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Since the emergence of SARS-CoV-2, health policy measures employed to minimise the impact of the covid-19 pandemic have varied substantially across countries and jurisdictions. These policy measures have affected many social and economic determinants of health, including accessibility to healthcare services. The overall impact of the pandemic and its associated policy measures therefore have implications for mortality beyond deaths with covid-19.

In this global comparative study of 37 countries, a reduction in life expectancy was found in men and women in all countries except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. We found no evidence of a change in life expectancy in 2020 in Denmark, Iceland, and South Korea. The highest reduction in life expectancy in men was observed in Russia, the US, Bulgaria, Lithuania, and Chile; the highest reduction in women was observed in Russia, the US, Bulgaria, Lithuania, and Spain. Years of life lost were higher than expected in all countries except Taiwan, New Zealand, Iceland, Denmark, South Korea, and Norway. In the remaining 31 countries, about 28 million excess years of life were lost in 2020 (17 million in men and 11 million in women). The highest excess YLL in both men and women were observed in Russia, Bulgaria, Lithuania, the US, and Poland. The excess YLL rate was relatively low in people younger than 65 years, except in Russia, the US, Lithuania, and Bulgaria. The excess YLL rates associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.

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