How many years of life are lost to covid?

A few weeks back I wrote an article about how high the risk of dying from covid is. I mentioned that a senior representative of the World Health Organization (WHO) had recently said that the WHO’s best estimate was that roughly one in 750 people who get infected die of the disease. I also mentioned a study published by the WHO, authored by professor John Ioannidis at Stanford University, which was based on antibody data. That study estimated that the mortality rate for covid was around 0,23% overall, which would mean that roughly one in 430 people who are infected overall die of the disease, and 0,05% for people under 70, which would mean that if you’re under 70, the risk of dying of covid is about one in 2,000.

Since then, professor Ioannidis has updated his figures. The newer numbers have been published in The European Journal of Clinical Investigation. The modifications have been made to compensate for the fact that the earlier estimates were extrapolated from the countries that were hardest hit by covid. When this is accounted for, the new estimate is that covid kills around 0,15-0,20% of those infected, so around one in 600 infected people die of the disease overall. Among people under 70 years of age, the revised estimate is that 0,03-0,04% die, which is around one in 3,000.

However, professor Ioannidis also mentions that the fatality rate varies a lot between countries, related to varying levels of risk factors. As I mentioned in a previous article, the main risk factor for dying of covid is obesity. So countries with high levels of obesity will be hit harder than countries with low levels, which likely explains why the US has been hit so much harder by covid than Japan. Other health related factors that increase the risk of dying of covid are high age, organ transplantation, uncontrolled diabetes, chronic obstructive pulmonary disease, liver failure, kidney failure, and cancer. Basically, the things that predispose you to dying in the near future more generally, also predispose you to dying of covid.

In his article, professor Ioannidis mentions attempts that have been made to estimate the number of years of life lost, on average, when someone dies of covid, and I think this is interesting to explore further, because it is actually extremely important when trying to determine how severe covid is. When a small child dies, for whatever reason, that generally means around 80 years of life are lost. If a 90-year old dies, for whatever reason, that usually means at most a few years of life have been lost. Most people therefore reasonably think it’s much more tragic when a small child dies than when a very old person dies, because much more potential lifetime has been lost.

So, if covid results in 20 years of life lost on average, that’s reasonably about 20 times worse than if it results in one year of life lost on average. And that’s why it’s important to know how many years of life are lost to covid, when someone succumbs to the disease.

So, how many years are lost?

An article was published in The Proceedings of the Nationol Academy of Science (PNAS) in July that sought to estimate this. Using cohort life tables (the tables that insurance companies use to predict how many years of life someone has left based on how old they are), they calculated that the average person who dies of covid loses 12 years of life!

To me, this number seems implausibly high, because it doesn’t match what I am seeing here in Sweden. Half of Swedish covid deaths happened in nursing homes, where median life expectancy is less than a year. If half of all people who died of covid in Sweden would have been dead within a year even without covid, that would mean that the other half who died would have had to have twenty plus years of life left, in order for the average to end up being 12 years.

Considering that the average age of those who have died of covid in Sweden is 84, while the average age of death in Sweden more generally is 82, that seems extremely unlikely. Just looking at the data from what has actually happened in Sweden, it seems more likely that the average amount of lifetime lost to covid is very low, a few years at most.

In fact, I would go so far as to venture that covid can not possibly have resulted in an average loss of 12 years of life per person who dies, based on what the real world numbers actually show. So, how could the authors of the article in PNAS get the numbers so wrong?

Well, there is one thing that they should certainly have done, which they didn’t do. They didn’t take co-morbid conditions in to account. An 82 year old with type 2 diabetes, heart failure, chronic obstructive pulmonary disease and high blood pressure has a much shorter life expectancy than an 82-year old without any underlying conditions.

And we know that most of the people who die of covid have multiple underlying conditions. According to official data from the US Centers for Disease Control (CDC), 94% of people who have so far died of covid in the US had at least one underlying condition, and the average person who died of covid had three underlying conditions. You would think that the authors of the article in PNAS would have taken this factor in to account, since the number of underlying conditions a person has makes a big difference to how much longer they can expect to live.

A separate study was published in Wellcome Open Research in April that did try to correct for co-morbidities. Somehow, even when factoring in co-morbidities, this study still managed to arrive at an average of 12 years of life lost per person dying of covid. In other words, factoring in co-morbidities made zero difference to the projected years of life lost. Very strange.

If that was correct, it would mean that the average person dying of covid in Sweden, being 84 years old, would have lived to 96 if covid hadn’t happened. That is in spite of the fact that this average person has multiple underlying co-morbidities, and also in spite of the fact that the average 84 year old in Sweden can only expect to live seven more years, and will on average die around the age of 91.

So, if the authors of the study are right, this would mean that the average person dying of covid is healthier than the average person, since the average person dying of covid has 12 years of life left, and the average 84-year old only has seven years of life left. But we know the exact opposite is true – the people dying of covid are in general significantly less healthy than the average person. Admittedly, the data used in the study are taken from Italy and the UK, and I’m extrapolating to Sweden, but I find it implausible that the difference could possibly be that big.

So, something is fishy about the numbers. What?

Actually multiple things.

First, the authors only include eleven specific co-morbidities in their analysis, which means that all other co-morbidities that could affect years of life lost are excluded. As an example, cystic fibrosis is excluded from the analysis. The average life expectancy of a person with cystic fibrosis is 44 years. If a 40 year old with cystic fibrosis catches covid and dies, they would be considered completely healthy in the modeling done in this study, and would contribute around 45 years of life lost, when their real life expectancy is much lower.

Obesity, widely recognized as the biggest risk factor for severe covid, is not included in the modeling (probably because the authors didn’t consider it a “co-morbidity”), which means that people with obesity are considered to have the same life expectancy as non-obese people. Ignoring risk factors in this way will give the impression that people who die of covid are healthier than they really are, which will in turn lead to an over-estimation of their remaining years of life.

Second, the severity of co-morbidities is not factored in. Someone with end-stage chronic obstructive pulmonary disease (COPD) has a much shorter life expectancy than someone with mild COPD, and is probably much more likely to die if they catch covid, but this was also ignored in the modeling.

So, although the modeling in this second study attempted to factor in co-morbidities, it did so in an incomplete way, which likely resulted in a big overestimation of the number of years of life lost.

In the sub-group analysis, where the authors divide things up by age and number of co-morbidities, they find that a person age 80+ with three co-morbidities likely loses 6-7 years of life if they die of covid. Considering that the average person dying of covid is 80+ and has three co-morbidities, this seems like a much more reasonable number than the twelve years presented above. But it still seems high when compared with the real world data we have at this point in the pandemic.

Let’s say this number is right though, and the average person who dies of covid loses 6-7 years of life. Considering that roughly 1,4 million people have now died of covid, that would mean around 9 million years of life have been lost to covid so far.

To gain some perspective on the issue, let’s talk about measles. Measles is a disease that mostly kills children under the age of five. So, whenever someone dies of measles, the average number of life years lost is around 80. As a result of the global obsession with covid this year, measles vaccination programs have been paused in 26 countries. That means 94 million children are at risk of not getting their measles vaccines. It will only take about 110,000 children dying of measles because they didn’t get their vaccine, for the total number of life years lost to be the same as those lost due to covid.

And measles is just one disease. There’s also polio, tetanus, and yellow fever, to name a few. These are diseases that maim and kill children, but which can easily be prevented with vaccinations. How many years of life will be lost in total due to lockdown and to the world’s single-minded focus on covid this year?

Probably many times more than are lost to covid directly.

You might also be interested in my article about the Swedish response to covid, or my article about whether or not long covid is really a new disease.

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28 thoughts on “How many years of life are lost to covid?”

  1. Thank you for taking the time to undertake some detailed analyses into this Coronavirus SARS- Cov2 and Covid19. I wish more analysts and scientists advising governments would do the same. How have we allowed ourselves to be steered by so much poor analysis and understanding of people like those in SAGE? Can you put all your findings on the website please if you haven’t already done so?
    Kind regards

  2. I must wonder at what point we became so afraid of death? Yes every old and frail person dying of COVID19 is in itself a tragedy for the people involved. Maybe for the person dying it might even be a blessing in the end…I saw someone wither away in a care home…but I am getting philosophical here.

    But in the grand scheme of things, all the diseases, accidents, suicides and natural deaths that occur each year, why are we fixating on this one cause? In Germany I found for 2014 that almost 15.000 people died from alcohol related diseases. That is about the number of deaths from or “with” COVID19 up to last week. Except for laws prohibiting alcohol for minors, a few taxes and state sponsored rehab we just live with that number.

    Why is our (in as a society) reaction tho this particular disease so out of proportion?

  3. “the new estimate is that covid kills around 0,15-0,20% of those infected,”

    That’s around the same fatality rate as seasonal influenza, so are we being lied to about this “deadly dsease” (BBC, the Guardian et al)? Are you saying that the world has been turned upside down, millions of lives put at danger from death, NOT from the coronavirus but from the Lockdown and its effects?

  4. I am grateful for these detailed and sober accounts, as the general information we are getting is often so panicky and overexceited. As a retired GP I don’t takw too much notice of those warnings, but to know details feels good! Thank you!

  5. Another excellent article based on science as opposed to the hysteria in the US. When I try to explain “risk” to my friends and use examples of it that occur with everyday existence, such as driving to work daily for a 40 year old, the risk of a 7 year old dying of measles or flu, a dim light seems to arise. If you could add a risk of daily living activities or infections with other pathogens into your article based on age groups, individuals with less abstract reasoning may get a clearer perspective. Disproportionate or irrational fear reigns supreme in our media which is based on economic incentive and not a search for truth.

  6. Thank you for another interesting article.
    What I am worried about almost since the beginning of shut down and all these restricting measures is really
    how high the “collateral” demise is for so many people. From fear, loneliness, abuse, suicide, loss of livelihood etc. etc…..all because of this single minded concentration on -19 and constant fear inducing talk….

  7. Great life as long as you are an anorexic. So we are being encouraged to eat nothing and be skinny as that means the virus won’t affect us? My nephew has non Hodgkin’s lymphoma and until the deadly virus which is going to murder 1,000,000’s he was on regular chemotherapy. Then that was stopped as the virus is more deadly than terminal cancer?? Now he’s in hospital and after three tests and several weeks they have managed to pass on the virus to him! Now when he dies from the cancer on his death certificate will be died from COVID-19.

  8. On the subject of Measles deaths resulting from a drop in immunisation rates, most children receive (or should receive) the MMR immunisation. It appears that MMR also provides cross-immunity to coronaviruses. So a useful response to COVID is to *increase* MMR immunisations.

  9. Dear Doctor Rushworth
    You would benefit from reading ‘How to end the autism epidemic’ by J.B.Handley.
    The book is packed with with references to the latest reasearch that show us that various vaccines can trigger autism responses in a large minority of vulnerable children.
    Even some of the top Doctors in the field are confirming that this is the case, after they retire.
    But of course the pharmaceutical giants profit so very much from their vaccination programmes so it will be an uphill battle to get the truth accepted by the mainstream.

  10. Thank you for another excellent article. The last two paragraphs on the reduction of measles vaccinations and the possible loss of life from young people dying is very crucial.
    It’s interesting to me that the lawmakers are ignoring this important consequence of their policies.
    This fact seems to have escaped the WHO, Anthony Fauci and all the other governments who are promoting the covid mass hysteria.
    Every action has a cost, and they are not counting the cost of the covid reaction .

  11. Thank you so much for your articles.

    Have you had a chance to read the recent JAMA paper estimating years-of-life-lost in US children as a result of missed school? Again – the impact of lockdowns on children was projected to be significantly greater than any benefit in the forms of ‘lives saved’ from covid.

    My 98 year old grandmother is horrified to see the world ‘value’ her remaining years over those of my little girl. And by ‘value’ I mean to try and ruin her remaining years by cutting her off from the people who are her sole reason for staying alive. Cruelty upon cruelty.

  12. At the beginning of this so called pandemic, back in March, I felt that people like me were being blamed for being responsible for lockdown measures to protect our lives. At that time I felt very angry about this supposition, and afraid of possible repercussions by the negatively affected population, that is to say those under retirement age.

    OK, so I’m well over state retirement age, although I remained in employment years after. I consider myself as being healthy, but now appear to be lumped together with all + 65’s irrespective of frailty or adverse health conditions.

    Sorry, I don’t require to be segregated from society, to be afraid of my Children or Grandchildren visiting me, or indeed carrying out any social and domestic activity. I actively reject any such regulations – My Life is MY LIFE, not the States.

    I do appreciate that many more unfortunate individuals are passing their last days in care either dependant on relatives and / or voluntary helpers, many are in care homes / hospices. They are most emphatically in need of as much help, compassion and protection as can be provided. The rest of us are well able to proceed with our lives as normal and appropriate.

    Why does the medical profession use only one variable – such as age in this case – as an indicator of possible vulnerability or disease prognosis. In engineering we have to take into account many factors in coming to a satisfactory design solution. Think of that next time you travel by air!

    1. Hi Ray,
      I absolutely agree, and in one-on-one encounters with patients, doctors do generally make decisions based on the individual situation and biological age of the patient, not based on the number on their birth certificate.

  13. Thank you for some sanity, Dr. Rushworth. Since all governments have access to this kind of information, why is the fear-mongering continuing? Here in Canada the leaders are clearly corrupt but I don’t think that is the case in Sweden. Why do you think the panic is at such an exaggerated level and even Sweden is starting to talk about lockdowns and masks?

    1. Hi Louise,
      Good question. I think once you’ve gone far enough in one direction, it’s hard to turn around and go back. Easier to just keep going forward. I think most politicians are just following the path of least resistance.

  14. >William Bowlessays:
    >29 November, 2020 at 14:41
    >“the new estimate is that covid kills around 0,15-0,20% of those infected,”

    >That’s around the same fatality rate as seasonal influenza

    however, there is greater herd immunity with influenza, while covid can potentially be obtained by anyone

  15. Prof. Raoult’s team at IHU MArseille in France have estimated that 90% of people who died at their hospital/institute had less than 1 year left of life expectancy.

  16. In many articles etc. the following is stated:-
    “For people over 80, the illness has a lethality of more than 5%.”
    OK, this is a plain enough , but then a few questions arise.
    Do over 80’s have any immunity at all ?
    Does their overall health status have any bearing at all ?
    Does suffering from Dementia have an adverse prognosis ?
    Similarly does an active lifestyle have any advantage ?
    These questions also could be applied to other age groups, so basically should the only variable in determining lethality be the date on a Birth Certificate ? If not what other factors need to be addressed ?
    Please use standard logic functions such as – AND , OR, AND/OR , EXOR,
    Example: Frail AND Age 64 is different from Frail OR Age 64

  17. I don’t think the issue should be time. Whether it’s a day or a decade, life is precious and so is how it should be lived. To see this nasty, vindictive incompetents, forcing sick people back into unprotected ‘care’ homes, just turns my stomach. The issue here is simple, protecting vulnerable people but treating them with dignity.

  18. Excellent point that I share. The official approach to this year’s maybe more extreme version of what goes around comes around virus has been too much like the old saying ~~> to a hammer, everything looks like a nail. To a virologist, everything looks like a virus. We’ve needed some official perspective that does adequate risk assessment by including experts from other facets of the infectious disease environment such as philosophy / beliefs etc., psychology / mental health, economics and mental health, terrain theorists as well as the germ / virus theorists. In the US, some experts anticipated a higher rate of death due to how diseased we were and are before this latest viral assault. Ironic, that the not very healthy US has employed one of the most draconian overreactions on the planet, right out of the Communist Party playbook. An elevated fear of death may be Ma Nature’s warning of what’s to come. Fear is definitely at epidemic proportions [and who know who feeds on fear, right?!]

  19. North American newspapers are publishing articles blatantly stating that Sweden has renounced its unique approach to Covid, and is now adopting the lockdown model. As I understand it this is not true. Gathering sizes have been reduced, and older students will do remote learning, but Sweden is not closing schools or ordering businesses to shut down. The media here is determined to punish Sweden for daring to be different. An article from you on exactly how things stand in Sweden today would be very helpful.

    1. Hi Brian,
      Yeah, it isn’t true. The Swedish government is definitely sounding more alarmist and aggressive now than they were in spring, but they are limited by law in terms of what they can do. The recommendations are more severe now than in spring, but they are still only recommendations for the most part. There are some new real restrictions, for example that restaurants have to stop serving alcohol at 22.00, and close at 22.30 (which is apparently when sars-cov-2 gets out of bed and starts attacking people). I’m writing an update about what’s happening in Sweden, should be out in a week or two.

  20. As well as Sweden it would be helpful to look at policies in Finland, Norway, Iceland and Denmark. There’s no apparently lockdown in Finland. Finland and Norway have no excess deaths in 2020 according to Euromomo. Finland apparently has the best vitamin D levels in Europe as a result of supplementation, or rather fortification of foods.

    Is high-dose vitamin D a full replacement for a vaccine in conferring immunity? It’s certainly being downplayed and opposed by the UK NHS which has grudgingly agreed that maybe ‘vulnerable’ people in care homes should get 400 IU per day. I take over 4,000 IU per day autumn to spring. Dr Fauci apparently takes 6,000 so maybe this ought to be better known. See also Dr David Grimes’s blog where he investigates the scandalously high death rate of ethnic minority doctors, apparently due to darker skin and lower vitamin D levels.

  21. Glad to see this mentioned. Measles morbidity is mitigated by vitamin A. Much less risk, but less profit, to supplement a vitamin. The mumps component of the MMR is also interesting. Unfortunately, details of the settlement appear closed. However, the US recently submitted a statement of interest one can read.

    Keep widening that scope. This year’s tricks are nothing new.

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