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Only 47% of obese people are vaccinated against Covid-19 in France, while they are at high risk of developing serious forms. Associations and specialized professionals regret the late opening of the vaccination campaign to obese people.
“From April 2020, I quickly understood that something was wrong,” recalls Anne-Sophie Joly, president of the national collective of obese associations (Cndao). Very early on, in the field, resuscitators reported to him more frequent cases of death in Covid-19 patients suffering from obesity, that is to say with a higher body mass index (BMI). to 30. An intuition today largely confirmed by the figures: between January and March 2021, 47% of people hospitalized in French intensive care units for Covid-19 were obese, or nearly one in two patients, after data from Public Health France.
Obesity has since been recognized as a risk factor. And yet at the end of May, less than one in two people with obesity (47.6%) received their first dose of the Covid-19 vaccine. A vaccination rate “low in view of the risks”, alerted the Health Insurance, which published, for the first time on May 23, data on the progress of vaccination coverage according to comorbidities.
If this rate is not higher, it is because obese people between the ages of 18 and 55 had to wait until the 1er May to have the right to make a vaccination appointment. “For too long, obesity was not one of the comorbidities recognized for having access to vaccination”, deplores Claire Carette, nutritionist and diabetologist at the Georges-Pompidou European Hospital. “They have only been entitled to it for about a month, it will take time to catch up,” she regrets. “We really fought for the eligibility of the obese to be advanced, but there was probably not enough vaccines in view of the number of obese people in France. We are nearly 8 million”, underlines Anne-Sophie Joly.
Obesity is not recognized as a disease in France
Another problem: obesity in France is poorly detected and poorly identified. Health Insurance data only take into account people supported by a healthcare establishment for their obesity, ie only 10% of obese people. Invisible, the others escape radar and it is not known whether they are sufficiently protected against Covid-19. Still others don’t know what BMI is, let alone how to calculate it. “Obesity is very widely underdiagnosed in France, where it is not recognized as a disease, including by doctors,” said Dr Claire Carette. Unlike the WHO, which has considered obesity as a chronic pathology since 1997, France persists in treating it as a risk factor.
Also, specialist medical staff also complain about the lack of funds granted, which causes very long delays in accessing obesity care. “As specialists, we would like to have more resources to take charge of this category. With us, it takes 3 to 6 months to get an appointment. We work as a team with dieticians, psychologists, or these consultations -they have not yet been reimbursed, which puts off some of the people concerned, ”regrets Dr Claire Carette.
Obesity and precariousness : a double scourge
The issue of access to healthcare is all the more important as obesity affects vulnerable populations more. “Eating well is expensive. Obesity does not only affect the poor, but there is an increased prevalence in disadvantaged social categories, who are known to be less receptive to care or prevention messages, such as vaccination campaign against Covid-19 “, explains the obesity specialist.
In the Parisian suburbs, Seine-Saint-Denis, one of the territories most bereaved by the coronavirus, is both the second poorest department in France and the one with the most obese people: they represent 20% of the population, against 10% in Paris. Only 37.4% of people identified as obese by Health Insurance have been vaccinated with at least one dose, a figure below the national average.
“There is work to be done on health policies by matching them with the actions of the Ministry of the City to reach out to the most disadvantaged populations,” said Claire Carette. “We know that there are ongoing programs and an awareness of the authorities, but we hope things will move faster.”
The Covid-19 pandemic has made it possible to appreciate the importance of the fight against obesity. “The problem must not be forgotten,” worries Anne-Sophie Joly, recalling the figure of around 40,000 obese people who died from Covid-19 in France. “That a 25-year-old dies in Covid intensive care because he was obese, it is not understandable. We must recognize the problem, provide information and benevolent prevention.” His collective, the Cndao, is participating in the writing of a roadmap on obesity on behalf of the Ministry of Health.