Friday, January 28

Covid-19. Soaring hospital admissions: the month of all dangers

How far will the Omicron wave rise? No one can yet answer this question. But its current level is already fearful of the worst.

Three times more infections in ten days

With more than 330,000 contaminations in 24 hours on Wednesday, the epidemic level in France reached unprecedented heights, still unthinkable just two weeks ago. This is six times more than the maximum levels reached in previous waves – that is to say around 50,000 contaminations in 24 hours.

And this is not a flash in the pan: every day a new record, with the threshold of 100,000 contaminations crossed at Christmas, that of 200,000 just a few days later, and that of 300,000 at the beginning of January. In less than ten days, the number of contaminations has tripled.

The Omicron variant, recalls Gabriel Attal, would be “less virulent”: according to British data, its virulence would be reduced by 50 to 70%. Figures often repeated, but not yet scientifically confirmed.

“Stratospheric levels” of the epidemic

On Wednesday, Gabriel Attal was cautious: the government spokesperson spoke of a dangerousness divided by two or three … figure accompanied by many precautions:

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“Our fight against the epidemic is still far from over. The epidemic has changed in nature and size. The incidence rate has tripled. It exceeds 1,800 cases per 100,000 inhabitants. In all regions of France, it is above 1000 and reaches stratospheric levels in certain regions such as Île-de-France and Corsica, ”he said shortly after the Council of Ministers. Before adding:

This rise in contamination will continue and no reversal of the trend is expected.

Gabriel Attal Wednesday

Corollary of these “stratospheric” levels: even less virulent, the Omicron variant risks being as deadly or even more deadly than its predecessors.

Less virulence to qualify

Indeed, as Guillaume Rozier, the founder of Covid Tracker reminds us, we are currently seeing five times fewer hospital deaths for the same number of contaminations.

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However, this comes back, with five times more contamination … to an equivalent level of mortality.

Above all, we do not know why Omicron is less virulent: is it in itself? Or thanks to vaccination, barrier gestures, measures taken …? The answer is: all at once. But to what extent?

Clearly, for example, if vaccination is the main responsible for this lesser severity, the 5 million vaccinated have something to worry about: they will have to deal with a virus that is still as dangerous for them, but which will circulate much more strongly.

Already more than 200 deaths per day

The average number of daily deaths returned this week above 200, a level that had not been reached since … last May. And yet, we were then in the downward phase of the epidemic. In the “rising” phase, we have to go back to October 2020 to reach such a level of mortality.

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The same goes for hospitalizations and critical care services: the average maximum level reached over a week was 3,500 admissions per day for the first wave, 2,700 for the second.

The Pasteur Institute, at the end of December, published models anticipating the rise of Omicron. Among the optimistic scenarios, two are already obsolete: they anticipated 1400 to 1900 admissions per day.

The dreaded level of hospitalization at the end of January already exceeded

There are currently between 2,500 and 3,000. Which is already above the dreaded average level for … end of January!

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There remain the darkest scenarios, with 5,000 admissions per day – and this would already be a leap into the unknown: anticipated for the end of January also, this hypothesis assumes a virulence of Omicron two times lower than that of Delta – which would be the case, according to Gabriel Attal. But also an intermediate or low “transmission advantage” (contagiousness). However, if we have only one certainty about Omicron, it is its incredible infectious power – estimated, sometimes, five times greater than that of Delta.

We must therefore look at the scenarios of the Pasteur Institute considering both severity halved (-54%) and high transmissibility: this time we find expected peaks of 10,000 … even 17,000 daily admissions.

Little or no braking action

The Pasteur Institute took care to moderate these projections according to individual behavior: the 5,000 scenario, for example, would only lead to 2,500 hospitalizations per day if the French reduce their contacts by 20%. Likewise, an increase in the rate of administration of the booster dose by 50% would reduce the hospital impact by 9 to 17% depending on the scenarios.

But if the government is betting everything on vaccination – no less than 25 million French people have already received their booster dose – other measures are almost non-existent, and the epidemic is on the rise.

More than 500,000 daily cases per day?

The Pasteur Institute had also modeled the number of daily contaminations expected from January 3.

According to these data, it is rather the intermediate scenario that seems to hold the line, with a level of infections (red curve) around 300,000 per day at the beginning of January.

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But a curve, again, worrying, which rises to more than 500,000 daily contaminations by the middle of the month – if no braking measure takes place.

Many unanswered questions

Current hospitalizations are largely made up of patients with the Delta variant – the impact of infections on the hospital is generally delayed by two weeks. Moreover, on the curve, there is a “flat” around Christmas, before a clear rise just after.

So how far will the Omicron wave rise? How many hospitalizations? What role will children play, in school but little or no vaccination? Will vaccination be enough, even increased, to curb the number of severe forms? How to measure the epidemic, when screening is saturated? What about antigenic tests and self-tests, less reliable with this variant?

So many questions that remain, to this day, without a precise answer, even if the most optimistic scenarios are obsolete. The Minister of Health Olivier Véran had warned: the month of January will be “difficult” in hospitals.

Reference-www.leprogres.fr

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