Background. The impact of the COVID-19 pandemic on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or intensive care unit (ICU) admission, results in prolonged and chronic illness, or leads to premature death. Our objectives were to quantify the total disease burden of acute COVID-19 in the Netherlands in 2020 using the disability-adjusted life-years (DALY) measure, and to investigate how disease burden varies between age-groups and occupation categories.
Methods. Using standard methods and diverse data sources (registered COVID-19 deaths, hospital and ICU admissions, population-level seroprevalence, mandatory notifications, and the literature) , we estimated the total years of life lost (YLL), years lived with disability (YLD), DALY and DALY per 100,000 population due to COVID-19, excluding its post-acute sequelae, and additionally stratified by 5-year age-group and occupation.
Results. The total disease burden in the Netherlands in 2020 due to acute COVID-19 was 273,500 (95% CI: 268,500–278,800) DALY, and the per-capita burden was 1570 (95% CI: 1540–1600) DALY/100,000, of which 99.4% consisted of YLL. The per-capita burden increased steeply with age, starting from the 60-64 years age-group. The per-capita burden by occupation category was highest for healthcare workers and lowest for the catering sector.
Conclusions. SARS-CoV-2 infection and associated premature mortality was responsible for a considerable direct health burden in the Netherlands, despite extensive public health measures. Total DALY were much higher than for other high-burden infectious diseases, but lower than the estimated annual burden from coronary heart disease. These findings are valuable for informing public health decision-makers regarding the expected health burden due to COVID-19 among subgroups of the population, and the possible gains from targeted preventative interventions.