Resumption of the Covid epidemic: what to expect in Occitania? – Free noon

As indicators tremble, the World Health Organization is sounding the alarm. Alain Fischer, the French “vaccine man”, is for his part more “vigilant” than “worried”. Montpellier’s Mircea Sofonea, epidemiologist in infectious diseases, rejects the specter of a re-containment.

Incidence rate on the rise, vaccination in slow motion, third dose in small steps, and already the return of the mask to school in 40 departments: the indicators of the Covid epidemic are on the rise again and the reaction is organized. But what to expect

A tense situation again

Hans Kluge, the director of the World Health Organization, sounded the alarm on Thursday at a press conference on the very worrying circulation of the virus in Europe, became the“epicenter” of the epidemic. In a context of “insufficient vaccine protection” (47% of the population) and “relaxation of sanitary measures and barrier gestures”, the projections are worrying: 500,000 dead by February 2022.

In France, indicates Public Health France, the circulation of the virus is also accelerating: + 10,050 cases in one day, from November 2 to 3. Alain Fischer remained reassuring on Thursday on France Info: “We are in a context where we have a change of weather favorable to the virus.” The Chairman of the Vaccine Strategy Steering Committee “is not in worry but vigilance”.

The situation in Occitania.
SOPHIE WAUQUIER

Towards a fifth wave?

“It is difficult today to know how far the reproduction rate, the” R “, will increase”, estimates Mircéa Sofonea, lecturer in epidemiology and evolution of infectious diseases at the University of Montpellier. “This is the status quo today, with an” R “around 1.1, in a period of school holidays that breaks the chains of transmission. It is not much. If we stay like this, the wave will exist, but it will have a moderate hospital impact. If, at the start of the school year, there is an acceleration in the circulation of the virus, if we have, for example, an R of 1.2, and if we remain on this dynamic in November and December, we must fear hospital tensions. . But we are not there yet, and above all, we have time to react “.

A reassuring element: “We do not see the emergence of a mutant of the disturbing Delta variant, which could be a game-changer”. “The word vague is too strong, the increase is moderate, and we are very far from saturation of hospitals”, insists Alain Fischer.

Should we be worried?

“We expected a comeback, we didn’t know when”, recalls Mircea Sofonea. According to him, today, “there is no reason to worry the same way as during the first waves”. “We start from a lower level of incidence, from a lower level of hospitalization … the epidemic would have to progress much more to have a worrying hospital impact. Everything is slower, and we know what to do to avoid tensions: increase vaccination coverage, administer third doses, reinvest the barrier gestures where they may have been released, and above all, do so on a territorial basis. “

With what leeway? Like France, Occitanie has some flaws in the vaccination of the most vulnerable : 10.3% of 50-64 year olds are not vaccinated, it is better for 65-74 year olds (5.8% unvaccinated), the figure goes up in those over 75: 9.8%.

How to convince them? “There is a ceiling, but we must not give up, and stop the pedagogy, it’s worth persevering. Behavior changes can take months”, says the researcher. He also thinks that we are better able to fight against Covid, while knowledge of the virus is improving: “I am part of the ANSES expert group working on aerosol transmission, it took more than a year to obtain recognition from the WHO.”

TGV and TER

How to explain in a simple way the current epidemic situation? Mircea Sofonea uses a railway metaphor: “The first wave was the TGV. The second wave, we were in a TER, but we didn’t want to see the obstacle, we ended up reaching it. third wave, we were still in a TER, but we did not want to brake when we saw the obstacles. With the fourth wave, we were faced with obstacles that we did not know when we thought we would overcome them. “

“There, we are still in a TER, we can see the obstacle in the distance, but we have several options to avoid it: we can brake, fork … We don’t need to make a firm and final decision now . “

The specter of a re-containment?

“No, clearly, this is not a hypothesis. We have one of the best vaccine coverage, the French have become accustomed to the barrier gestures that we are intended to remove in the long term … we must re-mobilize them to pass a final milestone . Post-infectious immunity will allow us to go through a transitional phase, before an endemic phase, of life with the virus “., indicates Mircea Sofonea, who specifies that“we are not at all in the same scenario as last fall“.

For him, “If we are all vigilant, we can get out of it. But weariness must not turn into an antagonistic reaction”.

“We must not relax”

Thomas Hottier is Managing Director of the Inovie group, a major player in medical biology in Occitanie, and in France, where he accounts for 18% of the activity.

The Covid “comfort” tests have been paying off since October 15. What is the impact ?

We see an overall decrease of 50%, stronger on the antigenic tests than on the PCRs. But people have not all understood the current system, with which we fully agree with regard to the “comfort” tests that should be waived: in the collective unconscious, a prescription is now necessarily required for get tested and be reimbursed. This is the case for contact cases and unvaccinated major symptomatic people.

On the other hand, vaccinated people and adolescents do not need a prescription to be tested and reimbursed. In total, the tests are still reimbursed for 90% of the population. Now is not the time to slack off. We have been seeing a tremor in epidemic indicators for several weeks.

Why call him back?

The danger is to believe that you are immune when you are vaccinated, and not to be tested if you have symptoms.

You also regret that the so-called “multiplex” tests, which allow the search for several viruses, are not deployed even though they are recommended by the high health authority …

Multiplex tests target 25 pathogens and are only prescribed in rare cases. Perhaps it would have been necessary to make a simpler device, which targets winter viruses, 4 or 5 viruses including that of influenza, to avoid confusion and the risk of contamination in the current context.

On a more general level, would you like us to learn lessons from the crisis?

We must dust off the nomenclature of acts, without spending more money. An example: the screening of positive Covid tests is always requested, and reimbursed. What is the point when the Delta variant is overwhelmingly in the majority today? It would be better to have systematic sequencing, which makes it possible to monitor the evolution of the virus.

In addition, we should already anticipate the next crises, plan for the future of molecular biology for example, knowing that equipment has been acquired in the context of the Covid. In the future, it is the emergence of multidrug resistant bacteria that worries us.