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Study: Excess Mortality in France

A pre-print study by P. Moulaire et al titled “Expected and observed deaths in France from 2020 to 2022: accurately assessing the excess mortality during the COVID-19 pandemic period” posted on 14 December 2023 confirms what is generally already known, that there is no small number of excess mortality in France since 2020.

The paper is 24 pages long. The main text is about 15 pages, the remaining are references and figures.

The study assessed three models: the “average model”, the “linear model”, and the “quadratic model” based on the 18.6 million deaths in France recorded between 1990 and 2023.

Although the linear model is not bad in some ways, the quadratic model is, on balance and not surprisingly, the most accurate. This model yielded the following:

The estimated excess mortality in year 2020 was 49,352 [40,257; 58,165] additional deaths, dropped to 43,028 [29,071; 56,381] deaths in 2021, and rebounded to 54,373 [34,696; 73,187] deaths in 2022. Therefore, a total of 146,753 [103,940; 187,459] excess deaths were estimated from 2020 to 2022 with 96,692 [74,572; 116,937] excess deaths occurring in males (66% of the excess deaths).

The authors speculate as to why 2022 excess mortality is higher than the previous two years.

Actually, the mortality directly attributed to COVID-19 decreased over time during the pandemic period, with a corresponding number of death certificates mentioning COVID-19 (suspected or confirmed) of 76,800, in 2020, 69,114 in 2021, and 50,211 in 2022. Opposed time trends between excess mortality and COVID-19 directly-related deaths suggest that indirect factors such as the disturbance of the health care system have increased mortality in 2022.

As a sidebar, notice that death certificates mentioning COVID-19 could have been merely “suspected” rather than “confirmed” (and even then there is the question of the means of confirmation).

But back to the point of the cause of excess mortality: funny how the authors, not surprisingly, do not mention you-know-what as a possible cause. It would, after all, be interesting to analyze the timing of the (excess) deaths relative to vaccine uptake.

The Organisation for Economic Co-operation and Development (OECD) keeps track of weekly excess mortality. I do not know how these figures are calculated in detail, only that the expected number of deaths is based on the average of the actual number of deaths over the past five years for that particular week.

According to the OECD, the excess mortality in France in 2020 was 62,828, in 2021 was 57,962 and in 2022 was 71,752. Therefore, a total of 192,542 deaths can be estimated for the period 2020 to 2022.

These figures are clearly higher than the estimations provided by the study’s quadratic model. Although the figures for 2020, 2021 and the total for the 3-year period are outside of the study’s 95% CI, the 2022 figure falls within it.

In any case, the trend is generally similar with 2022 higher than the previous two years. One wonders why…

The OECD data for France is plotted below. Also included merely as a visual aid is the vaccine uptake (%) according to the European Centre for Disease Prevention and Control (ECDC).

Excess mortality (%) and vaccine uptake (%) in France from 2020 week 1 to 2023 week 41.
Excess mortality (%) and vaccine uptake (%) in France from 2020 week 1 to 2023 week 41.

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