Mortality in France: Covid remains the third cause of death in 2021

What did the French die of in 2021, the second year of the Covid-19 pandemic? The answer can be found in a study by Inserm, French Public Health and the Ministry of Health, published on Tuesday, December 19. The number of people killed in France that year was exactly 660,168, slightly less than the previous year (667,497 deaths in 2020, including 69,238 due to Covid).

Each death certificate was reviewed to determine the “underlying cause,” which is the “disease, injury, or circumstance in the case of a violent death that caused the pathological process leading to” death.

Here are the key lessons to remember.

There are still many deaths from Covid in 2021…

With 60,895 deaths, or almost 10% of the total, Covid was the third leading cause of death in 2021, behind tumors (almost 170,000 deaths) and cardiovascular disease (almost 138,000). This top three has not changed in 2020. , according to the World Health Organization definition used by experts in France.

Two-thirds of deaths due to Covid occurred in public hospitals, slightly more than in 2020. Only 15% were recorded in nursing homes, which is half as much as last year. Among the likely explanations: the most vulnerable residents died already in 2020, during two very strong first waves of the epidemic.

The departments with the most residents dying from Covid in 2021 are located overseas. The population there is more likely to suffer from pathologies such as diabetes and obesity, which are known to be risk factors in case of infection.

…but less and less among older people

Men still had a greater risk of dying from Covid in 2021 than women, but because older people, who are the most frail, are predominantly women, the same number of people of each gender will die from the infection in 2021.

It is not surprising that the main victims of coronavirus that year were the elderly. Half of the 60,895 deaths were over 85 years of age. But in this age group, the number of deaths fell steadily during the first half of the year… during which a vaccination campaign began, targeting the most vulnerable sections of the population first.

This decline is “likely due to a combination of progressive vaccination, the persistence of barrier gestures, epidemic management and prevention measures, and population-based preventative behavior among the most vulnerable groups,” the study authors wrote.

“Younger populations later benefited from the vaccination coverage effect and, conversely, the gradual lifting of lockdown measures exposed them to greater risk of contracting the virus,” they add.

Several types of deaths are on the rise

Respiratory diseases other than Covid account for low mortality in 2021, as in 2020, no doubt due to the “continuation of measures taken to limit the impact of the health crisis.” Some pathologies caused at least as many deaths in 2021 as in 2020, reversing the downward trend seen in the pre-Covid years. This applies in particular to the digestive system, as well as the endocrine, nutritional and metabolic systems (especially those related to diabetes).

These events can be explained by “indirect consequences of the Covid-19 epidemic (delay in care, greater social isolation affecting behaviour, increased harmful drinking, difficulties accessing health care, consequences for those with Covid-19 as a contributing cause) . etc.), without the ability at this stage to estimate the share of these factors in the observed increase.” In particular, restrictions and anxiety may have increased incentives to drink alcohol and impaired monitoring of chronic diseases.