Covid-19 Death Tolls In Europe Highlight Stark Regional Differences In 2020 And 2021

(MENAFN- The Conversation) The political decisions made during 2020 and 2021 to combat the Covid-19 pandemic profoundly altered daily life. Professionally, societies faced partial unemployment and widespread adoption of remote work; personally, individuals endured lockdowns and social distancing measures. These interventions aimed to reduce infection rates and ease pressure on healthcare systems, with the primary public health goal of minimizing deaths.

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More than five years after the pandemic began, what do we know about its impact on human longevity? Here's a closer look.

A decline in global life expectancy

Initial assessments of the pandemic's toll have been refined over time. According to a World Health Organization (WHO) report published in May 2024, global life expectancy declined by 1.8 years between 2019 and 2021, erasing a decade of progress. These estimates rely on“excess mortality”, a metric that measures the difference between observed mortality during the pandemic and expected mortality in its absence.

Excess mortality can be quantified using different indicators, such as the number of excess deaths . However, comparing this indicator between countries of different sizes and age structures can be challenging. Another informative metric is the loss of life expectancy at birth, calculated globally by organisations such as the WHO.

The regular calculation, publication and dissemination of excess mortality indicators are vital for comparing the pandemic's impact across countries at the national level. However, it is important to recognise that the pandemic did not affect all areas within countries equally. Variability in the severity of the pandemic's impact often stemmed from differing confinement strategies implemented to contain the virus.

This uneven distribution highlights the need to quantify these indicators at a more granular geographical level. Such localised analysis can reveal the regions most severely affected, providing valuable insights into the pandemic's effects and enabling the development of targeted response strategies.

In a series of studies conducted in 2024, we introduced an innovative method to calculate excess mortality at the regional level . We used this method to estimate excess mortality in 561 European regions in 2020 and expanded the scope to 569 regions across 25 countries in 2020 and 2021 . The findings, based on loss of life expectancy at birth, reveal stark contrasts in the pandemic's impact across Europe.

In 2020, significant declines in life expectancy were observed in northern Italy and Spain

Figure 1 illustrates the spatial distribution of estimated losses of life expectancy in 2020. These losses were highest in northern Italy and central Spain. In the Italian regions of Bergamo and Cremona, life expectancy dropped by nearly four years, while Piacenza experienced a decline of three and a half years. In Spain, the regions of Segovia, Ciudad Real, Cuenca and Madrid saw losses of approximately three years.

The losses were even more pronounced among men (data not presented here), who were disproportionately affected by the pandemic. In Cremona, the decline in life expectancy among men reached nearly five years, while in Bergamo, it was close to four and a half years.

Figure 1: Estimated loss of observed life expectancy at birth (e0) in 2020 across 569 regions in 25 European countries. Estimates are for both sexes combined. Fourni par l'auteur

Eastern Europe, particularly Poland, along with eastern Sweden and northern and eastern France, also experienced significant, though less severe, declines. In France, the Paris region and areas near the German border recorded the highest losses, ranging from 1.5 to 2 years.

In contrast, other regions saw much smaller impacts. This is particularly true for southern Italy, much of Scandinavia and Germany, southern parts of the United Kingdom, and western France. In these regions, observed life expectancy is close to what would have been expected in the absence of the pandemic. In France, the implementation of lockdown measures in March and November likely prevented the pandemic from spreading across the entire country from the initial clusters in the north and east.

In 2021, a shift in the pandemic toward Eastern Europe

Figure 2 shows the estimated losses of life expectancy in 2021. At a glance, the regions most affected by excess mortality during the Covid-19 pandemic differed significantly from those in 2020. The most substantial losses were concentrated in Eastern Europe.

Figure 2: Estimated loss of observed life expectancy at birth (e0) in 2021 across 569 regions in 25 European countries. Estimates are for both sexes combined. Fourni par l'auteur

Among regions where life expectancy declined by more than two years, 61 of Poland's 73 regions, 12 of the Czech Republic's 14 regions, all eight Hungarian regions, and seven of Slovakia's eight regions were affected. In contrast, only one Italian region and one Spanish region experienced losses exceeding two years, despite these countries being heavily impacted in 2020.

Germany saw much greater losses in 2021 than in 2020, particularly in its eastern regions, where declines often exceeded 1.5 years. In southern Saxony, Halle and Lusatia, losses approached two years. Conversely, Spain and Scandinavia recorded the lowest declines in life expectancy.

In France, the losses were more uniform than in 2020, generally ranging from 0 to 1.5 years. The highest loss occurred in the Parisian suburbs, particularly Seine-Saint-Denis, where life expectancy fell by 1.5 years – or two years for men.

What is the overall assessment for these two years?

To determine the overall impact of 2020 and 2021 in terms of life expectancy loss, we used an indicator that sums up the years of life lost due to the pandemic over this two-year period. This method allows us to rank the 569 European regions.

The regions most affected were Pulawy, Bytom and Przemyski in southeastern Poland, along with Kosice and Presov in eastern Slovakia. Among the top 50 regions, Eastern Europe dominated, with 36 Polish regions, six Slovakian regions, two Czech regions, one Hungarian region, and both Lithuanian regions included. Italian regions such as Cremona, Bergamo and Piacenza also ranked high, falling between the 15th and 30th positions. In France, Seine-Saint-Denis ranked 81st, while all other French regions were outside the top 100.

It is crucial to analyse the impact of a crisis like the Covid-19 pandemic at a fine geographical scale, as within-country disparities can be significant. This was particularly evident in Italy in 2020, where the north was far more affected than the south, and in Germany in 2021, with stark differences between the west and the east.

Our study highlighted the severe impact of the pandemic in specific European regions, where life expectancy losses exceeded three years. The most affected regions shifted over time, moving from areas with traditionally high life expectancy (such as northern Italy, central Spain and the greater Paris region) in 2020 to regions with traditionally lower life expectancy (Eastern Europe) in 2021. France was relatively spared compared to the rest of Europe, with the notable exception of Seine-Saint-Denis.

The coming years will be critical in determining whether life expectancy levels can return to their long-term trajectories or if the pandemic has caused lasting structural changes in certain regions.

This article was originally published in French

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