On October 8, Public Health France, Drees and Inserm published a study on the main causes of mortality in France in 2022. After tumors and cardio-neurovascular diseases, diseases of the respiratory system (excluding Covid -19) come in as the 3rd cause of death while the number of deaths due to Sars-CoV-2 has become the 5th cause of death, after having decreased by almost a third compared to 2021.
Pour 20 MinutesIsabelle Parent du Châtelet, head of the respiratory infections and vaccinations unit at Public Health France, analyzed the latest data concerning influenza and Covid, in particular as causes of mortality during the 2023-2024 season.
What observations can we make about the number of deaths from flu and Covid last season?
Among the 161,416 deaths declared by electronic death certificate from all causes, 1,862 [1,2 %] were with a mention of influenza as a morbid condition having directly caused or contributed to the death. Among them, 88% were aged 65 and over. Concerning Covid-19, 5,671 deaths [3,5 %] were reported with mention of infection, 95% of whom were aged 65 or older. There were therefore more deaths with the mention “Covid” than deaths with the mention “flu”.
However, mentions of viruses attributable to deaths are undoubtedly not systematic in the certificates. Modeling work had made it possible to estimate a number of 9,000 to 10,000 annual deaths from influenza.
For clarification, the report from Public Health France, published in April 2024 which presents these data, mentions that mortality data from electronic certification of deaths only covers 43% of national mortality. But deaths that occur following hospitalizations, which is often the case for the two infections mentioned, represent approximately 66% of deaths.
How can we explain these trends?
For the flu, the proportion of deaths with flu mention has returned to approximately the mortality levels before the 2020 pandemic. And for Covid, mortality is decreasing. The Covid-19 virus continues to circulate, it is not at the levels that we could observe at the start of the pandemic, but it is still there and it does not really have any seasonality. You can have waves in the spring, a little before summer, in the fall and then see it return in winter. As we can see through the hospitalization data for example for the elderly, it remains an infection which has an impact on public health and which can be partially prevented.
How can we best prevent these infections?
Vaccination and barrier gestures (notably wearing a mask when you have symptoms and when you are in contact with people at risk) are the two key prevention measures. So, when we see that more than 40% of people interviewed for the Coviprev study say they do not wear masks, even in the presence of symptoms, that is striking. Because it’s not just for Covid, all diseases that are transmitted through the respiratory tract should lead to the reflex of wearing a mask. This was the lesson we thought we had learned from the pandemic. And obviously, that’s not entirely the case. However, as previously mentioned, Sars-Cov2 is rife all year round. We must therefore not lift our vigilance as long as it is circulating and not minimize its consequences.
Our file on Covid-19
The campaign for flu and Covid has been joint since last season. And the vaccination coverage data for the 2023-2024 season was really insufficient: 54% of people aged 65 and over, who are in the targeted audience, were vaccinated. For Covid-19, for these same targeted people, vaccination coverage was 30.2%. For the most vulnerable people (e.g. 80 years and over, residents of nursing homes, immunocompromised), there are two vaccination appointments against Covid-19 per year due to the lack of seasonality in traffic. of the virus and the fact that vaccines do not provide long-lasting protection.
What do you say to people who think that vaccines are useless against Covid and the flu?
The important message to convey is that flu vaccines are re-evaluated each year to best adapt to viruses that could circulate during the winter season. For Covid too, vaccine production is adjusted to variants which become the majority. Thus, the vaccine used against Sars-Cov2 for the current campaign targets the latest JN.1 variant.
For information, for the 2023-2024 vaccination campaign, the effectiveness of influenza vaccines was around 53%. So, even if it is not 100% effective, the vaccine still reduces the risk of contracting the flu by 50%.
