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Monitoring life expectancy levels during the COVID-19 pandemic: Example of the unequal impact in Spanish regions

Background: The COVID-19 pandemic is causing substantial increases in mortality worldwide. To provide an interpretable summary of the impact on mortality of the COVID-19 pandemic we estimate weekly and annual life expectancies at birth in Spain and its regions. Methods: We used daily death count data from the Spanish Daily Mortality Surveillance System, MoMo, and death counts from 2018, and population on 1 July, 2019 by region (CCAA), age groups, and sex from the Spanish National Statistics Institute. We estimated weekly and annual (2019 and 2020*, the shifted annual calendar period up to 10 May 2020) life expectancies at birth as well as their differences over a short period of time. Results: Weekly life expectancies at birth in Spain were lower in weeks 11-20, 2020 compared to the same weeks in 2019. This drop in weekly life expectancy was especially strong in weeks 13 and 14 (March 23rd to April 5th), with national declines ranging between 6.1 and 7.6 years and maximum regional weekly declines of up to 15 years in Madrid. Annual life expectancy differences between 2019 and 2020* also reflected an overall drop in annual life expectancy of 0.8 years for both men and women. These drops ranged between 0 years in several regions (e.g. Canary and Balearic Islands) to 2.7 years among men in Madrid. Conclusions: Weekly and annual life expectancy are easy to interpret measures for understanding the heterogeneity of mortality patterns across Spanish regions. Weekly life expectancy is a valuable indicator of the immediate intensity of health impacts from the pandemic. This sensitive indicator is also useful for understanding disparities and communicating the gravity of the situation because differences are expressed in intuitive year units.