 15%和 25%。鉴于病死率的不确定性，如果 95%预测区间内 50%的新冠感染率，那么在北美洲和欧洲，预期寿命将下降 3 至 9 年；在拉丁美洲和加勒比，下降 3 至 8 年；在东南亚，下降 2 至 7 年；在撒哈拉以南非洲，下降 1 至 4 年。在所有流行率假设下，只要新冠感染率低于 1%或 2%，新冠大流行就不会对预期寿命产生实质性影响。
在预期寿命相对较高的地区，如果感染流行率超过 1%或 2%，新冠大流行将打破预期寿命增加的长期趋势，导致期间预期寿命下降。预期寿命是人类发展的关键指标，死亡率的上升，尤其是在脆弱的人口亚群中，将使一个国家的人类发展进程倒退。
