AbstractThe present study estimates the burden of COVID-19 on mortality. The state-of-the-art method of actuarial science is used to estimate the expected number of all-cause deaths in 2020 to 2022, if there had been no pandemic. Then the number of observed all-cause deaths is compared with this expected number of all-cause deaths, yielding the excess mortality in Germany for the pandemic years 2020 to 2022.The expected number of deaths is computed using the period life tables provided by the Federal Statistical Office of Germany and the longevity factors of the generation life table provided by the German Association of Actuaries. In addition, the expected number of deaths is computed for each month separately and compared to the observed number, yielding the monthly development of excess mortality. Finally, the increase in stillbirths in the years 2020 to 2022 is examined.In 2020, the observed number of deaths was close to the expected number with respect to the empirical standard deviation. By contrast, in 2021, the observed number of deaths was two empirical standard deviations above the expected number. The high excess mortality in 2021 was almost entirely due to an increase in deaths in the age groups between 15 and 79 and started to accumulate only from April 2021 onwards. A similar mortality pattern was observed for stillbirths with an increase of about 11 percent in the second quarter of the year 2021.Something must have happened in April 2021 that led to a sudden and sustained increase in mortality in the age groups below 80 years, although no such effects on mortality had been observed during the COVID-19 pandemic so far.ConclusionThe present study used the state-of-the-art method of actuarial science to estimate the expected number of all-cause deaths and the increase in all-cause mortality for the pandemic years 2020 to 2022 in Germany.In 2020 the observed number of deaths was extremely close to the expected number, but in 2021 the observed number of deaths was far above the expected number in the order of twice the empirical standard deviation. The analysis of the age-dependent monthly excess mortality showed, that a high excess mortality observed in the age groups between 15 and 79 starting from April 2021 is responsible for the excess mortality in 2021. An analysis of the number of stillbirths revealed a similar mortality pattern than observed for the age group between 15 and 79 years.As a starting point for further investigations explaining this mortality patterns, we compared the excess mortality to the number of reported COVID-19 deaths and the number of COVID-19 vaccinations. This leads to several open questions, the most important being the covariation between the excess mortality and the COVID-19 vaccinations.
