In April, an elderly resident living in Seine-Saint-Denis, France's poorest commune on the edge of Paris, went to hospital worried they had Covid-19. The test returned negative and the pensioner was sent home. Ten days later they were found dead.
For now, the death does not appear in France's official Covid-19 death toll, which includes only those who die in hospitals and nursing homes.
But data from the INSEE statistics office shows a nationwide increase in deaths at home. The rise is particularly pronounced in some of the low-income suburbs ringing central Paris.
"It's clear Covid-19 is killing a lot more people in their homes," said a healthcare worker familiar with the pensioner's death, "because they didn't know that they had it or were too wary to contact people for help."
The coronavirus has killed more than 25,500 people in France, the world's fifth highest toll behind the United States, Britain, Italy and Spain.
The government plans to add home deaths in June. How many is hard to project as health authorities are not conducting Covid-19 tests on people who die at home.
INSEE data shows that 109,327 people died in France during the March 1-April 20 period, a 26 percent and 15 percent increase on the corresponding periods in 2019 and 2018. Known Covid-19 related deaths account therefore for 19 percent of total deaths.
The data shows that deaths at home during this period jumped by 28 percent from 2019 to 26,324.
Jacques Battistoni, president of France's National Union of General Practitioners, told Reuters his organisation estimated that at least 9,000 people had died of Covid-19 at home. He said that was based on one in every six of France's 55,000 general practitioners reporting at least one suspected Covid-19 death.
"People have been scared of going to their doctors or disturbing them and the symptoms can be benign," Battistoni said.
"WE'RE GOING TO FIND MORE"
Official statistics show the rise in mortality rates during the coronavirus outbreak has been markedly higher in some of the lower-income districts on the outside of the ring-road encircling Paris.
Deaths at home during the same six-week period more than doubled in Seine-Saint-Denis to the northwest, Val-de-Marne to the east and Hauts-de-Seine to the west, compared to 2019 and 2018.
The heavy toll highlights how the combination of cramped social housing, workers with frontline jobs and a population distrustful of the authorities turned such areas into infection hot spots where many were reluctant to seek help.
Doctors have cautioned the excess mortality rate could also be linked to people dying from other illnesses because the coronavirus outbreak has deterred people from seeking medical attention.
Health Minister Olivier Veran told parliament on April 29 that the Public Health Authority, which is in charge of compiling Covid-19 data, would have an answer on home deaths in June.
Asked about the forecast of at least 9,000 deaths by Battistoni's union, he told lawmakers: "We've received a first alert from (them) about possible excess mortality at home, but which may not necessarily be related to Covid but medical complications of people who have not gone to hospital."
Edouard Jean-Baptiste, a general practitioner on the eastern edge of Paris, said it could take as long as a year to get a full picture of the impact of Covid-19, as was the case with annual flu figures.
"I think in the coming weeks and months we're going to find more people dead from Covid-19 at home and whom we knew nothing about," he said.