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US Coronavirus: these indicators which give hope

01:55  24 may  2020
01:55  24 may  2020 Source:   lejdd.fr

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Près de 15 jours après le déconfinement, les indicateurs sont plutôt positifs, et les nouveaux cas moins nombreux. Certains spécialistes estiment même que l’épidémie est derrière nous. Mais les autorités appellent à la prudence. © AFP

Almost 15 days after the deconfinement, the indicators are rather positive, and the new cases fewer. Some specialists even believe that the epidemic is behind us. But the authorities call for caution.

Time for the verdict. Fourteen days - maximum incubation time for Covid-19 - after the start of deconfinement, indicators measuring its health impact will be known this week. The latest figures are quite positive. Experts believe that the epidemic is behind us. But this observation is not unanimous.

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What do the figures say?

The number of patients in intensive care, a thermometer of the tension of the hospital system, continues to decrease since April 8. On Saturday, there were 1,665 serious cases, against 2,132 a week earlier, according to the Directorate General of Health. Deaths are also declining: between Thursday and Friday, 74 deaths from Covid-19 were recorded in hospitals, against more than 600 daily newspapers in early April. "There is no worrying signal emerging," confirms epidemiologist Daniel Lévy-Bruhl, head of the respiratory infections unit at Public Health France. In its bulletin of May 21, the agency, which also scrutinizes Covid consultations, emergency medical services or emergency room visits, noted a continued decline in these other indicators. "But the data available today mainly reflect what happened at the very end of the confinement," he said.

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No region is of particular concern, despite the 46 foci of infection identified since the end of containment. Rather good news, according to Daniel Lévy-Bruhl: "We detect them and therefore we break potential transmission chains, thanks to 'contact tracing'. We can however wonder: what part escapes us? Risk is everywhere, without being particularly strong. "

What do generalists observe?

The MG France union conducted a survey of its members during the first week of deconfinement, to which 2,292 general practitioners from all over France responded. According to its results, revealed by the JDD, these generalists received 6,097 possible cases from Covid-19. After a virologic PCR test, 344 of them tested positive. "Or a positivity rate of 5 to 6%, calculates Jacques Battistoni, the president of MG France, which seems reasonable if we compare it to that of 2% announced by Olivier Véran, which related to all the tests practiced. "

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By extrapolating this result to all of France, we would obtain 158,000 possible cases of Covid-19, and 8,972 confirmed positive. The survey will be repeated this week. "The idea is to be able to measure the trend fifteen days apart, specifies Jacques Battistoni, to see if these rates change, and how." Results on June 4.

Should we fear a second wave?

It is still possible, said Olivier Véran on the eve of the Ascension weekend. If there is hope for the seasonality of the virus, "today the potential for a second wave is clearly there: there is no group immunity," added epidemiologist Daniel Lévy-Bruhl. Everything will depend on the collective attitude of the French.

On Wednesday, the director of the European Center for Disease Prevention and Control, Andrea Ammon, told the Guardian that the question was not whether this new wave of contamination will take place, but "when, and how much" she will. According to her, "85% to 90%" of the population remains exposed to Covid-19.

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This figure therefore includes deaths and recovered or discharged patients (cases with an outcome). For example, a quantity growing by 7% every period (in this case daily) has a growth factor of 1.07. A growth factor above 1 indicates an increase, whereas one which remains between 0 and 1 it is a sign

In our hospitals, the arrivals of seriously ill patients are decreasing. But experts warn of a possible winter return of Sars-CoV-2, like other coronaviruses, or of a very slow restart of the epidemic with an explosion of cases in several months.

What if the epidemic was behind us?

Several experts, minority, support this hypothesis. Jean-François Toussaint, professor of physiology at Paris-Descartes University, believes that in France the epidemic is ending. "After successive waves of diffusion in autumn-winter and an explosive phase in spring, the peak was crossed on April 6." No wonder, he said, since the epidemic is "already behind in 50 countries." "They have crossed the summit, gone down the wave and there are no more deaths. This disease is therefore not endemic," he argues.

According to the epidemiologist and researcher at Inserm Laurent Toubiana, the virus would have circulated "quietly" in France, probably in the fall, without being spotted. It has affected many people, but very few have been diagnosed, only the severe forms have emerged. "The epidemic was meteoric, but it has already affected everyone she could touch, he postulates. She will not iron." According to his estimates, as of May 6, more than 12 million French people had been in contact with the virus. Or 20% of the population.

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A figure much higher than the 4.4% advanced on May 13 by researchers from the Institut Pasteur in Science. "We will never know, says Laurent Toubiana. Among all these infected, many remained asymptomatic; others are insensitive to this virus and are not detectable. Their immune system rejected it without making specific antibodies."

Will we achieve collective immunity?

The results of large-scale surveys carried out by Inserm will provide reliable data on the serological status of the French at the end of May. In theory, the protection threshold is reached when 60 to 70% of the population has been contaminated. But, in addition to unknowns about the protection conferred by antibodies and its potential duration, this threshold is debated.

A study by the Liverpool School of Tropical Medicine argues that it could be between 10 and 20% only, not everyone is sensitive to the new coronavirus. American researchers estimate, in the journal Cell, that 40 to 60% of the population could be protected against Covid-19 without even having been contaminated. This "cross-immunity" is believed to be due to past exposure to other coronaviruses.

The idea of ​​collective immunity already acquired is "far from unanimous", nuance Daniel Lévy-Bruhl, who considers it crucial to maintain barrier gestures, even with a positive serological test: "We can always transmit the virus : the hands have no antibodies. "

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