New wave of covid-19: why France is doing better … for now – Le Télégramme

Does good vaccination coverage in France explain the current number of cases of covid, which is lower than elsewhere?

Philippe Amouyel, professor of public health at the Lille University Hospital: Spain, Portugal, Italy, and, to a lesser extent, France, have significant vaccination rates that exceed 75%. These three southern European countries have slightly older populations and they have succeeded in vaccinating these age groups, which are more than 95% advanced. Under these conditions, the number of people that the Delta variant can still infect is more limited in these countries. France is in an intermediate situation: we are well vaccinated, we have caught up well. But we still have a small deficit over the over 80s.

Yves Coppieters, professor of public health at the Free University of Brussels (ULB): The vaccination rate is not the only explanatory factor. In Belgium the coverage is quite good and in Flanders it is almost the highest in Europe. However, we see an explosion of contaminations.

Antoine Flahault, director of the Institute for Global Health (ISG) at the University of Geneva: The high vaccination coverage represented an immune brake, delaying the arrival of the autumn wave, but it does not block it on its own, whatever the level of coverage reached. The effectiveness of vaccines is indeed imperfect vis-à-vis the transmission of the virus.

So what are the other explanations for this weaker circulation of the virus in France today?

Yves Coppieters: Maintaining barrier gestures is a key factor. France experienced a fourth wave in July, which made it possible to maintain these barrier gestures in August and September, even if they are currently being observed to be less respectful. But, in many other countries like Belgium, the summer period has, on the contrary, been synonymous with a great relaxation.

Antoine Flahault: A lesser relaxation of behavior was observed during the epidemic lull in September and October. In addition, social interactions often took place outside during a particularly mild start to autumn.

Philippe Amouyel: The various parameters that affect the number of cases are compliance with barrier gestures – wearing a mask, washing hands, ventilation – associated with the immunity acquired by a previous contamination and vaccination, to which is added the health pass. .

Is the health pass, still in force in France, really effective in containing contamination?

Philippe Amouyel: France will continue to keep it, I hope. Denmark, a pioneering country in terms of health passes, had descended to extremely low contamination rates. After lifting it on September 10, the epidemic took off again. In France, some prefects took the decision that in the event of presentation of a health pass, there was no longer any need for a mask. I think it was not a good idea.

Yves Coppieters: One thing is certain, the health pass has boosted vaccination in France. But does it really limit contamination? The effectiveness of vaccines on this point has been overestimated because of the more contagious Delta variant. Countries are also considering combining the health pass with a test or wearing a mask.

Antoine Flahault: The dikes seemed to hold up a little longer for countries that have extended the use of the sanitary pass, but we do not yet know how long they will be able to hold …

Should we expect a strong epidemic rebound in France?

Antoine Flahault: France, Portugal, Spain, Italy and Malta are the countries that have resisted the onslaught of the autumn wave that has hit Eastern and Central Europe the longest since the end of August, then Western Europe since the end of September. Since mid-October, these five countries have in turn experienced a rebound with a reproduction rate of the virus approaching or exceeding 1.2, that is to say an exponential growth of their contamination curve which is not controlled. for now. These countries are not yet seeing a rebound in their hospitalizations or deaths, even if the situation in Portugal and Italy seems to be deteriorating in this regard as well.

Yves Coppieters: We must fear a rebound in contaminations, hospitalizations, but not necessarily in resuscitation and mortality. Unfortunately, we cannot reduce the growth in hospitalizations. This is problematic, because all of our countries have broken health systems. As the contaminations resume, a whole series of personnel could be positive and discarded, which will put the services in difficulty.

Philippe Amouyel 😕 We have almost reached an incidence of 100 positive tests per 100,000 inhabitants, which is a warning signal. There is also a rise in hospitalizations, even if it is low. During the summer, in Metropolitan France, there was a decoupling between the increase in the number of cases and hospitalizations in intensive care. What is absolutely necessary is to preserve this decoupling, because it is the hospital saturation that creates the health crisis. However, there, saturation is likely to switch, not only because of the covid but also by the return of the flu, bronchiolitis and gastroenteritis.

What needs to be done to contain this wave of covid?

Antoine Flahault : It seems that Europe has not yet sufficiently integrated the major role of aerosol transmission in indoor environments. There is an urgent need to enact standards prohibiting the reception of the public in insufficiently ventilated indoor places. It would be necessary to demand systematic measurement of the CO2 concentration in these enclosed spaces, and, when it is not possible to ventilate them sufficiently, require the installation of HEPA air purifiers. Finally, it would probably be necessary to broaden the positioning of the new antiviral treatments arriving this fall on the European market.

Philippe Amouyel: We must continue to vaccinate those who are not, and continue with the third dose, especially for those over 65. We must resume the barrier gestures that we could have overlooked: wearing a mask, washing hands, ventilation. They are effective not only against covid but also against other viruses.

Yves Coppieters: It is also necessary to go to be tested at the slightest symptom. And countries must not wait for an exponential increase in cases to put back this layer of barrier gestures, because it will already be almost too late.