Excess mortality to stay high without control of COVID-19 – Swiss Re

Four years after the outbreak of the COVID-19 pandemic, many countries continue to report significantly higher mortality rates compared to pre-pandemic levels, according to a new report from the Swiss Re Institute.

The report, titled “The Future of Excess Deaths After COVID-19,” warns that without intervention, excess deaths could remain 3% higher than pre-pandemic levels in the United States and 2.5% in the United Kingdom by 2033.

Paul Murray (pictured above), CEO of Life & Health Reinsurance at Swiss Re, emphasized that COVID-19 continues to have a significant impact on mortality rates. In 2023, the United States reported an average of 1,500 deaths per week from COVID-19, a number comparable to deaths from fentanyl or firearms.

“If this continues, our analysis suggests a potential scenario of excess mortality continuing into the next decade,” Murray said.

However, he added that excess deaths could quickly return to pre-pandemic levels if COVID-19 is controlled through vaccination and other health measures. Long-term improvements in access to health care and healthy lifestyle choices are also expected to play a role in reducing mortality rates.

Excess mortality measures deaths above the expected rate for a population, where the baseline is generally stable due to long-term, unchanging causes of death. Significant changes in excess mortality are often associated with major events such as epidemics or medical breakthroughs, but these are often temporary deviations from baseline.

In the case of COVID-19, however, excess mortality remains high years after the peak of the epidemic.

In 2021, overdose deaths rose to 23% over the 2019 baseline in the United States, while the United Kingdom experienced an 11% increase. By 2023, overdose deaths had declined but remained much higher than pre-pandemic levels, ranging from 3-7% in the US and 5-8% in the UK, according to Swiss Re Institute estimates.

If current trends continue, the report suggests that excess mortality could stabilize at 3% in the US and 2.5% in the UK by 2033.

What causes excess mortality?

Respiratory diseases, including COVID-19 and influenza, are identified as the leading causes of excess mortality in the current and future. Other important factors include cardiovascular disease, cancer, and metabolic conditions, with specific causes varying based on country reporting methods.

Murray pointed to the direct impact of COVID-19 on cardiovascular death rates as a significant concern. COVID-19 has not only led to deaths from respiratory problems but also contributed to heart failure and other heart conditions.

The epidemic has also had an indirect impact on health care systems, with disruptions leading to delays in important tests and surgeries. Many conditions, such as hypertension, go undiagnosed during violence, leaving patients untreated and at high risk of death.

Advances in healthcare

The Swiss Re report also presents a highly optimistic scenario where excess mortality could return to pre-pandemic levels by early 2028. This will depend on the combined effects of medical advances, including the development of personalized mRNA vaccines for cancer and weight loss injections. , as well as reducing the long-term impact of COVID-19 and increasing acceptance of healthy lifestyle choices.

Murray noted that in this case, improvements in access to health care, combined with new treatments, could help reduce the long-term effects of the epidemic and bring death rates back in line with pre-pandemic expectations.

High mortality rates present challenges for insurers, as changes in mortality rates may affect risk assessment and pricing strategies. Swiss Re's analysis suggests that insurers may need to re-examine their underwriting processes, risk appetites, and mortality assumptions in pricing and underwriting.

Insurers can also play a major role in reducing these risks by implementing targeted prevention programs for policyholders, helping to promote healthy behaviors and early detection of medical conditions. This approach may contribute to longevity and help manage the long-term effects of the epidemic on mortality rates.

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