The Impact of Covid-19 on Higher-Age Mortality
Main Article Content
Abstract
We propose a simple model for accelerated deaths that draws on the observation that many of those who died from Covid-19 were often, but not always, much less healthy than the average for their age group; further, the vast majority who died were over the age of 50. The model predicts that, in the absence of additional secondary effects, the impact on the life expectancy of survivors (the anti-selection effect) will be very small, and that the degree of impact depends on the average years of life lost by those who die from Covid-19. The philosophy underpinning the model is supported by reference to both all-cause mortality by age and all-cause mortality by socio-economic deprivation group. In combination, these support a proportionality link between Covid-19 mortality and individual frailty or death rates. The Accelerated Deaths Model is consistent with the mortality experience associated with respiratory diseases over the period 2013-15 and with past seasonal influenza epidemics.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
Bhaskaran, K., Rentsch, C. T., Hickman, G, Hulme, W. J., Schultze. A., Curtis, H.J, Wing, K., Warren-Gash, C., Tomlinson, L., Bates, C. J., Mathur, R., MacKenna, B., Mahalingasivam, V., Wong, A., Walker, A. J., Morton, C. E., Grint, D., Mehrkar, A., Eggo, R. M., Inglesby, P., Douglas, I. J., McDonald, H. I., Cockburn, J., Williamson, E. J., Evans, D., Parry, J., Hester, F., Harper, S., Evans, S. J. W., Bacon, S., Smeeth, L., and Goldacre, B. (2022) Overall and cause-specific hospitalisation and death after Covid-19 hospitalisation in England: A cohort study using linked primary care, secondary care, and death registration data in the OpenSAFELY platform. PLoS Med 19(1): e1003871. DOI: doi.org/10.1371/journal.pmed.1003871
Cairns, A.J.G., Blake, D., Kessler, A., Kessler, M., and Mathur, R. (2024) Covid‑19 mortality: The Proportionality Hypothesis. European Actuarial Journal. DOI: doi.org/10.1007/s13385-024-00400-9
Cairns, A.J.G., Wen, J., and Kleinow, T. (2024) Drivers of mortality: Risk factors and inequality. Journal of the Royal Statistical Society (Series A), 187: 989-1012
Carannante, M., D’Amato, V., and Iaccarino, G. (2022) The future evolution of the mortality acceleration due to the COVID-19: The Charlson Comorbidity Index in stochastic setting. Frontiers in Cardiovascular Medicine, 9. DOI: 10.3389/fcvm .2022.938086
Case, A. and Deaton, A. (2015) Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Woodrow Wilson School of Public and International Affairs and Department of Economics, Princeton University, Princeton, NJ 08544.
Case, A. and Deaton, A. (2017) Mortality and morbidity in the 21st century. Brookings Papers on Economic Activity, Spring: 397-476.
Continuous Mortality Investigation (2019) Regular monitoring of England & Wales. CMI Working Paper 111.
Docherty, A.B., Harrison, E. M., Green, C. A., Hardwick, H. E., Pius, R., Norman, L., Holden, K. A., Read, J. M., Dondelinger, F., Carson, G., Merson, L., Lee, J., Plotkin, D., Sigfrid, L., Halpin, S., Jackson, C., Gamble, C., Horby, P. W., Nguyen-Van-Tam, J. S., Dunning, J., Openshaw, P. J. M., Baillie, J. K., and Semple, M. G. (2020) Features of 16,749 hospitalized UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol. MedArchiv Preprint, 28 April. DOI: doi.org/10.1101/2020.04.23.20076042
Ferguson, N. M., Laydon, D., Nedjati-Gilani, G., Imai, N., Ainslie, K., Baguelin, M., Bhatia, S., Boonyasiri, A., Cucunubá, Z., Cuomo-Dannenburg, G., Dighe, A., Dorigatti, I., Fu, H., Gaythorpe, K., Green, W., Hamlet, A., Hinsley, W., Okell, L. C., van Elsland, S., Thompson, H., Verity, R., Volz, E., Wang, H., Wang, Y., Walker, P. G. T., Walters, C., Winskill, P., Whittaker, C., Donnelly, C. A., Riley, S., and Ghani, A. C. (2020) Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College Covid-19 Response Team, 16 March; https://spiral.imperial.ac.uk:8443/bitstream/10044/1/77482/14/2020-03-16-COVID19-Report-9.pdf
Gompertz, B. (1825) On the nature of the function expressive of the law of human mortality, and on a new mode of determining the value of life contingencies. Philosophical Transactions of the Royal Society of London, 115: 513–585.
Hanlon, P., Chadwick, F., Shah, A., Wood, R., Minton, J., McCartney, G., Fischbacher, C., Mair, F.S., Husmeier, D., Matthiopoulos, J., and McAllister, D.A., (2020) COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study. Wellcome Open Res, 5:75; https://wellcomeopenresearch.org/articles/5-75
Krueger, A. B. (2017) Where have all the workers gone? An inquiry into the decline of the U.S. labor force participation rate. Brookings Papers on Economic Activity, Fall, 2017(2): 1-87. DOI:10.1353 /eca.2017.0012
Luo, Q., O’Connell, D.L., Yu, X.Q., Kahn, C., Caruana, M., Pesola, F., Sasieni, P., Grogan, P.B., Aranda, S., Cabasag, C.J., Soerjomataram, I., Steinberg, J., and Canfell, K. (2022) Cancer incidence and mortality in Australia from 2020 to 2044 and an exploratory analysis of the potential effect of treatment delays during the Covid-19 pandemic: A statistical modelling study. Lancet Public Health, 7: e537–48.
Mäki N., and Martikainen P. (2012) A register-based study on excess suicide mortality among unemployed men and women during different levels of unemployment in Finland. Journal of Epidemiolgy and Community Health, 66: 302-307; https://jech.bmj.com/content/66/4/302.long
Reeves, A., McKee, M., Gunnell, D., Chang, S.-S., Basu, S., Barr, B., Stuckler, D. (2015) Economic shocks, resilience, and male suicides in the Great Recession: Cross-national analysis of 20 EU countries. European Journal of Public Health, 25(3): 404–409. DOI: doi.org/10.1093/eurpub/cku168
Stuckler, D., Basu, S., Suhrcke, M., Coutts, A., and McKee, M. (2009) The public health effect of economic crises and alternative policy responses in Europe: An empirical analysis. Lancet, 374(9686):3 15-323. DOI: doi.org/10.1016/S0140-6736(09)61124-7
Wu, D., Shu, T., Yang, X., Song, J.-X., Zhang, M., Yao, C., Liu, W., Huang, M., Yu, Y., Yang, Q., Zhu, T., Xu, J., Mu, J., Wang, Y., Wang, H., Tang, T., Ren, Y., Wu, Y., Lin, S.-H., Qiu, Y., Zhang, D.-Y., Shang, Y., and Zhou, X. (2020) Plasma metabolomic and lipidomic alterations associated with Covid-19 , Wuhan Institute of Virology, 7 April; https://www.medrxiv.org/content/10.1101/2020.04.05.20053819v3.full.pdf.
Yang, H.-C., Fogo, A. B., Nie. X., and Zhang, C. (2020) Renal histopathological analysis of 26 postmortem findings of patients with Covid-19 in China. Kidney International; https://www.kidney-international.org/article/S0085-2538(20)30369-0/fulltext.
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., Xiang, J., Wang, Y., Song, B., Gu, X., Guan, L., Wei, Y., Li, H., Wu, X., Xu, J., Tu, S., Zhang, Y., Chen, H., and Cao, B. (2020) Clinical course and risk factors for mortality of adult inpatients with Covid-19 in Wuhan, China: A retrospective cohort study. Lancet, 28 March, 95(10229):1054-1062. DOI: 10.1016/S0140-6736(20)30566-3.