Rise in incidence rate: “Covid-19 has become a disease like any other”

Rise in incidence rate: “Covid-19 has become a disease like any other”
Rise in incidence rate: “Covid-19 has become a disease like any other”

A simple thrill or the return of a fifth wave? For the first time in two months, the incidence rate is on the rise again in France. The epidemic indicator stands at around 46 positive cases per 100,000 inhabitants, where it reached 43 in the first week of October – or + 4.1%. If it has not exceeded the alert threshold – set at 50 – this increase must be observed with caution, while several departments have experienced an increase in daily contamination in recent days. The infectious disease specialist at the Raymond-Poincaré hospital in Garches, Benjamin Davido, is not surprised by this resumption of Covid-19 infections in the territory, but stresses that it is still too early to mention a fifth wave.

L’Express: How do you read the slight increase in the incidence rate in France?

Benjamin Davido: I predicted that the epidemic would resume around October 15 – as the fall-winter period approaches. Some have called me a pessimist, but infectious diseases are history repeating itself. And that’s not worrying. From the moment the virus hits in the fall or winter, it will find seasonality – which also allows us to better understand the virus. For the moment, we had not managed to observe this concerning the Covid-19. Moreover, the increase in contaminations does not necessarily mean the arrival of a hospital wave. Currently, we are at a moment of respite.

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Certainly, the numbers are starting to shudder – but if we stay below 10,000 daily contaminations, that’s fine. We must avoid a scenario similar to that of England – which has reached 40,000 daily contaminations. The challenge will be to maintain a low circulation of the virus in the territory and not to lose the effectiveness of the vaccine. As we vaccinated very late – a good part received the injections in June – we can imagine that with an effective vaccine for six months we are covered until December. When the temperatures cool down, we will have more visibility. It will be the moment of truth on the number of contaminations that we will have this winter.

So it’s still too early to consider a fifth wave?

You could say using the term “fifth epidemic curve”. When we speak of wave, it implies a side “submersion”. For example, the fourth wave recorded less contamination than the previous ones, but it took place in a particular context since health establishments are used to being understaffed during the summer. The organization of the healthcare system was therefore not the same. Currently, our goal is to do everything so that there is no wave of hospitality. But one of my concerns is whether we are going to end up with people in hospital who have not yet received a third dose (the number of positive cases among 60-79 year olds is up by 21% over a week, Editor’s note).

Indeed, my concern is the following: I have the impression that we have, in part, forgotten that the immunity remains relatively transient. However, if we do not manage to set up a vaccination campaign for the third dose – it began on September 15 and currently concerns the most vulnerable population – we risk finding ourselves in a situation where a certain number of people who did not recall will have lost their immunity in January. Currently, we are on the brake pedal, but it can let go. The only way to avoid this is with vaccination. The latter is not an epidemic control tool, it is a prevention tool.

How to explain this increase in the number of contaminations?

It is the conjunction of seasonality and the relaxation of barrier gestures linked to the fact that we are vaccinated (73% of the population has a complete vaccination schedule). We are immune therefore better protected. We no longer put on three seat belts and we no longer activate all the airbags. When you are vaccinated, you are in a less risk situation. Consequences: it is also more difficult to hide at home and limit our contacts. Added to this is the winter period. The circulation of the Delta variant is not related to the temperature – since it is rife in midsummer – but rather to the lifestyle that this season implies. In winter, it gets dark earlier, we live more confined and we open the windows less.

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Are hospitals ready to face a new rise in Covid-19 patients?

One thing is certain: we will be prepared on a material and logistical level. Now, Covid-19 has become a disease like any other and normally, this fifth wave should be weaker than the previous ones. But on the more human side, the multiple rebounds of the epidemic have had consequences. I found this fourth wave very tough psychologically. At that moment, everyone thinks: “It’s a day without end”. And most caregivers thought it was never going to end. Last summer, we kept the Covid-19 unit open, which was full every day. We even had to refuse some patients. I think this will all leave its mark in the minds of health workers. There is a certain weariness, especially when we see that nine out of ten patients are not vaccinated.

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