Tribune. The health crisis has cast a harsh light on the flaws in our health system, which was already under strain even before the emergence of the pandemic. This system is largely based on the self-sacrifice of staff whose mobilization we support on December 4, 2021 in defense of the public hospital.
These structural difficulties have multiple causes, some intrinsic to the organization of care and the lack of resources, others are more profound, in connection with the epidemic of chronic diseases that has been observed in recent decades, including the environmental origin is now scientifically established.
The victims of Covid are primarily people with chronic diseases (obesity, hypertension, diabetes, cardiovascular diseases, etc.) and 15% of deaths from the coronavirus are also linked to air pollution. In February 2021, Epi-lighthouse (National Health Insurance Fund-CNAM / National Agency for Medicines and Health Products Safety-ANSM) carried out an analysis of data on the entire French population, i.e. 67 million people, in order to identify chronic diseases and factors such as age or gender that may lead to an increased risk of hospitalization or death for Covid-19.
The doubling of chronic diseases
The conclusion is clear. Out of 47 chronic conditions analyzed, 46 are associated with increased risks of hospitalization and death for Covid-19. Certainly, age and sex are important factors, but, after adjusting for these two factors, the increase in the risk of hospitalization and death is 150% for obesity and heart failure, 100% for diabetes or chronic respiratory diseases… The risk is doubled in the most disadvantaged populations.
Richard Horton, editor-in-chief of Lancet, was able to speak in this regard of “syndemic”, that is to say a pandemic whose magnitude comes from factors other than the infectious cause. In France, the number of chronically ill people has doubled over the past two decades and this phenomenon will increase if nothing is done.
The report of the CNAM published in 2021 gives the reality of the epidemic of chronic diseases in 2018: 21 million people affected and a projection of 23 million for 2023. Between 2012 and 2018, cardiovascular diseases went from 3.5 million to 4.9 million (2023 forecast: 5.5 million), and diabetes from 2.9 million to 3.9 million (2023 projection: 4.4 million).
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