France in “absolute vigilance” – Liberation


The Covid-19 pandemic in Francedossier
Despite the surge in contamination, the moderate increase in hospitalizations gives hope for a very attenuated epidemic rebound in metropolitan France.

A harbinger of a new health catastrophe or an inconsequential scent of the epidemic wave that is paralyzing several countries in continental Europe today? One thing is certain: the delta variant is making its big comeback in metropolitan France. Since the beginning of November, the contaminations counter has started to panic again. Monday, for the first time since mid-September, the incidence rate, or the number of weekly cases per 100,000 inhabitants, rose above 100, twice the official alert threshold. Nothing to do with the dramatic level recorded in Germany (more than 300 cases per 100,000 inhabitants) and especially in Austria (815).

But the rise affects “all the regions” and all age groups, Public Health France (SPF) in its epidemiological bulletin of November 11, which alerts on“Accelerating the progression of the epidemic”. In fact, the viral outbreak is still in its early stages, with the number of infected now doubling every two to twenty days. What put the executive on alert. “Vigilance is absolute”, government spokesman Gabriel Attal insisted on Tuesday, at the microphone of France Inter. Not without immediately tempering his words: “There is no containment planned today, neither near nor far.” Clearly, we are still far from the red alert.

“Amplify the” go to “”

For now, infectious disease specialists are not panicking about this new viral outbreak. “I’m not too concerned at the moment”, admits Professor Gilles Pialoux, yet usually among the first to demand braking measures from the authorities. “If contaminations are on the rise again, hospital admissions only increased over the same period by 7%, and by 9% for critical care admissions, explains the head of the infectious disease department at Tenon hospital in Paris. This disconnection between the infection curve and that of hospitalizations, very clear in France, is reassuring for the moment. Thanks to the combined effect of vaccination and the health pass, we are not approaching the wave at all under the same conditions as our neighbors across the Rhine. “

While in Germany as in Austria, some hospitals are overflowing, the pressure on the French health system remains bearable, in view of past crises. On November 16, 1,277 Covid patients were hospitalized in critical care: at the beginning of November 2020, at the peak of the second wave, they were more than 4,900… Infectious diseases at Saint-Antoine hospital, Professor Karine Lacombe is no more alarmist that his colleague from Tenon: “I am optimistic that the efforts we have made in recent months will enable us to cope”, she insists, congratulating herself on the level “appreciable” vaccination coverage (74.9% of the population has a complete vaccination schedule). According to a study by Public Health France published on Tuesday, the vaccination had “A significant impact on the epidemic, in particular for those eligible in priority”. More precisely, from the third wave (from March to May 2021), the weekly number of contaminations and deaths linked to Covid fell by 90% for residents in nursing homes, compared to the second wave of autumn 2020 …

The will expressed by Emmanuel Macron on November 9 to consolidate vaccination coverage, by calling to responsibility the 6 million unvaccinated people but also by matching the validity of the health pass to the third dose for those over 65 years old reassured the hospital staff. . “Half of the Covid patients hospitalized at the moment in my department are unvaccinated, insists Karine Lacombe. Not all of them are antivax, far from it. It is imperative to amplify the “going towards”. ” Vaccinate and especially revaccinate. For the infectious disease specialist, mobilizing the French on the booster dose is crucial. “The other half of my patients are vaccinated but do not have a sufficiently high level of antibodies, she emphasizes. Sometimes the fault is immunosuppressive treatment associated with certain comorbidities. But also often with age, the effectiveness of the vaccine decreasing over the months in those over 60 years old. “

“Cautious optimism”

A drop in immunity documented by an Israeli study published in late October in The New England Journal of Medicine : in people over 60, the effectiveness of the vaccine against infection against Covid drops to 57% after six months, even if it remains high (86%) against severe forms. “To protect the elderly, the third dose is necessary, insists Professor Lacombe. More broadly, all vulnerable people, starting with the obese, should be concerned by the recall. ” According to the President of the Scientific Council, Jean-François Delfraissy, who says he feeds a “Cautious optimism”, the vaccination effort, combined with a strict application of the health pass and barrier gestures in public places, should allow the health system to overcome the looming problem. “We have the tools and we must use them, adds Professor Pialoux. The public hospital today simply no longer has the means to absorb a wave of similar magnitude to the first three. An epidemic rebound would already be really worrying if it were to mesh with other winter viruses, such as influenza or bronchiolitis. ”

Because between departures, recruitment difficulties and the need to take the plethora of accumulated leave by December 31, the shortage of caregivers now weighs on the functioning of establishments. This is true at AP-HP, where more than 1,000 nursing positions are now vacant. But the province is not spared, the understaffing being felt from Grenoble (where the health authorities had to activate the white plan) to Bordeaux, via Lille. For lack of staff to take care of it, bed closures are piling up. At the worst time. Conclusion of Professor Pialoux: “This time the wave would not have to be very high to put the hospital very low.”


Source: Libération by www.liberation.fr.

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