How mortality has evolved in France since the start of the coronavirus crisis

The first wave of coronavirus, which raged around the world from February to May, left its mark. Exhausted health systems, a moribund economy and a million deaths later, it is time to take stock, before facing the second wave of the pandemic. A study conducted by Imperial College London (United Kingdom), in partnership with the National Institute for Demographic Studies (INED), and published in the journal Nature Medicine, examines mortality by integrating the part caused by Covid-19. In this ranking of industrialized countries, France comes eighth out of 21, all causes of mortality combined. France is behind England, Spain, Italy, Scotland, Belgium, the Netherlands and Sweden, but ahead of Portugal, Switzerland and Austria.

In their methodology, the researchers only highlighted industrialized countries with more than four million inhabitants, and based their table on weekly mortality figures between mid-February and mid-May. As the study points out, the consequences of the Covid-19 pandemic are not limited to the one million deaths worldwide. To fully appreciate the influence of the coronavirus on a planetary scale, it is essential to take into account the deaths linked to other diseases which could not be treated during the pandemic. Finally, as healthcare systems and the economy have been strained by the pandemic, the social consequences are also another factor to factor into this data.

More than 200,000 additional deaths from Covid-19

The research team produced a table of the impact of the coronavirus in each country. First, they used different statistical models to estimate the number of deaths that would have occurred between mid-February and mid-May if these countries had not been hit by the pandemic. These figures were then compared to the actual number of deaths during this period, in order to estimate the death toll caused by the first wave of Covid-19.

Between mid-February and the end of May, 206,000 additional deaths were recorded in these 21 countries, compared to the levels expected if the pandemic had not hit them. This figure (206,000) corresponds in a normal year to the total number of deaths attributable to lung cancer, and it is also more than double those linked to diabetes or breast cancer.

“The pandemic has affected people’s lives and health in many different ways. For example, some may have had their surgery or treatment postponed, or may have lost the help they relied on for their day-to-day medical needs.comments Vasillis Kontis, doctor at Imperial College London and first author of the study. Taking these factors into account, the study of Covid-19 deaths alone is too limited; studying deaths from all causes gives us a better understanding of how countries handled the pandemic and cared for the health of their people during lockdowns.”

The study tells us that France can be considered as a country having moderately felt the consequences of the coronavirus, in particular on the number of deaths. France has recorded around 35 deaths per 100,000 inhabitants, i.e. a relative increase in deaths of 13%. This is less than that suffered by our Belgian neighbors (27%) but almost twice as much as in Switzerland (7%).

“The consequences in France have not been as strong as in England, Italy or Spain, but France still remains above the median of the 21 countries in terms of excess mortality. France also stands out as a country whose excess death toll has been lower than the number of Covid-19 deaths.emphasizes Dr. Michel Guillot, research director at INED and co-author of the study. This suggests that there has not been a major under-registration of Covid-19 deaths in France, but also that the pandemic and the health policy response may have generated a drop in deaths from covid-19. other causes. This is why excess mortality is such an important metric, it provides a clear and comprehensive picture of how the pandemic has affected mortality, both directly and indirectly.”

Lessons to be learned in public health

In light of these results, the researchers believe that lessons must be learned from these results in order to prevent a possible second wave from being as deadly. This is particularly the case for containment measures, which were put in place in France once the pandemic was well established in the population. “Countries with effective and comprehensive local testing and contact tracing campaigns in place, or those without such systems but with early and effective containment measures in place, experienced a lower death toll during the COVID-19 pandemic. first wavesays Jonathan Pearson-Stuttard, doctor at Imperial College London and co-author of the study. As we enter the second wave, testing and tracing programs, and support for people who need to self-isolate, represent our most important lever to minimize the influence of the pandemic on direct Covid deaths. -19 and deaths from other conditions. Such programs also reduce the need to return to extended lockdowns.”

Similarly, the main countries that have been heavily bereaved by Covid-19 are also those that have not invested enough in their public health system, particularly in hospitals. “Long-term investment in national health systems is what allows a country to both respond to the pandemic and continue to provide the routine routine care that people need. We cannot dismantle the health system for austerity and then expect it to take care of people when the need is greatest, especially among poor and marginalized sub-populations, said Majid Ezzati, professor at Imperial College London and lead author of the study. A strong and equitable healthcare system is the only way to tackle existing inequalities and ensure that the nation is more resilient to future pandemics.”