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Abstract While the direct effects of the pandemic are well documented, less is known about the indirect ones, including changes in healthcare provision or human behavior. This paper aims to study the impact of indirect consequences on mortality, focusing on two leading causes (cardiovascular diseases, COVID-19) and places of death in Czechia, during the COVID-19 pandemic, one of the most severely affected European countries. The analysis was performed using data from the Czech Statistical Office and the Institute of Health Information and Statistics. The study compares annual mortality changes during three time periods: pre-pandemic (2018–2019), pandemic beginning and peaking (2020–2021), and pandemic fading (2022). Pandemic years were covered by the WHO public health emergency of international concern. Abridged life tables were computed, and Pollard's decomposition was used to calculate the contributions of causes and places of death on annual differences in life expectancy. Seasonal decomposition of monthly time series revealed an increase in cardiovascular mortality at home or in social care facilities corresponding to limitations in healthcare. While COVID-19 had a systemic negative effect on life expectancy during the pandemic, the impact of cardiovascular mortality according to place of death changed over time. This study contributes to the evidence base of systemic risks during health crises and emergency response.

Abstract When evaluating vaccine efficacy, the conventional measures include reduction of risk of hospitalization and death. The number of patients dying with or without vaccination is often in the public spotlight. However, when evaluating public health interventions or the burden of disease, it is more illustrative to use mortality metrics taking into account also prematurity of the deaths, such as years of life lost (YLL) or years of life saved (YLS) thanks to the vaccination. We develop this approach for evaluation of the difference in YLL and YLS between COVID-19 victims with or without completed vaccination in the autumn pandemic wave (2021, October–December) in Czechia. For the analysis, individual data about all COVID-19 deaths in the country (N = 5797, during the studied period) was used. While 40.6% of the deaths are in cohorts with completed vaccination, this corresponds to 35.1% of years of life lost. The role of vaccination is expressed using YLS and hypothetical numbers of deaths. The registered number of deaths is approximately 3.5 times lower than it would be expected without vaccination. The results illustrate that vaccination is more effective in saving lives than suggested by simplistic comparisons.