Where are we with the 8th wave of Covid? How will it develop? What about the emergence of new varieties? These are the first questions that the government asked the Health Risk Watch and Anticipation Committee. Its name: The Covars. Installed for a month, the body replaces the scientific council, special Covid, led by Professor Jean-François Delfraissy. It is no longer just a matter of dealing with one crisis, but of anticipating the next ones.
Its nineteen members – infectious disease doctor, virologist, veterinarian, emergency physician – led by immunologist Brigitte Autran, deliver their guidelines in a first opinion. The stakes are high; reduce the impact of Covid and winter infections while protecting a fragile health system. Their motto consists of four verbs: “Prevent, detect, treat and involve”. Explanations.
What is the cause of the current recovery?
After the start of the school year, the curve, carried by the BA.5 subvariant, accelerated again, resulting in an 8th wave and a number of cases of 576 per year. 100,000 inhabitants. According to members of Covars, this reboot does not appear to be due to the appearance of a new variant. But it is very “probably” associated with a combination of several factors: decrease in collective immunity, climatic conditions favorable for the spread of the virus, resumption of school.
Is this 8th wave considered worrisome?
If the impact among the over-65s is still to be “monitored”, specialists believe that this epidemic wave is of “moderate” intensity. The risk of complications or death is similar to that observed with the BA.1 and BA.2 subvariants, which caused the 5th and 6th waves from December 2021 and March 2022, respectively. Good news, the impact in the hospital was less than these earlier outbreaks because there were fewer contaminations in total and therefore fewer deaths.
When is the peak?
It seems to have been achieved. The number of cases is decreasing, but it can still be expected, with a delay of two to three weeks, an increase in admissions. The members of Covars speak of an “early signal of a slowdown in the dynamics of the current wave”. The school holidays, which have just started and are spreading the population, as well as the current mild weather which is conducive to outdoor activities, should “confirm” this slowdown. But let’s not claim victory too quickly. First, temperatures will logically drop again. And the BA.5 subvariant, the majority in France since the end of June, could be replaced by the latest: BQ.1.1.
Should we expect a 9th wave soon?
According to the nineteen members, these “encouraging signals must be tempered” by the rapid growth of the BQ.1.1 variant in France, discovered in mid-September and responsible for 15% of the positive cases in early October. They note that the level of immune escape from this sublineage is “uncertain.” This new enemy is likely to cause a very large number of contaminations, including among vaccinated or already infected.
In their opinion, the experts explain: “If this trend were to be confirmed, it could call into question the apparently initiated plateau-decline dynamics of the wave. Since the beginning of the year, we have faced a cascade of Omicron subvariants, to the point that it looks like an “alphabet soup,” as Dr. Maria van Kerkhove noted during the recent World Health Organization press conference. And as soon as you become the majority, boom… a new wave begins. Also watch out for an increase in absenteeism, this winter, at the hospital, a consequence of a “fatigue” or even a “general fatigue” affecting the nursing staff. Usually about 7 to 10% for paramedic nursing staff, it peaked at 11 to 16% last winter. So the game is not yet won.
What are the envisaged scenarios?
If a new variant does not appear, the models do not expect a “big recovery in admissions”. However, there is one who plays spoilsport: BQ.1.1. On this particular variant, it is necessary to wait to know it better in order to anticipate the consequences of its circulation. But now the very first data show a “significant immune escape” even in people already contaminated with BA.2 and BA.5.
The members of Covars also explain that it is necessary to take into account all the infectious diseases of the winter, which are returning: influenza, bronchiolitis, gastroenteritis… “These epidemics greatly increase the tension in the specialized services”, we can read in the message.
And what do we do now?
First, prevent, that is, “quickly” reinforce the new campaign, driven by the arrival of bivalent vaccines, adapted to Omicron to target the 18 million eligible people within three months: more than 80 years, pregnant women, immunocompromised. .. summer, the previous campaign was only a “half success”, the experts clarify. These new bivalent vaccines have only been available since September 26 and October 3. Moderna’s first targets both the original strain of the virus, known as Wuhan, and BA.1, Omicron’s little brother. The other from Pfizer is fighting BA.5. Objective: “strongly expand information to the very demanding population about bivalent vaccines and their availability (who and when should be vaccinated?), open centers in community centers, e.g. »
Are we still wearing the mask?
Yes ! Moreover, the experts note, “communication must be strengthened, incentive, simple, clear and repeated”. This measure must be combined with barrier moves (physical distancing, etc.) because it is unlikely to be enough to extinguish the epidemic. Covars requests the maintenance of the obligation to wear a mask in healthcare structures, such as in hospitals. He also recommends ventilating the premises wherever the situation calls for it, especially in schools, which many epidemiologists have been calling for for almost two years. According to the statement, air quality monitoring should become “a pillar of health promotion and the fight against respiratory diseases, especially in schools”.
Is the isolation of positive cases over?
None. Covars does not question the isolation of infected people. And with regard to the treatments, he recommends speeding up the use of Paxlovid, this pill that is little used in France and which, however, makes it possible to limit the severe forms in the most fragile ones. The government had ordered 500,000 doses of it by the end of January 2022. Good news, it remains effective against current variants.
Faced with this uncertain context: new worrisome enemy, weakened hospital, return of winter diseases… The Covars experts conclude that the situation “does not allow us in the short term to consider the integration of Covid in a trivialized management of health risks associated to seasonal infections.In other words, we cannot consider Covid as a simple bronchitis.