Direct impact of COVID-19 by estimating disability-adjusted life years at national level in France in 2020, 2023, Haneef et al

Abstract

Background
The World Health Organization declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on March 11, 2020. The standardized approach of disability-adjusted life years (DALYs) allows for quantifying the combined impact of morbidity and mortality of diseases and injuries. The main objective of this study was to estimate the direct impact of COVID-19 in France in 2020, using DALYs to combine the population health impact of infection fatalities, acute symptomatic infections and their post-acute consequences, in 28 days (baseline) up to 140 days, following the initial infection.

Methods
National mortality, COVID-19 screening, and hospital admission data were used to calculate DALYs based on the European Burden of Disease Network consensus disease model. Scenario analyses were performed by varying the number of symptomatic cases and duration of symptoms up to a maximum of 140 days, defining COVID-19 deaths using the underlying, and associated, cause of death.

Results
In 2020, the estimated DALYs due to COVID-19 in France were 990 710 (1472 per 100 000), with 99% of burden due to mortality (982 531 years of life lost, YLL) and 1% due to morbidity (8179 years lived with disability, YLD), following the initial infection. The contribution of YLD reached 375%, assuming the duration of 140 days of post-acute consequences of COVID-19. Post-acute consequences contributed to 49% of the total morbidity burden. The contribution of YLD due to acute symptomatic infections among people younger than 70 years was higher (67%) than among people aged 70 years and above (33%). YLL among people aged 70 years and above, contributed to 74% of the total YLL.

Conclusions
COVID-19 had a substantial impact on population health in France in 2020. The majority of population health loss was due to mortality. Men had higher population health loss due to COVID-19 than women. Post-acute consequences of COVID-19 had a large contribution to the YLD component of the disease burden, even when we assume the shortest duration of 28 days, long COVID burden is large. Further research is recommended to assess the impact of health inequalities associated with these estimates.

Open access, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0280990

 

What can you make of this paper? I highly doubt assuming long Covid lasts 140 days is a good measure. Especially when people with more severe LC are likely to stay debilitated for longer.

 

This is more of a hospital-usage study than anything to do with disability, it basically doesn't count LC at all. Or more accurately, it's a fraction of the burden of acute COVID.

The whole thing where medicine only considers things happening in medical facilities has long reached its limit. Everything is reduced to this, the framing of most MDs I see out there is that only hospital beds and deaths count, the rest is irrelevant. They genuinely don't seem to understand that illness impairs functioning, having no theory or model that accounts for it.

It's a big world out there, almost all of it is happening outside of those facilities. We don't have a healthcare profession, we have a diseasecare profession instead. There is no health there, only disease and death, the rest is neglected.