Since the start of the pandemic, scientists have been challenged to estimate the impact of COVID-19 on the worldwide population. Research in many countries has concentrated on finding a feasible way of quantifying the effects in terms of severity and ill-health of the infection and its short- and long-term impact, as well as in terms of mortality. All of these factors can be combined when estimating disability-adjusted life years (DALYs). COVID-19 DALY estimates from Germany and Scotland will be presented as examples for burden of disease calculations. The methods used are aligned with the guidelines developed by the European Burden of Disease Network for estimating DALYs due to COVID-19. Nevertheless, both studies made adaptations, which depended largely on data availability and quality, and country-specific context upon which burden of disease assessments were undertaken. The German study showed that a total of 305,641 DALYs (368 per 100,000 persons) were lost in the population in 2020 due to COVID-19. There were 9.6 years of life lost (YLL) per death; women lost fewer YLL than men (8.1 vs. 11.0 YLL). In Scotland, DALYs due to COVID-19 ranged from 96,500 to 108,200 in 2020. This estimate meant that COVID-19 was framed as the second leading cause of disease and injury, with only ischaemic heart disease having a larger impact on population health in Scotland. Both studies indicated that over 98% of DALYs were due to YLL, i.e., a high proportion of DALYs is due to COVID-19 mortality. Notwithstanding methodological differences, the inputs from both studies could be used with common methodology to facilitate comparisons across countries. These findings illustrate how burden of disease indicators can be useful for monitoring public health in an ongoing pandemic.
Burden of Disease of COVID-19 in European countries: examples from Germany and Scotland