Covid-19 has caused a prolonged decline in life expectancy levels, leading to global mortality changes unprecedented in the last 70 years, according to a study.
The researchers from the University of Oxford, UK, and Max Planck Institute for Demographic Research in Germany used data from 29 countries in Europe, as well as Chile and the US.
The study, published on Monday in the journal Nature Human Behaviour, found that life expectancy in 2021 remained lower than expected across all 29 countries, had pre-pandemic trends continued.
Previous global epidemics have seen fairly rapid "bounce backs" to life expectancy levels, the researchers said.
However, the scale and magnitude of Covid-19, on mortality, confounds claims it has had no more impact than a flu-like illness, they said.
The researchers noted that life expectancy losses during recurring flu epidemics over the second-half of the 20th century have been much smaller and less widespread than those seen in the pandemic.
A clear geographical divide appeared in 2021. The researchers found most countries in Western Europe experienced life expectancy bounce backs from the sharp losses in 2020.
Sweden, Switzerland, Belgium and France saw complete bounce backs, returning to pre-pandemic life expectancy levels. While England and Wales saw partial bounce backs from 2020 levels in 2021.
Life expectancy in Scotland and Northern Ireland, however, remained at the same depressed level as 2020.
However, Eastern Europe and the US witnessed worsening or compounded losses in life expectancy over the same period.
The scale of life expectancy losses during the Covid-19 pandemic in Eastern Europe were similar to those last seen at the break-up of the Soviet Union, according to the researchers.
This East-West divide in life expectancy during Covid-19 generally reflects bigger losses in countries which had lower pre-pandemic life expectancy levels, they said. Bulgaria was the worst-hit of the countries studied, with a decline in life expectancy of nearly 43 months, over two years of the pandemic.
"Bulgaria, Chile, Croatia, Czech Republic, Estonia, Germany, Greece, Hungary, Lithuania, Poland, and Slovakia suffered substantially higher life expectancy deficits in 2021 compared to 2020, indicating a worsening mortality burden over the course of the pandemic," the authors of the study said.
In addition to pre-pandemic life expectancy, there appeared to be a vaccination effect which followed the same East-West divide in Europe. Countries with higher proportions of fully vaccinated people experienced smaller life expectancy deficits.
Older ages, especially those over 80 who had seen the bulk of deaths in 2020, benefitted from vaccine protection and a decline in excess mortality in 2021.
"A notable shift between 2020 and 2021 was that the age patterns of excess mortality shifted in 2021 towards younger age groups, as vaccines began to protect the old," said Ridhi Kashyap, a study co-author from Oxford.
However, there were "outliers," which had surprisingly high life expectancy losses, in spite of high vaccination rates.
"Finer-grained details of the age prioritization of vaccine roll-out and the types of vaccines used may account for some of these differences, as well as correlations between vaccine uptake and compliance with non-pharmaceutical interventions or the overall health care system capacity," said Jonas Scholey, study co-author from the Max Planck Institute.
"Countries, such as Sweden, Switzerland, Belgium and France, managed a recovery to pre-pandemic levels of life expectancy because they managed to protect both the old and the young," Scholey said.
The research team voices concern, however, about the possible wider international impact of the pandemic.
"In 2020, losses in life expectancy suffered in Brazil and Mexico exceeded those experienced in the US, so it is likely these countries may have continued suffering mortality impacts in 2021 -- even potentially exceeding the 43 months we estimated for Bulgaria," said study co-author, Jose Manuel Aburto.