The COVID pandemic has caused an unprecedented increase in mortality worldwide, leading to a decrease in life expectancy. During research last year, we found that in 2020 significant loss of life expectancyincluding over two years in the US and one year in England and Wales.

In a new study published in The Nature of Human Behavior, we now show that in 2021 life expectancy recovered somewhat in most Western European countries, while Eastern Europe and the US saw further losses. However, in 2021, only Norway exceeded pre-pandemic life expectancy, and everywhere else the situation is worse than it would have been without the pandemic.

We knew the outlook for 2021 was mixed, with the excitement of vaccine rollout being tempered by the sheer number of infections caused by a series of new and highly transmissible variants.

To assess the impact of these changes on life expectancy, our research team from the University of Oxford Leverhulme Center for Demographic Sciences and Max Planck Institute for Demographic Research collected data from 29 mostly European countries (plus Chile and the USA).

Life expectancy is a measure we use to summarize the death pattern of a country in a given year. It is calculated on the basis of deaths from all causes, so it does not depend on the accuracy of the recording of deaths from COVID and can give us a broader picture of how the pandemic has affected mortality.

Life expectancy is not a prediction of the life expectancy of a child born today. Rather, it is the number of years someone born today could expect to live their entire life at the current year’s death rate (or 2021 in the case of our study). It is therefore a snapshot of current mortality conditions if they continued without any improvement or deterioration.

Demographers find life expectancy a very useful summary measure of population mortality because it is comparable across countries and over time. Big swings up or down can tell us that something has changed dramatically, as happened with COVID. The size of these drops allows us to compare mortality shocks across locations and times.

Life expectancy during COVID-19

We found that in 2021, compared to 2020, the impact of the pandemic on mortality varied significantly between countries. Life expectancy fell in almost every country we studied in 2020, except for Denmark and Norway. But in 2021, life expectancy in some countries improved compared to 2020, while in others it became even worse.

The further declines we found in Eastern Europe are likely because the region avoided some of them early waves of COVID during 2020in conjunction with less vaccine absorption when big waves actually arrived in 2021. Bulgaria was the most extreme example with a staggering 3.5 years of losses from 2019 (1.5 years in 2020 and two years in 2021).

Despite the early distribution of the vaccineThe US continued to pull away from Western Europe with an additional loss of almost three months in 2021 after losing more than two years in 2020. reduces absorption of vaccine and booster compared to their Western European counterparts, which is likely the reason for this difference in 2021.

But life expectancy in the US began to lag behind European countries for many years, so some of these shortfalls in the US may reflect underlying health vulnerabilities that have been exacerbated by the COVID pandemic. While most of their life expectancy losses can be attributed to confirmed deaths from COVIDin the US, the death rate also continued to rise due to a drug overdose.

England and Wales fell somewhere in the middle, gaining 2.1 months in 2021 after losing almost a year in 2020. Even for countries that have performed relatively well, COVID has still disrupted the trajectory of improved mortality that we typically see from year to year.

Life expectancy at birth by country, 2019–2021

Overall, mortality in 2021 compared to 2020 has shifted slightly towards younger people. This is likely due to higher vaccination coverage and more precautions at older ages.

Indeed, countries with better vaccination coverage of people over the age of 60 had better life expectancy. The death rate for the over-80s in the US has even returned to pre-pandemic levels. But total life expectancy was worse in 2021 due to worsening under-60 mortality.

We also compared recent declines in life expectancy with historical crises that resulted in significant deaths. Loss on the scale we saw during the pandemic has not been seen since World War II in Western Europe or since the collapse of the Soviet Union in Eastern Europe.

Meanwhile, previous flu epidemics have shown fairly rapid recovery in life expectancy. The impact of COVID has so far been larger and more persistent, challenging the common claim that it is “just like the flu.”

Constraints and Looking Ahead

Because estimates of life expectancy require accurate data on deaths by age and sex, we were unable to accurately calculate life expectancy for all countries in the world in this study.

We know that countries like Brazil and Mexico suffered large life expectancy losses in 2020, and it is likely that they continued to suffer further losses in 2021. The death toll from COVID in countries like India may never be accurately calculated due to data limitations, but we do know death toll was significant.

Looking ahead, prospects for life expectancy recovery in 2022 and beyond is still hazy. We expect that discrepancies will continue due to differences between countries in the use of vaccines and boosters, previous infections, and subsequent public health measures (or lack thereof).

The full impact of delayed health care and the ongoing strain on the health care system remains to be seen. New variants that evade existing immunity are likely to emerge, and the long-term impact of COVID infections on the health of survivors remains unknown.

While we hope that mortality will return to pre-pandemic levels (and even begin to improve again), the continued excess mortality in England and elsewhere in 2022 indicates that we are not fully back from mortality the effects of the pandemic, and the path to recovery remains uncertain.

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