We understand from reading this that the health crisis will have lasting effects on the health of the French. This Tuesday morning, a study on the major causes of death in 2021 in France, carried out by Inserm, Drees and Santé Publique, was made public. In 2021, there were 660,168 deaths, a figure lower than that of 2020 (667,497 deaths), but which remains significantly higher than that of previous years, even taking into account the aging of the population. The report highlights Covid-19 in third place among causes of mortality and argues that in general, the health crisis has had indirect effects on several pathologies.
What are the main causes of death in 2021?
The consequences of the Covid-19 epidemic on mortality are described in the study as “still major in 2021, directly causing 61,000 deaths”, which represents approximately 9% of deaths from all causes in 2021. Covid-19 comes, as in 2020, in third place among causes of death, after tumors and diseases of the circulatory system. The epidemic was particularly virulent in the overseas departments and regions (DROM), in which vaccination coverage was lower than in mainland France.
Tumors represent more than a quarter of deaths and affected more than 55% of men. “Tumors of the lung, bronchi and trachea represent 17.9% of tumor deaths,” the report also points out. Mortality from tumors continues to decline, with the exception of pancreatic tumors and melanomas, which are still increasing. Diseases of the circulatory system are responsible for around 20% of deaths in 2021 and affect 47.4% of men.
What are the indirect effects of covid 19?
Between 2015 and 2019, the trend was downward in mortality linked to endocrine, nutritional and metabolic diseases and, since 2020, a reversal of this trend is at work and is confirmed in 2021. The 2021 data also includes new way an increase in deaths linked to digestive and circulatory system diseases. “The deviations from the past trend are consistent with international results and contribute to documenting possible direct and indirect effects of the Covid-19 epidemic on mortality,” the study cautiously advances.
It is the context of the epidemic and its constraints which could help to explain these changes. The study mentions “indirect effects of the Covid-19 epidemic (delay in care, greater social isolation affecting behavior, increase in harmful alcohol consumption, difficulties in accessing care, after-effects for those in which Covid-19 is an associated cause, etc.) » Other factors unrelated to the epidemic cannot be excluded and the health authorities point to results which encourage additional studies to better understand these increases in mortality.
At the same time, deaths due to respiratory diseases, diseases of the nervous system including Alzheimer’s disease and dementia are falling in France in 2021, more pronounced than the 2015-2019 trend. “These declines could be linked, as in 2020, to competition between Covid-19 and these other causes,” analyzes the study. It is possible that some of the people who died from Covid-19 would have died from another cause the same year, in the absence of a pandemic.” For respiratory diseases, the social distancing measures imposed during the health crisis led to a very low circulation of influenza viruses, before December 2021.
What are the first mortality figures for 2022?
INSEE estimates for the year 2022 “an increase of 54,000 deaths compared to those expected in the absence of a Covid-19 epidemic or other unusual events”, reports the study. According to these estimates, which are not yet consolidated, Covid-19 would have caused the deaths of around 41,000 people in 2022.
The projections would confirm an upward trend, in 2022, for certain diseases (metabolic, nutritional, endocrine, digestive and circulatory). “The largest increase observed in 2022 would concern diseases of the respiratory system, with 9,000 more deaths than in 2021 (45,000 compared to 36,000). This increase could be linked to the two winter epidemic episodes, say the health authorities. However, the numbers of deaths reported to the population would not exceed those before the health crisis: the standardized rates would remain lower than those of 2018 and 2019.”