The coronavirus epidemic hitting the world at the start of 2020 exceeds most of the epidemics known in Europe in recent years. This is the case in terms of the extent of its consequences, in particular health, economic and social.
Italy, Spain, but also France have more deaths than other European nations, without the reasons being very clear. Rules and dates for setting up confinement, compulsory or optional wearing of masks, health system, etc. There are many avenues. But another answer could be found not in the dozens of figures and dashboards dedicated to Covid-19 in real time, but in the data related to influenza.
Each year, the member countries of the European Union send Eurostat details of the causes of death that have taken place on its territory, which then publish these data with a two-year lag. In the case of France, it is the National Institute of Health and Medical Research (Inserm), via the Center for Epidemiology on Medical Causes of Death (CépiDc) which sends them to Luxembourg, where finds the headquarters of the European body responsible for the aggregation and dissemination of Community data.
Among the various causes of death identified in the data set is therefore influenza. And since 1994, France accounts on average for more than 17% of European deaths in this area, while it weighs between 12% and 13% of its population. Italy, for its part, lists 18.6% of deaths linked to influenza, for less than 12% of the European population.
Contrary to this trend is Germany, whose population represents around 15.5% of the European population and which accounts "only" for 6.5% of influenza deaths in Europe.
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Flu deaths in Europe compared to the population
"These figures should be taken with great care," explains Grégoire Rey, director of CépiDc. As the symptoms of influenza are not very specific, the cause of death indicated on the death certificate does not necessarily stipulate it, even if the epidemic has greatly contributed to the death of the person. According to the doctor who will note a death, the flu can be indicated as the sole cause of death or not indicated at all.
However, if the flu affects the entire population, it is fatal, especially for the elderly. And it is here that one of the explanations for these important figures is found: “France and Italy have a population with a high life expectancy, so many people arrive at advanced ages. It is this public that is the most fragile in the face of the flu, ”continues Grégoire Rey.
The vaccination coverage in question
However, vaccination coverage in different countries is also an important factor to take into account. "In recent years, the trend has been towards vaccine-bashing in France," notes France Meslé, research director at the National Institute for Demographic Studies (INED).
The French are now among the most skeptical Europeans about vaccines. A Eurobarometer published in March 2019 indicated that 30% of French respondents considered that it was not important to be vaccinated regularly, a proportion twice as large as the European average. A sufficient proportion to place the country in last place among European countries convinced by vaccination, alongside ... Italy.
These doubts, which are gradually appearing in the population, are felt in the data available on vaccination coverage: while in 2009, 64% of French people over 65 were vaccinated against influenza, they were less than 50% in 2017.
Thus, between the doubts that are beginning to appear on the usefulness of vaccines and a population structure that allows many people to get older, Italy and France are quite logically in the front line among the countries that pay the heaviest toll for flu in Europe.
