Expected and observed deaths in France from 2020 to 2022: accurately assessing the excess mortality during the COVID-19 pandemic period

Abstract

AbstractBackgroundExcess mortality has been used worldwide for summarizing the COVID-19 pandemic-related burden. In France, the reported estimates for years 2020 and 2021 vary by a factor of three, and reported evolving trends for year 2022 are discordant.ObjectivesWe aimed at selecting the most appropriate modelling approach enabling an accurate estimation of the excess mortality in France during the 2020−2022 pandemic years.MethodBased on the 18,646,089 deaths that occurred In France between 1990 and 2023, the natural trend of age-and gender-specific death rates over time was considered according to three models which performances were compared for accurately predicting mortality data in the absence of pandemic perturbations. The best modelling approach was then used for estimating age-and gender-specific excess deaths and corresponding expected years of life lost in the individuals deceased in 2020, 2021, and 2022.ResultsA quadratic model trained with years 2010−2019 estimated that 49,352 [40,257; 58,165] (mean [95% confidence interval]), 43,028 [29,071; 56,381], and 54,373 [34,696; 73,187] excess deaths occurred in France in 2020, 2021 and 2022, respectively. Corresponding years of life lost rose over time with 503,289 [446,347; 561,415], 581,495 [493,911; 671,162], and 667,439 [544,196; 794,225] years of life lost for the individuals deceased in 2020, 2021, and 2022, respectively.ConclusionThe study proposes a reliable method for accurately estimating excess mortality. Applying this method to the 2020−2022 years of the COVID-19 pandemic in France yielded estimates of excess mortality that peaked in year 2022.