Paid and unpaid productivity losses across 28 European countries due to excess deaths and COVID-19 deaths from 2020 to 2023

Abstract

Background: The COVID-19 pandemic has caused significant epidemiological and economic burdens. Although extensive epidemiological research exists, data on productivity losses resulting from COVID-19 remain limited. Therefore, this study aimed to estimate paid and unpaid productivity losses from excess deaths and COVID-19 deaths across 28 European countries from 2020 to 2023. Methods: This study used retrospective, population-level Eurostat data and a societal perspective to estimate paid and unpaid productivity losses (indirect costs) related to mortality caused by the COVID-19 pandemic (excess deaths and COVID-19 attributable deaths) in 28 European countries (European Union and Norway) from 2020 to 2023. For paid (market) losses, we applied the alternatives of the human capital approach (HCA) and the friction cost approach (FCA); for unpaid (non-market) losses, we used the opportunity cost approach (OCA). Results: Total paid productivity losses from excess deaths in 2020-2023 across all 28 countries combined were €82.9 billion in the Human Capital Approach and €3.9 billion in the Friction Cost Approach. Non-paid productivity losses amounted to €96.0 billion, of which €28.6 billion were attributable to the employed and €67.4 billion to the non-employed. For COVID-19 deaths, the productivity losses were lower: €35.0 billion for HCA, €2.1 billion for FCA, and 56.2 billion for unpaid losses (€12.4 billion for the employed, and €43.8 billion for the non-employed). The highest relative economic burden was experienced in the Central and Eastern European countries and three Baltic states (Latvia, Lithuania and Estonia). Losses were higher among men than women, particularly in paid productivity losses (>80% of total). Age-specific paid losses and unpaid losses among the employed were the greatest in the middle-aged (40-59), while for unpaid losses among non-employed, most of the burden was identified in the elderly (aged 60-74). Additionally, we identified heterogeneous time patterns across regions, with Central and Southern European countries experiencing the highest losses in 2021, Western countries in 2022 and Northern ones in 2023. Conclusions: This study shows that the burden of productivity losses caused by pandemic mortality was substantial, highly variable across regions and over time, and sensitive to the baseline mortality and valuation method used.