Assessing the potential impact of COVID-19 on life expectancy

Background The COVID-19 pandemic has caused a significant number of deaths worldwide. If the prevalence of the virus infection continues to rise, it can potentially have an impact on life expectancy. This paper provides first estimates of the potential impact of the COVID-19 pandemic on period life expectancy. Methods From the estimates of bias-adjusted age-specific case fatality rates in Hubei (China) and a range of six assumptions of prevalence rates ranging from 1% to 70%, we built a discrete-time microsimulation model that simulates the number of infected by COVID-19, the number of dying from it and the number of dying 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, South Eastern Asia, and Sub-Saharan African. For each region, 100,000 individuals per each 5-year age group are simulated. Results At 10% 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 South Eastern Asia and in Sub-Saharan Africa, one year lost in life expectancy corresponds to a prevalence of infection of about 15% and 25%, respectively. Given the uncertainty in fatality rates, with a prevalence of COVID-19 infections of 50% 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 South Eastern Asia and by 1 to 4 in Sub-Saharan Africa. In all prevalence scenarios, as long as the prevalence rate of COVID-19 infection remains below 1 or 2%, COVID-19 would not affect life expectancy in a substantial manner. Interpretation In the regions with relatively high life expectancy, for a prevalence of infection threshold above 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 the country back on their path of human development.