Life expectancy and Covid: how vaccines have protected us, by Pr Alain Fischer

Covid-19 is undoubtedly responsible for the death of more than 16 million people worldwide, including more than 150,000 in France. It thus comes to interrupt the continuous increase in life expectancy observed in most countries since 1950. A study, recently published in the journal Nature Human Behaviour quantified the impact of the pandemic on life expectancy in 2020 and 2021 in 30 countries that have reliable mortality statistics.

The findings are instructive. As expected, with the exception of the Scandinavian countries (Sweden excluded, it did not confine its population in 2020), a drop in life expectancy was first observed everywhere in Europe. For France, it is just over six months and is primarily the result of excess mortality among people aged over 60. This reduction was weaker in Germany, but of the order of one year in Spain, Italy and Great Britain, and reached two years in the United States! These data illustrate the seriousness of the Covid, although it is less than that of the 1918 flu pandemic which had caused a reduction in life expectancy, albeit transitory, of sixteen years in France!

The evolution of life expectancy in 2021 makes it possible to assess the impact of the measures taken to limit the consequences of the pandemic, in particular the effect of vaccination which began at the end of 2020. A few countries including France have completely or almost completely caught up with the deficit in life expectancy observed in 2020. Thus, the deficit at the end of 2021 is no longer in France at more than 1.2 months, with a more marked catch-up in the second half of 2021. Britain, the catch-up was only modest. In Eastern Europe and the United States, life expectancy continued to decline. In the latter country, mortality linked to opiate addiction may have played a role, but the pandemic nevertheless played a major role. Indeed, this study shows a very strong correlation between increased life expectancy and anti-Covid vaccination coverage in the last quarter of 2021, particularly among those over 60. We must remain cautious because a correlation does not establish a cause and effect relationship. However, she strongly suggests it.

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The rationale for vaccination policies

Several conclusions can therefore be drawn from this publication. First, the effect of the pandemic on life expectancy has had no precedent since 1945. Second, it suggests that countries, including France, which ensured high vaccination coverage of their populations were able to save the lives of a large number of people, especially the elderly and frail. This work provides convincing data on the validity of the vaccination policies implemented by these countries. Despite the few shortcomings of these in France (elderly people, people in a difficult economic situation, minorities less well vaccinated), the results obtained must be credited to those who have taken on the responsibilities of public health policy.

It is strange that in this context, in France and only in France, a Minister of Health has been indicted for a putative insufficiency of public action. This no doubt reflects the striking contrast between the results obtained and the perception of the French people of this policy. From a recent survey (Slavaco) led by sociologist Jeremy Ward, it appears that 56% of French people think that scientific information on vaccines has been concealed or that, for 36%, the health pass was not necessary. This survey shows a limited confidence of a fraction of the population in the country’s health policy. This dissociation between perception and action (vaccination, respect for barrier gestures, etc.) undoubtedly reflects a certain French state of mind. Probably, it justifies a posteriori a pragmatic approach to the vaccination policy which combined explanation, building trust, incentive (health pass) and, if necessary, obligation (for health professionals).

France has certainly not been at the forefront of innovation against the Covid, in contrast to the United States and to a lesser extent Great Britain. Yet it has better health outcomes: differences in social policy explain this contrast. We can nevertheless formulate the hope that our country will be able to carry out an advanced social policy and a policy favorable to research, both public and private.

Alain Fischer is professor emeritus at the Collège de France and co-founder of the Institute of Genetic Diseases (Imagine).