Likely Effects of the 2019 Coronavirus Epidemic in the UK on Life Expectancy and Whole Life Multipliers

The life expectancy of the Claimant is a crucial factor in quantifying awards for future losses, in many personal injury and clinical negligence claims. The National Life Tables (NLT), published annually by the Office for National Statistics (ONS) provides expectations of life by age and sex, based on historical data and allow an approximation of the life expectancy of the particular Claimant who may be claiming losses for the remainder of their life.

In some cases, e.g. that of the injured Claimant requiring nursing care for life as a result of an accident, who has a diagnosis of cancer and is in remission at the time of the accident, or the Claimant who has been a heavy lifelong smoker, it is possible to argue that the life expectancy given by the NLT for their particular age should be reduced because of the effect of their cancer or smoking history on their individual life expectancy.

In the former case a report from an Oncologist would be obtained to estimate the life expectancy of the Claimant with her particular history, type of tumour, staging and treatment history and the multipliers for future loss for life altered accordingly. In the case of the lifelong heavy smoker, it may be possible to simply rely upon the medical literature[1] to provide an estimation of life expectancy.

In both of the above examples the opinion of the expert Oncologist, and of the conclusions of the authors, draw on year’s of published academic research. Before any settled conclusions can be reached in relation to the effects on populations or individuals of the current Coronavirus pandemic on life expectancy in the UK, it is likely that months if not years of academic research will be necessary.

Any predictions therefore as to the likelihood of the Coronavirus having a noticeable effect on life expectancy and multipliers must therefore remain firmly in the realm of speculation. But with that in mind, this article will attempt to briefly address three questions:

1. The likely effect, if any, on the NLT, of Coronavirus;
2. The likely effect, if any on the NLT of the response to Coronavirus;
3. The likely effects on multipliers for individuals who have recovered from Coronavirus

Likely effect of Coronavirus on the NLT

The uncertainties are many and varied, but, it is tentatively suggested that there is unlikely to be any significant long term effect on NLT and therefore multipliers, as a result of this current outbreak of Coronavirus at least.

The first reason for this is that the NLT are specifically prepared in a way that is designed to avoid short term increases in mortality to skewing the figures and affecting long term trends. As set out above, they are published annually, but they are based on population estimates and births and deaths for a period of three consecutive years. The ONS own guide states that the three-year rolling averages are used to smooth fluctuations due to exceptional events, for example, a “flu” epidemic.

Second, most of the evidence to date suggests that the age distribution of deaths from Coronavirus follows that of deaths in the population of deaths from all causes.

Fig 1.

We are still in the early stages of the epidemic in the UK, so things may change, but so far, at the date of writing, across Europe the official mortality figures show that there have been less deaths so far this year than is normal  (see figs. 2 and 3 below).

Fig. 2 All cause mortality across Europe (Euromomo.eu)

Fig.3 Mortality in England & Wales in the year to date as at 27.03.2020 (ONS)

With less than average mortality and a normal age distribution for deaths, it is difficult to see at present how there could be any effect on overall life expectancy for any particular age group from this outbreak.

Third, previous flu epidemics. With significant mortality have had little or ne effect on the NLT. In 2014/15 there were 28,000 excess flu deaths in the UK.  Throughout this period life expectancy per the NLT continued to rise, and there was no discernible reduction in the increase in life expectancy outside of a general slowing trend.

Fig.4 Public Health England Annual Influenza Report 2018/19 – page 52

Table 7. Number of deaths associated with influenza observed through the FluMOMO algorithm with confidence intervals, England, 2014 to 2015 season to 2018 to 2019 (up to week 15)

The most pessimistic claims about the likely mortality rate from Coronavirus in the UK, come from the Imperial College Covid 19 Response Team paper of 16.03.20[2], a paper that has not been subject to formal peer review, but has shaped  government policy and precipitated the current lockdown. This suggested upwards of 250,000 deaths if the government didn’t change course from mitigation to suppression. With these measures now in place the authors predict overall excess mortality of 20,000.

The Imperial paper  has been heavily criticised in some scientific quarters, both for its underlying assumptions and the concerning fact that the statistical model upon which it is based has not been released and remains a secret, but in any event, assuming that the model and its assumptions prove accurate, the authors have subsequently admitted that up to 2/3 of those who are expected to die, would have died this year in any event[3] and would therefore have added to the mortality figures for the NLT in the same period in any event.

Some support for the 2/3 figure has come from Italy where on 22.03.20, Dr Prof Walter Ricciardi, scientific adviser to Italy’s minister of health stated in a newspaper interview[4] that “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates (of those with coronavirus) have shown a direct causality from coronavirus”. Presumably that means that the other 88% would likely  have died within a short period with or without Coronavirus.

It is likely that for the UK, until figures are broken down between “died of” rather than “died with” Coronavirus, it will be difficult to properly ascertain the true effect on mortality rates, and any consequential effects on overall longevity.

Likely effect of response Coronavirus on the NLT

There is perhaps a greater chance that the indirect effects of the Coronavirus will have a significant impact on the NLT and upon multipliers. It has been pointed out by the Institute for Fiscal Studies that the damaging effects of the economic shutdown on the economy could lead to more deaths than the Coronavirus itself, on the basis that significant reductions in GDP and the funding of health and public services that go along with that have a significant impact on health and longevity.[5]

Philip Thomas, Professor of Risk Management at Bristol University, has warned  that If the coronavirus lockdown leads to a fall in GDP of more than 6.4%, more years of life will be lost due to the subsequent recession than will be gained through beating the virus. His research suggests that this level of reduction in GDP would reduce life expectancy by 3 months across the board.[6]

The direst predictions for the looming economic downturn far outweigh such a modest fall in GDP, so within a few years it may be that an appreciable effect on multipliers may be noticeable. Whether that effect is a reduction in the upward trend, or large enough to actually reduce life expectancy and whole life multipliers will remain to be seen.

Likely effect on multipliers for individuals who have recovered from Coronavirus

Like the cohort of cancer patients in remission or the lifelong heavy smokers, the recovered Coronavirus patients will in due course be the subject of academic study. For the vast majority who are currently thought to suffer no more than mild to moderate symptoms, without the severe complications which are said to characterise many of the serious cases, it is perhaps unlikely, in the absence of any as yet entirely unknown serious aftereffects of the virus, that there will be an identifiable effect on life expectancy.

Early reports concerning the potential for long term effects on recovered Coronavirus patients are limited, but some early reports have suggested that some of the seriously affected patients who have subsequently recovered have been left, for now at least, with seriously compromised lung function.[7]

If that is confirmed by statistically significant studies in the months and year’s ahead then it is likely that in these cases there will need to be adjustments to the whole life multipliers to reflect a reduction in life expectancy, as with other respiratory conditions such as COPD.

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[1] E,g Streppel M et al: “Mortality and life expectancy in relation to long term cigarette, cigar and pipe smoking: The Zutphan Study” Tobacco Control 2007, Vol 16, pp107-113.

[2] https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf?fbclid=IwAR3Kzs4nAgT0CRk7Ru2D0Tu_2fVpBFnMlxa-qOO0u29W7lJSPnfllGwWZP8

[3] https://www.telegraph.co.uk/news/2020/03/25/two-thirds-patients-die-coronavirus-would-have-died-year-anyway/

[4] https://web.archive.org/web/20200324214448/https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/

[5] https://www.ifs.org.uk/publications/14799

[6] https://www.bbc.co.uk/news/health-51979654

[7] https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/

Nick Blake is a member of the Farrar’s Building Personal Injury Team.  Please direct any instructions or training requests to the Farrar’s Building Clerking Team.

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