By David Shaw
Everyone knows that older people are at greater risk of dying if infected with coronavirus. Some have even suggested that most people dying of the virus would have died this year or next year anyway because of their age and frailty. But this is not true. In fact, the typical person who dies because of the virus loses over a decade of life. This means that in the UK alone, with almost 50,000 deaths from the virus, half a million years of life have already been lost. Each death is awful, but so is each lost day, month and year; the tragedy is much worse than many people realised. And that is before we consider other lost lives and life among other casualties of coronavirus. In this blog, I briefly explore these issues.
Coronavirus has killed over 44,000 people in the UK as of the middle of May, and the eventual figure may be substantially higher. Initially it was seen as a problem for older people; then it emerged than many young people were dying too. Nonetheless, the widespread misconception remained that it mainly killed old people, and that those old people would soon have died anyway. But this last claim is clearly false. A recent study (using data from Italy) found that, after adjusting for long-term health conditions, women who die of Covid-19 lose on average 13 years of life; men lose 11. So the typical Covid victim loses not ‘just’ a few months or a couple of years, but twelve years of life. Over a decade that could, and should have been spent watching grandchildren – and children – growing up. Instead, they are dead, and all the life they would have had has been lost. Assuming that the final death toll is 50,000 (which is probably a conservative estimate; one prediction puts the total at over 60,000 by mid-May), this means that the total life lost may well be over 600,000 years in the UK alone. Globally, there have been at least 320,444 deaths, equating to over 3 million years of lost life (assuming generalisability from the Italian data).
And of course, the loss is not only that of the person who has died. If not for the coronavirus, bereaved families and friends would have had over ten more years with its victims. It is not just the loss of a loved one that hurts; it is the loss of all the time we could have spent with them, and their ongoing absence where and when there should have been presence. This ongoing loss can severely reduce the quality of life of those left behind.
We should also remember that those who die because of Covid-19 are not the only ones whose lives are shortened by the virus. While many people who are hospitalised return to normal function, some of those who survive are likely to have ongoing health issues as a result, particularly lung and kidney problems caused by complications of acute respiratory distress syndrome. These complications will reduce their quality of life, and may shorten their lives as well, resulting in additional lost years of life.
And as we now know, there are many indirect victims as well. Excess mortality has soared since the pandemic began, and not all excess deaths are attributable to the virus. Though the reasons for this ‘excess excess’ are not yet clear, the focus on Covid-19 has had the side effect of increasing mortality from other conditions. Some people may have been reluctant to attend hospital because of fear of getting Covid, and died as a result. Other patients will have been denied a lifesaving organ because transplantation from living donors has entirely ceased and transplantation from deceased donors is down 90% – both side effects of the virus. All of these patients will have lost not only their lives, but many years of life. (Even before the pandemic, one person died every day waiting for an organ in the UK, and that was when over 10 transplantations from deceased donors alone were taking place every day.)
But we must also consider those who have not yet died, but will die sooner because of delayed consultation and diagnosis caused by the virus. Cancer screening programmes have been suspended, GPs are doing telephone consultations, and as already mentioned many people are delaying contacting their GPs because of concerns about the virus. This does not mean that these people will die soon, but they may die sooner than they would have if the pandemic had not occurred; yet more lost years of life. And they, of course, have families too.
It may never be possible to quantify the number of years of life lost to the virus, or even the precise number of people who died as an indirect result of it, much less the year of life lost; it is even less likely that the harm done to survivors of the virus and the families of victims will ever be counted accurately. But in trying to comprehend the magnitude of the destruction wrought by the coronavirus, we should at least try to bear in mind not only the sheer loss of lives, but the even greater loss of life – in the UK alone, over half a million years of lost light that will never return.
Author: David Shaw
Affiliations: Institute for Biomedical Ethics, University of Basel; Care and Public Health Research Institute, Maastricht University
Competing interests: none