How demography and population science contribute to our understanding of this public health crisis and the confinement period:

The COVID-19 epidemic deeply disrupted the French health system in what was already a difficult context.

The broad objective of this project is to assess the direct and indirect effects of the epidemic (and/or lockdown) on the health of the French population using French National Health Data System (SNDS data. 
Patient cohorts with chronic pathologies that can be readily identified in the SNDS (e.g., solid tumor cancer, AIDS, sickle cell disease, cystic fibrosis, kidney failure requiring dialysis, diabetes, psychiatric disorders) will be drawn up: For each cohort the following information will be determined:

• levels of treatment use and consumption, morbidity, and mortality (before, during and after France’s first lockdown period, March 17-May 11, 2020);
• frequency of serious COVID-19 infections: admission to ICU, in-hospital mortality, mortality up to 60 days beyond hospital admission;
• population heterogeneity in connection with mortality-associated factors: sex, age, comorbidities, social categories (determined using INSEE’s index of social deprivation), type of residence (institution versus ordinary household), type of employment, place of birth, and geographic zone in France. 

The Ministry of Solidarity and Health is funding the project as part of the PREPS research program (Programme de Recherche sur la Performance du Système de soins).

Project partners: 

--hospital complex of Annecy-Genevois (Tristan Delory); 

--INED (Sophie Le Coeur, Myriam Khlat, Gil Bellis, Émilie Counil, INED Statistical Methods Service); 

--INSERM Mixed Research/Service Unit 1136 (Nathanaël Lapidus, Pierre-Yves Boëlle, Gilles Hejblum). 

By creating a bilingual French-English internet platform providing international data on the demographics of deaths linked to the COVID-19 pandemic, INED has shown its excellence in making standardized data available to the scientific community and citizens at large. International comparisons are a key, integral component of INED-led research. A substantial labor of rationally organized, continuous data accumulation is what made it possible as early as April 2020 to begin studying mortality variations across a considerable number of countries in connection with respective national policies for combatting COVID-19; to assess the French situation from an international perspective; and to document death data collection methodologies in the countries involved.

Many countries took drastic, unprecedented measures to counter the COVID-19 pandemic. Within Europe, the first country to be hit, Italy, was also the first to respond by deciding to quarantine the main epidemic “hot spots,” decreeing a country-wide lockdown, and choosing to suspend all non-essential activities. The other European countries, with the exception of Sweden, instated a general lockdown with varyingly tight restrictions at some point between the March 5 and 23.

At the international level, policy measures have been both multiple and diverse (prohibition of large gatherings, closing of schools and public venues, border closings, population lockdowns, tracking people’s movements via their cell phones, and others); those policies have had repercussions on COVID-19 mortality dynamics. By taking into account demographics-based disparities in mortality, researchers have been able to develop the tools needed for rigorous assessment of the quality and comparability of all available data on deaths due to the virus. This preliminary work is crucial to precise analysis of trends and well-founded projections.

Currently, the platform provides mortality data on Austria, Belgium, Germany, Italy, the Netherlands, Norway, Portugal, South Korea, Spain, Sweden, Ukraine, the United Kingdom, and the United States. Data on other countries will be available soon.

For more information:

Read our interview with INED senior researcher France Meslé and Jean-Marie Robine, a senior researcher at INSERM and advisor on aging and social issues in France and across the world to INED’s Office of the Director.

The SAPRIS project is a longitudinal general population survey designed to identify the epidemiological and social issues of the coronavirus public health crisis in France. It draws on the following five existing national general population cohorts, comprising a total of over 200,000 persons: Constances;  Étude Familiale E3N-E4N;  ELFE (French Longitudinal Study from Birth);   Epipage2;  and NutriNet Santé. Participants will be questioned on the problems and issues implicated in the epidemic and the lock-down (confinement) measures in France. Research focuses include the incidence of COVID-19 symptoms and other health problems; whether or not people seek medical care; risk perception; the effects of infection prevention measures on daily life, social relations, and work; and trust in public and scientific recommendations. The impact of lock-down on children will also be studied, in terms of its effects on parent-child relations and leisure activities, particularly screen use; as well as home schooling conditions and children’s overall wellbeing in a situation of confinement. Study of childhood-related problematics will focus in particular on ELFE/Epipage cohort respondents.

This national survey will be conducted by a multidisciplinary group of researchers from INSERM (Institut National de la Santé et de la Recherche Médicale); INED; the CNRS; the Universities of Paris-Saclay, the Sorbonne, Sorbonne Paris-Nord and Paris Dauphine-PSL; the Caisse Nationale de Assurance Maladie (CNAM: the national health insurance fund), and INRAe (Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement). 

For more information [FR]

The number of people who may be expected to end their lives in nursing care facilities during lockdown for sudden public health crises is likely to be particularly high and the experience particularly traumatizing. The Higher Education, Research and Innovation Ministry has requested the plateforme nationale pour la recherche sur la fin de vie (PNRFV) [national platform for end-of-life research] to develop a multicenter qualitative study that will describe, analyze, and help understand this lived experience and the practices of persons confronted with end-of-life situations and death in nursing homes during the COVID-19 epidemic in France, specifically during the period of lockdown (confinement) and transition to de-confinement.

Humanities and social science research professionals are conducting telephone interviews with nursing home professionals and, wherever possible, family members and residents.

The aim of the project is to use the findings to formulate recommendations and arrangements for improving end-of-life accompaniment in nursing homes during a public health crisis. It is also to improve our knowledge of end of life, the accompaniment of dying persons, and grieving processes under extraordinary temporal conditions.

Emmanuelle Cambois, Senior Researcher at INED, Sophie Pennec, Senior Researcher at INED and Jean-Marie Robine, Senior Researcher at INSERM and advisor to INED management in charge of ageing issues participate in the scientific council of this project.

Contact : plateforme.recherche.findevie @ ubfc.fr

Summary of research: During the SARS-COV2 2020 pandemic, the lethality rate has been highest among subjects aged 80 or over, particularly those with underlying co-morbidities. Elderly subjects living in France’s EHPADs (Établissements pour Personnes Agées Dépendantes: skilled nursing care facilities) are therefore particularly vulnerable due to their individual and contextual characteristics (age, co-morbidities, collective living situation, access to treatment). Approximately 600,000 old and oldest-old subjects live in these facilities in France. The aims of the COVID-EHPAD research project are

1. to determine over-mortality among subjects living in EHPADs during and after the epidemic;
2. to determine the causes of death (the share related to COVID-19 and share not related);
3. to determine the risk of serious SARS-COV-2 infection;
4. to evaluate treatment during the epidemic of subjects living in EHPADS in the areas of i) care for COVID-19 and ii) care for other pathologies in the context of lockdown and hospital saturation.

The consortium of researchers involved is under development. Jean-Marie Robine will participate in this project.

Contact: Florence CANOUI-POITRINE 

Housing situation has once again become a crucial dimension of our living conditions since much of our social activities are currently taking place in our living spaces.

The COCOVI project (Confinement, Conditions de vie et Inégalités) will analyze housing conditions and household life in France during the COVID-19 pandemic, measuring disparities before and during lockdown (confinement) between households of different social milieus, located in different geographical environments (rural, peri-urban, city center, single-family suburban, dense housing projects, etc.). Situational disparities may be due to changes in household composition and arrangements and/or temporary or definitive changes in residence and housing. 

The project will be run by researchers of INED’s “Housing, Spatial inequalities and Trajectories” research unit and will draw on three complementary types of data:

• in-depth interviews with households confined in different types of areas that are also sites of former ethnographic field studies;
• secondary processing of public statistics general population surveys (notably the “Logement” [Housing] survey);
• an ad hoc questionnaire to be taken by approximately 1000 persons constituting a representative sample of France’s adult population. The questionnaire survey will be conducted jointly with a group of researchers from COCONEL (Coronavirus et confinement: Enquête Longitudinal), INSERM (Institut National de la Santé et de la Recherche Médicale), IRD (Institut de Recherche sur le Développement), the ANR (Agence Nationale de la Recherche) and the IFOP opinion poll institute: Patrick Peretti-Watel (scientific coordinator), Valérie Seror, Sébastien Cortaredona, Odile Launay, Jocelyn Raude, Pierre Verger (research consortium), François Beck, Stéphane Legleye, Olivier L’Haridon, Jeremy Ward (Steering Committee).

First Results

This project includes a survey questionnaire (the COCONEL-1 “Housing and living conditions” survey) of the adult French population designed for the purpose of a first overall assessment of the effects of lockdown in France (confinement). The survey inquired into living spaces and places, income, work and working at home, children and family relations, social contacts and the feeling of isolation, young people’s experience, and family solidarity during the pandemic. The first findings have revealed major changes in daily living conditions and housing uses and inhabiting modes. The survey has also shown how confinement widened existing social gaps in French society, to the detriment of women, young people, and people of relatively modest material and financial means. Interruption or loss of paid work, fall in income, fear for the future, feeling of isolation—all these indicators worsened cumulatively, deepening a range of existing inequalities.

To consult it, click here [FR]

Read the two issues of Population and Societies dedicated to the survey :

Population and Societies n° 578 

Population and Societies n° 579

Contact: Anne Lambert - anne.lambert @ ined.fr

The aim of the EpiCoV project is to characterize the prevalence of the epidemic at the national and "département" scales, measure the effects of living conditions on exposure to the virus and, conversely, the effects of the epidemic on living conditions. The “Epidemiology and living conditions” survey or EpiCoV was launched by INSERM and DREES (the statistics office of the French Ministry of Health and Solidarity), with assistance from INSEE and Santé-Publique-France, to analyze the effects of the COVID-19 pandemic. The EpiCoV team includes epidemiologists, sociologists, demographers, and economists from INSERM, INED, the CNRS, and the Universities of Paris-Saclay and Paris-Dauphine. 

The survey follows how the epidemic evolves by questioning the same respondents over several waves. The first was conducted partially on internet and partially by telephone from May 2 to June 2, 2020, thereby covering the end of the first general lockdown period, which began in March, and the first few weeks of reopening, which began on May 11. INSEE used the FIDELI (Demographic files on housing and individuals) database to draw a random sample of 135,000 people aged 15 or over on January 1, 2020, and living in ordinary?/typical? [le lecteur va-t-il savoir ce qu’est un “ménage ordinaire”?] household structures in metropolitan France, Martinique, Guadeloupe, and Reunion. The second survey section was conducted from late October to late November 2020. 

This project is carried  by Ariane Pailhé, senior Researcher at INED.

More information

This project, conducted under the egis of the WHO’s Collaborative Center for Maternal and Child Health, purports to document the state of preparation, quality, and resilience of maternal and child health services in different European Union countries in connection with the COVID-19 pandemic. The aim of the project is to improve the quality of in-hospital

This project is carried for France by Virgine Rosee, Researcher.maternal and neo-natal care.  

Remote working has increased to an unprecedented degree during the Covid-19 crisis. This has helped people protect their health and their jobs, but the specific context in which remote working was set up has also exacerbated what the literature has identified as its potentially negative effects, particularly for women due to unequal sharing of domestic and parenting responsibilities. Our hypothesis is that while appearing gender neutral, this way of organizing work affects men and women differently. We also posit effect heterogeneity by family situation and remote working mode. The aim of the project is to understand the impact of remote working on gender inequalities in work activity, family organization, overall wellbeing, and mental health. The project will analyze data from two major surveys representative of France’s general population: “Epidemiology and living conditions” or EpiCoV and “Survey on the experience of work and unemployment during the health crisis” or Tracov. 

The COVID-19 crisis has shaken up societies and raised new research questions. To avoid research redundancies or overlap and ensure that the most important questions are handled, it is crucial to coordinate research activities. It is for this purpose that INED has joined forces with the CNRS and INSERM’s HS3P-CriSE working group, whose aim is to develop research structuring initiatives in the social and human sciences and public health in connection with COVID-19, infectious diseases generally, and today’s major health and environmental crises. The group is designed to play a complementary role for existing, currently hatching, or projected research actions and initiatives, particularly calls for projects, by proposing scientific research programming plans. The focus will be on the situation in France; also and more widely on other countries, with particular emphasis on global South countries.

This project is carried for Ined by Myriam Khlat,Senior Researcher an head of the Research Unit Mortality, Health and Epidemiology 

For more information [FR] 

Valérie Golaz tells us about the COVID-19 indicators used in France

Être en couple chacun chez soi, une situation plus fréquente après une séparation, Population et Sociétés n°566, mai 2019

La famille à distance : Mobilités, territoires et liens familiaux. Christophe Imbert, Eva Lelièvre et David Lessault (Dir), Ined, 2018, 376 p

Continued cohabitation after the decision to separate: “Living together apart” in France, Wilfried Rault et Arnaud Régnier-Loilier, Journal of Marriage and Family, n°Early view, 2019, p. 1-16.

Le lien père-enfant au parloir : entre pertes et ressources, Marine Quennehen, Encyclo. Revue de l'école doctorale ED 382, n°10, 2020, p. 91-109.

Expérience carcérale et exercice de la paternité : le point de vue de pères détenus, Marine Quennehen, Champ pénal / Penal Field, n°16, 2019.

La paternité s’arrête-t-elle aux portes de la prison ?, Marine Quennehen, 2019, Revue Française des Affaires Sociales, n°4, 2019, p. 73-96.

Quatre questions clés sur les indicateurs de suivi de l’épidémie de COVID-19 en France. Article de Valérie Golaz, directrice de recherche à l’Ined, Bénédicte Gastineau, Marie-Laurence Flahaux, et Stéphanie Dos Santos, octobre 2020

25 ans de participation des hommes et des femmes au travail domestique : quels facteurs d’évolutions ?, Clara Champagne, Ariane Pailhé et Anne Solaz, Documents de travail, n°203, Ined, 2014, 45 p.

Échapper à l’enfermement domestique. Travail des femmes et luttes de classement en lotissement pavillonnaire, Anne Lambert, Actes de la Recherche en Sciences Sociales, n°215, 2016, p. 56-71.

La page portail du site de l’Ined sur les violences et les rapports de genre : 
https://www.ined.fr/fr/ressources-methodes/etat-de-la-recherche/violences-et-rapports-de-genre

Site internet de l’enquête Violences et Rapports de Genre (virage) : 
https://virage.site.ined.fr/

Site Internet de l’enquête Virage dans les Outre-mer : 
https://viragedom.site.ined.fr/

De la longue histoire des épidémies au Covid-19. Jean-Paul Sardon, . Les Analyses de Population & Avenir, 2020. hal-02557027f

Population review selection

Paléodémographie et démographie historique en contexte épidémique. La peste en Provence au XVIIIe siècle, Michel Signoli, Isabelle Séguy, Jean-Noël Biraben et al., Population, Vol. 57, n°6, 2002, p. 821-847.

After the epidemiologic transition: a reassessment of mortality from infectious diseases among over-65s in France and Italy, Aline Désesquelles, Elena Demuru, Marilena Pappagallo et al., International Journal of Public Health, vol. 60, n°8, 2015, p. 961-967.

The mortality impact of the August 2003 heat wave in France: Investigating the ‘harvesting’ effect and other long-term consequences, Laurent Toulemon et Magali Barbieri, Population Studies, vol. 62, n°1, 2008, p. 39-53.

La peste : bref état des connaissances actuelles, Isabelle Séguy et Guido Alfani, Annales de Démographie historique, vol. 134, n°2, 2017, p. 15.

Recul spectaculaire de la mortalité due à la grippe : le rôle de la vaccination, Population et Sociétés n°470, septembre 2010

Vers une anthropologie des catastrophes, Isabelle Séguy, Luc Buchet, Catherine Rigeade, et al., 2009, Editions APDCA / Ined, 553 p.

Population mondiale : vers une explosion ou une implosion ?, Population et Sociétés n°573, janvier 2020

Habiter seul ou avec des proches après 85 ans en France : de fortes disparités selon les départements, Population et Sociétés n°539, décembre 2016.

Vieillissement et fragilité : approches de santé publique, Bulletin épidémiologique hebdomadaire n°16-17, 11 juillet 2017