The idea that the COVID-19 pandemic merely hastened deaths that were already imminent has been deeply embedded in public debate since the crisis began. But a sweeping new analysis suggests that assumption is largely wrong. Instead of a self-correcting shock, the pandemic left behind a persistent rise in mortality across most wealthy nations — a legacy that has yet to fully unwind years after the worst waves passed.
According to an analysis of data from 34 countries reported by Bloomberg, COVID-19 did not simply “pull deaths forward” in time. In most cases, fatalities in the years following the pandemic failed to fall enough to offset the immense losses recorded during 2020 and 2021. That finding directly challenges the notion of mortality displacement, the idea that many of those who died from COVID-19 were so frail they would have died shortly thereafter anyway.
Researchers at the University of Hong Kong examined more than 350 million deaths recorded between 2015 and 2024, comparing observed fatalities with estimates of how many deaths would have been expected had pre-pandemic trends continued uninterrupted. The results were stark. In most countries, deaths remained elevated even after COVID-19’s emergency phase receded, indicating that the toll was not merely a matter of timing but a genuine deterioration in population health.
“We actually were surprised to see that we can only prove that in three out of 34 countries,” said David Bishai, the study’s senior author and director of HKU’s School of Public Health. COVID-19, he explained, did not kill enough people in most places to meaningfully reduce deaths in the years that followed. The idea that later mortality would naturally rebound downward simply did not materialize.
Only Greece, Latvia and Poland showed clear evidence that some post-pandemic decline reflected deaths that had been pulled forward during COVID-19. Even in those countries, the effect was limited, offsetting just 10% to 21% of excess deaths from the pandemic years, largely among people aged 85 and older. For the vast majority of nations studied, the losses endured rather than reversed.
The findings also cast new light on pandemic policy debates that continue to shape political discourse. Strategies that emphasized shielding high-risk populations while allowing the virus to spread more freely among others did not deliver better long-term outcomes, the analysis suggests. Countries that suffered higher death rates during COVID-19 generally continued to fare worse years later, undermining arguments that early sacrifices would balance out over time.
“It does not support the Great Barrington approach,” Bishai said, referring to the declaration that advocated protecting the vulnerable while minimizing restrictions for the broader population. Instead, the data imply that allowing widespread transmission came with enduring consequences, not just an accelerated timetable of deaths.
In the United States, the picture was mixed but still telling. By 2024, overall mortality had returned to its pre-pandemic pattern, neither clearly above nor below expectations. But that represented stabilization, not recovery. There was little evidence of a compensatory dip in deaths that would suggest earlier losses had been offset. In other words, the country did not experience a mortality “payback” after COVID-19 subsided.
The pandemic also delivered a sharp blow to life expectancy, reversing decades of steady gains across rich nations. While life expectancy plunged everywhere during the crisis, a central question since has been whether countries would resume their previous trajectory or settle into a new, lower baseline. The new analysis indicates that for much of Europe, the setback has proved stubbornly persistent.
Countries including France, Italy, the United Kingdom, Spain and Lithuania were still recording higher-than-expected death rates in 2024, suggesting the pandemic’s impact on health systems and population wellbeing has not fully faded. Lingering effects may include delayed medical care, long-term complications from COVID-19 infections, and broader social and economic disruptions that continue to influence mortality.
Not all countries shared this fate. New Zealand and Luxembourg stood out as rare exceptions, managing to keep deaths at or below expected levels throughout the entire period studied. Their experience highlights how decisive public health responses and sustained control of viral spread may have shielded populations not only during the crisis but also in its aftermath.
Still, experts caution that measuring “normal” mortality in a post-pandemic world is fraught with complexity. Lone Simonsen, who leads the PandemiX Center at Roskilde University in Denmark and was not involved in the research, noted that the study relies on assumptions about pre-pandemic trends that grow more uncertain the further they are projected forward. Shifts in population age structure, the return of influenza and other respiratory diseases, and the long shadow of delayed diagnoses and treatments all complicate the picture.
“There are a lot of moving parts,” Simonsen said. Her own analysis of New York City found no replacement mortality, with deaths returning to baseline levels soon after the city’s first COVID-19 wave. But she cautioned that identifying a true baseline years later is far more difficult, given how profoundly the pandemic altered health systems and behavior.
Across all countries examined, one pattern remained consistent: older adults bore the overwhelming share of excess deaths between 2020 and 2024. Any mortality displacement that did occur was concentrated almost entirely among the very old, reinforcing the conclusion that COVID-19’s toll was not evenly distributed across age groups.
Taken together, the findings suggest that for most wealthy nations, the damage inflicted by COVID-19 was real, lasting and not simply a matter of timing. As reported by Bloomberg, the analysis underscores a sobering reality: the pandemic did more than interrupt life expectancy trends for a moment. It reshaped them, leaving scars that continue to show up in death statistics years later.
