Last year in France, 675,000 people died. That is 53,800 more deaths than anticipated, given the ageing of the population, the trends recorded over the last ten to fifteen years... and "in the absence of a Covid-19 epidemic or other unusual events" such as influenza or heat wave, according to figures published Tuesday by INSEE. How to explain this excess mortality of 8.7% over the period?
"Deaths observed from 2010 to 2022 and expected from 2020 to 2022" Screenshot of the INSEE study published on June 6, 2023, entitled "53,800 more deaths than expected in 2022: higher excess mortality than in 2020 and 2021".
A year marked by flu and heat waves
If Covid-19 killed nearly 38,300 people in 2022, it is lower than the figures of the previous year (59,100 in 2021), had already pointed out Public Health France. "Deaths due to causes other than Covid-19have therefore increased in 2022," concludes INSEE.
Among the causes cited by the institute, the two influenza epidemics of the year 2022. "A first late epidemic in March-April, then an early second in December." The epidemic at the beginning of the year had been "most likely favored by the easing of control measures of the Covid-19 pandemic" at that time, said Public Health France. On March 14, the mask requirement had been lifted in almost all enclosed spaces. A few months later, in November, the influenza epidemic began earlier than in previous years with an incidence exceeding 100 physician visits for ILI as early as week 46 (November 14 to 20, 2022). Almost three weeks earlier than in 2017, the second earliest start in the last five years.
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These epidemics may also have been accentuated by post-Covid syndromes, especially among the elderly. Excess mortality in 2022 was 7.8% for those aged 85 to 94 and 9.8% for those over 95. "Some elderly patients may still have post-Covid syndromes that have weakened them," says Patrick Gasser, president of the union of medical specialists Avenir Spé. "Some elderly patients, for example, have presented chronic lung infections as a result of a Covid infection." The specialist adds, however, that it remains difficult to scientifically assess the consequences of this "weakening of patients".
France also experienced very strong heat that year. Heat waves caused more deaths in 2022 than in 2021. Nearly 2800 people died compared to 200 the previous year. "High temperaturesfor much of the summer could also lead to deaths outside heat waves," says INSEE.
The indirect consequences of Covid-19
Finally, INSEE points to a final explanation that is more difficult to grasp: the indirect consequences of Covid-19. How? By the "postponement of operations" or the decrease in "detection of other diseases". Many specialists had warned about the risks at the height of the crisis: "The Italians are the first to have expressed their concern because they realized very quickly that people were no longer consulting," explains Patrick Gasser. "Our patients who came back had much more serious pathologies than what we saw before," says the gastroenterologist. Patients came "six months or a year late."
For the specialist, it is indeed likely that late diagnoses and the discovery of "more aggressive and more advanced" pathologies can increase mortality in the long term. The doctor cites the discovery of already metastasized cancers or vascular pathologies, such as diabetes, at an advanced stage. But like INSEE, Patrick Gasser prefers to speak of a "probable hypothesis" and remain cautious in the absence of precise figures to date. "It will require further analysis," says the specialist. According to him, excess mortality among women (8%, compared to 5% in 2021), could for example be explained by the lack of treatment of breast cancer.
