This would mark the longest period of elevated peacetime excess mortality in the US. The key driver behind this sustained rise is the lingering impact of COVID-19, both as a direct cause of death and a contributor to increased cardiovascular mortality.
Excess mortality measures the number of deaths above the expected level in a given population. While it usually returns to baseline after a significant health event, such as an epidemic, this has not been the case following COVID-19. In 2021, the US saw a spike in excess mortality of 23% above 2019 levels, while the UK recorded an 11% rise. Despite the passing of the pandemic’s peak, excess mortality remained elevated in 2023, ranging from 3–7% in the US and 5–8% in the UK.
The Swiss Re report warns that unless the impact of COVID-19 on vulnerable populations is reduced, mortality rates may remain higher than pre-pandemic norms for years. The primary drivers of excess mortality include respiratory diseases like COVID-19 and influenza, as well as cardiovascular conditions and cancer.
Paul Murray, CEO L&H Reinsurance at Swiss Re said: “COVID-19 is far from over. The US reported an average of 1500 COVID-19 deaths a week for 2023 – comparable to fentanyl or firearm deaths.[1] If this continues, our analysis suggests a potential scenario of elevated excess mortality extending over the next decade. However, excess mortality can return to pre-pandemic levels much sooner. The first step is to get COVID under control, with measures such as vaccinations for the vulnerable. Over the longer term, medical advancements, a return to regular healthcare services, and the adoption of healthier lifestyle choices will be key.”
Optimistic Scenario for Mortality Rates
The report outlines an optimistic scenario where excess mortality returns to pre-pandemic levels by 2028, driven by advancements in healthcare. These could include breakthroughs such as personalized mRNA vaccines for cancer and weight loss injectables, alongside healthier lifestyle choices.
Cardiovascular Disease and COVID-19 Interplay
The report also highlights the significant interplay between COVID-19 and cardiovascular disease (CVD) mortality. The virus has contributed directly to heart-related deaths and indirectly by disrupting healthcare systems, leading to underdiagnosis and untreated conditions such as hypertension.
Implications for Insurers
The persistent elevated mortality rates present challenges for insurers, who may need to reassess their risk portfolios. Insurers are encouraged to adjust underwriting strategies and mortality assumptions while also focusing on prevention programs to support healthier lives for their policyholders.
Source: Swiss Re
