The study belongs to a strong team that has been working on this issue for years and has been very active during the pandemic. Their conclusions fit very well with the existing evidence, showing the effect that slow or ineffective vaccination can have on deaths and, therefore, on loss of life expectancy.  

Interestingly, they emphasise two points. On the one hand, the effect of covid-19 in Eastern European countries. On the other hand, the possible interruption of the process of rapprochement between life expectancy in Eastern and Western Europe in recent years, after a period of stagnation of life expectancy growth in Eastern European countries during the 1980s and 1990s.  

The persistent losses in life expectancy by covid-19 in eastern Europe and the recovery of life expectancy in the west are not known to create a new division in terms of mortality and life expectancy patterns between east and west.  

On the other hand, the researchers show how the pandemic in the United States has accentuated losses in life expectancy that were already showing up in pre-pandemic periods in middle-aged people. The authors say: "This is clear from the strong contribution of mortality increases below age 60 to life expectancy losses in 2020 and 2021. Because non-covid mortality also increased at these ages, this can be interpreted as a continuation and worsening of a pre-existing situation, a mortality crisis among working-age adults. In 2020, most of the excess non-covid-19 deaths in US men were due to external causes (mainly due to drug overdoses and homicide), almost 80% of which occurred at working ages". 

The study also clearly shows that pre-pandemic health conditions need to be known to see the effect of underlying conditions, such as obesity and diabetes, and how they may have contributed to the pandemic's effect or its long-term effects.  

While the covid-19 pandemic has been the most severe global health and mortality crisis since World War II, we will have to wait to see how long-term trends in life expectancy have been altered. The authors make an interesting comparison with past pandemics and mortality crises, most notably the 1918 influenza. In all of them, they conclude that recovery from these crises was rapid despite such large losses in years of life expectancy, mainly due to the age groups affected by the mortality crisis, which were much younger than today.  

For example, the authors note: "During World War I and the Spanish influenza epidemic, all countries for which historical data are available experienced substantial losses in life expectancy - the largest annual drops in life expectancy in the last 120 years. In most countries, life expectancy declined steadily over the four-year period of the crises, but the losses were greatest in 1918. The steepest drops in life expectancy during 1914-1918 were observed in Italy (-22.7 years) and France (-16.5 years)". 

The study shows the positive effect of rapid, efficient and widespread vaccination and non-pharmaceutical measures in the fight against a pandemic such as the current one, which have made it possible to save lives and thus reduce the effects of the loss of life expectancy.