Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark.
J Epidemiol Community Health. 2021 Aug;75(8):735-740. doi: 10.1136/jech-2020-215505. Epub 2021 Jan 19.
Deaths directly linked to COVID-19 infection may be misclassified, and the pandemic may have indirectly affected other causes of death. To overcome these measurement challenges, we estimate the impact of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality from week 10 of 2020, when the first COVID-19 death was registered, to week 47 ending 20 November 2020 in England and Wales through an analysis of excess mortality.
We estimated age and sex-specific excess mortality risk and deaths above a baseline adjusted for seasonality with a systematic comparison of four different models using data from the Office for National Statistics. We additionally provide estimates of life expectancy at birth and lifespan inequality defined as the SD in age at death.
There have been 57 419 (95% prediction interval: 54 197, 60 752) excess deaths in the first 47 weeks of 2020, 55% of which occurred in men. Excess deaths increased sharply with age and men experienced elevated risks of death in all age groups. Life expectancy at birth dropped 0.9 and 1.2 years for women and men relative to the 2019 levels, respectively. Lifespan inequality also fell over the same period by 5 months for both sexes.
Quantifying excess deaths and their impact on life expectancy at birth provide a more comprehensive picture of the burden of COVID-19 on mortality. Whether mortality will return to-or even fall below-the baseline level remains to be seen as the pandemic continues to unfold and diverse interventions are put in place.
与 COVID-19 感染直接相关的死亡可能被错误分类，大流行可能间接地影响了其他死因。为了克服这些测量挑战，我们通过分析超额死亡率，从 2020 年第 10 周（首次记录 COVID-19 死亡）到 2020 年 11 月 20 日第 47 周，估算了 COVID-19 大流行对英格兰和威尔士死亡率、预期寿命和寿命不平等的影响。
我们使用来自国家统计局的数据，通过系统比较四种不同模型，估计了特定年龄和性别的超额死亡率风险以及调整季节性后的基线以上的死亡人数。我们还提供了出生时预期寿命和寿命不平等的估计值，后者定义为死亡时年龄的标准差。
在 2020 年的前 47 周中，已有 57419 例（95%预测区间：54197，60752）超额死亡，其中 55%发生在男性中。超额死亡随着年龄的增长而急剧增加，男性在所有年龄组中都面临更高的死亡风险。与 2019 年相比，出生时预期寿命分别下降了 0.9 和 1.2 年。同期，两性的寿命不平等也下降了 5 个月。
定量评估超额死亡及其对出生时预期寿命的影响，提供了更全面的 COVID-19 对死亡率负担的了解。随着大流行的继续发展和实施各种干预措施，死亡率是否会恢复到甚至低于基线水平还有待观察。
