Sunday, May 22

Covid-19. Nearly 500,000 cases in 24 hours: the epidemic peak has not yet passed

Beware of any premature optimism in the face of a virus that would be “benign” and at a peak already reached: the WHO reminds us, the Covid-19 pandemic “is far from over”.

Omicron causes hospitalizations and deaths, and even the mildest cases overwhelm healthcare facilities. This pandemic is far from over and given the incredible growth of Omicron around the world, it is likely that new variants will emerge.

Tedros Adhanom Ghebreyesus, Director General of WHO

The Covid-19, soon “endemic”?

On January 11, the European Medicines Agency (EMA) estimated that although the disease is still in the pandemic phase, the spread of the Omicron variant will transform Covid-19 into an endemic disease with which humanity can learn to cope. live: “As immunity increases in the population – and with Omicron there will be a lot of natural immunity in addition to vaccination – we will move quickly towards a scenario that will be closer to endemicity”, said Marco Cavaleri, head of vaccine strategy at the Amsterdam-based EMA.

Others have also spoken of “the beginning of the end” of the pandemic with Omicron.

Several reassuring signs are emerging and are indeed prompting many political leaders to decree an early and rapid return to normal.

A less severe variant

First, a lesser severity of the Omicron variant: observed in South Africa, confirmed across the Channel or even in Denmark, this is a point that seems to be materializing: this results in a lower proportion of infected people who end up in the hospital. Better: the phenomenon would be even more marked for intensive care units.

Thus, according to data from the Drees (Direction of Research, Studies, Evaluation and Statistics) of the Ministry of Health, Omicron represented 90% of cases for the week of January 3 to 9, but only half daily hospitalizations and a little more than a quarter of intensive care admissions.

Another sign of the lesser virulence of Omicron: the duration of these hospitalizations decreases, with 6.5 days on average against 9.8 previously.

As a result, the government is resolutely optimistic: what if Omicron was a “chance” to widely immunize the population, without too much health damage? Every week, at the current rate of 300,000 contaminations per day, more than 4% of the population is infected.

Effective vaccines, but…

The high vaccination coverage in France (nearly 80% of the population has received two doses, more than a third of its booster dose) is also an asset – if only to preserve hospitals.

We will probably have new variants, but perhaps we will now be safe from the risk of hospital saturation

Antoine Flahault, epidemiologist

For his part, the boss of the WHO is much more cautious – at least on a global level: “In some countries, Covid cases seem to have peaked, which gives hope that the worst of this last wave is over. , but no country is out of the woods yet”.

Epidemic outbreak almost everywhere

In recent weeks, the epidemic has progressed in almost all countries of the world, with many contamination records.

Now is not the time to give up and wave the white flag. Omicron may be less severe on average, but the narrative that it is a mild illness is misleading, harms overall response and costs more lives

Tedros Andhanom Ghebreyesus

According to him, it is still “possible to significantly reduce the impact of the current wave” thanks to public health measures and vaccines.

Because, he said, “vaccines may be less effective at preventing Omicron infection, and its transmission, than they were against previous variants, but they are still exceptionally effective at preventing serious forms of the disease and deaths”.

Herd immunity, an outdated mirage

Are politicians right to rely on herd immunity? Not sure: according to Antoine Flahault, this concept “lived for the case of the coronavirus, since we see the immunity pierced on all sides by Omicron”.

This variant has the ability to reinfect people who have already been infected and/or vaccinated, its mutations probably allowing it to escape immunity by neutralizing antibodies.

This is evidenced by the work of researchers from the Institut Pasteur and the Vaccine Research Institute: after analyzing the blood of people vaccinated with two doses of Pfizer or AstraZeneca, they discovered that five months later their antibodies did not neutralize the variant. Omicron.

Admittedly, the booster dose restores protection to a sufficient level, but for how long? The British health agency estimates that it begins to decline after ten weeks. On the other hand, the efficacy against the severe forms would persist longer.

Result: herd immunity seems all the more unattainable as vaccines are imperfect and mutations are numerous and frequent.

Which variants after Omicron?

The lesser virulence of Omicron also has a counterpart: its very high contagiousness suggests a particularly high number of cases. However, even if a very small percentage of them must be hospitalized, this mathematically corresponds to a large number of patients: 1% of 500,000 infected people represents 5,000 hospital admissions… much more than ever before since the beginning. of the epidemic.

There will be new variants: to appear, active circulation of the virus and imperfect immunity are necessary – in other words, the conditions are perfectly met.

It remains to be seen… which variants: even more benign, even more contagious? Or the contrary? With an even stronger immune escape? There are no rules. And the circulation of the virus in animal reservoirs makes total eradication of the virus completely impossible.

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