Like a wind of freedom blowing over France. With the arrival of spring, the abandonment of the vaccination pass and the mask – except in transport – the French breathe in the beautiful days with enthusiasm. However, despite the government’s decision to lift health restrictions, the Covid-19 epidemic could still play a trick on us. Several indicators have started to rise again since the beginning of March, and in particular the number of contaminations and the incidence rate. There are thus regularly more than 100,000 daily cases for several days on the metropolitan territory.
Between the effects limited in the time of the vaccination, the new sub-variant BA.2 which imposes itself in Europe and the winter which is not finished yet, the virus is always among us. So is spring threatened by the resurgence of the epidemic in France? Several scientists give us their opinion.
Yves Buisson: “The pandemic is not over”
To say if we enter a sixth wave is a matter of appreciation. The epidemic curves for the moment look more like a rebound from the fifth wave, which has never completely come down to a standstill. We witnessed a regular decrease for several weeks before the indicators rose again from the beginning of March. The reproduction rate, “R”, has gone back above 1, which means that we are again in an epidemic phase. If the reasons are multifactorial, the main cause is the relaxation of the measures in anticipation of the French who did not wait for March 14 [date à laquelle le gouvernement a fait sauter les dernières restrictions anti-covid, NDLR].
One of the other factors is that we are still in winter with temperatures that favor transmission. Then there is the BA.2 sub-variant, which, thanks to all these factors, takes advantage of the situation to spread and supplant BA.1 in Europe. We are therefore witnessing an epidemic upsurge with a variant that proves to be more transmissible and perhaps more pathogenic. We are not immune to severe forms, so we should not consider that the pandemic is over, on the contrary it continues. Covid-19 has not said its last word because it does not confer long-lasting immunity and has a very high capacity for mutation. In my opinion, we released the barrier measures, the wearing of the mask and the vaccination pass too soon. We should have waited until May because in people’s minds, this means that the epidemic is over, when it is far from the case. And if the arrival of fine weather is a favorable factor in calming transmission, the virus will not stop spreading.
Yves Buisson is an epidemiologist and president of the Covid-19 unit of the National Academy of Medicine.
Antoine Flahault: “No indicator is green for the start of spring 2022”
Europe is entering a new wave of the pandemic, if we accept that a wave is the conjunction of a simultaneous increase in contaminations and severe forms which lead to excess hospitalizations and deaths. The current wave linked to the BA.1 subvariant, the seventh of the pandemic in France, according to the numbering dictated by molecular epidemiology, began in February and has led the contamination curve to rise continuously since the beginning of March. . The vaccine pass linked to a vaccine designed against the original strain of Sars-CoV-2 does not prove to be very effective in countering the progression of Omicron subvariants.
It is therefore not a very relevant measure unless it was associated with the recommendation of a new booster dose which could prove useful in preventing serious forms and could then justify again an extended use of the vaccination pass for stimulate vaccination. Wearing a mask in closed places should never have been lifted because the health indicators never fell to a level allowing it to be done safely. At the University of Geneva, we cannot predict the evolution of the pandemic beyond seven days. While it is true that next week will see the arrival of spring, no indicator is green for the start of spring 2022 in Europe.
Antoine Flahault is an epidemiologist, professor of public health at the University of Geneva and director of the Institute of Global Health at the Faculty of Medicine of the University of Geneva.
Catherine Hill: “The epidemic is starting again”
On the most reliable indicators, namely the number of admissions to hospital, intensive care and the number of deaths, we see that the epidemic is starting up again. Hospital admissions have been increasing again for eight days and intensive care arrivals are more or less stable, as is the number of deaths. Which means it’s not dropping anymore. And the French are less careful because the message sent by the government, with the lifting of restrictions, is that everything is going very well, when it is not really the case.
If we look at the arrivals at the hospital (1056 on average each day over the last 7 days), it is more than the peak of the fourth wave which was at 905. In addition, there are 116 deaths per day on average , it’s a lot. However, reinstating the vaccination pass would be useless and if the mask was enough to control the epidemic, we would know. Emphasis should therefore be placed on vaccinating those who are still unvaccinated. Still too many people over 80 have not received a booster dose, while there is already talk of a fourth dose for the oldest. And there are still 11.4% of those over 80 who have not yet received any injections! We must organize ourselves to go and vaccinate people who cannot go to their homes.
Catherine Hill is an epidemiologist and biostatistician.
Etienne Decroly: “Spring will be associated with a new wave”
We are currently entering a new wave linked to the growth of the BA.2 variant of Omicron, when the previous one was linked to the BA.1 variant. It is the replacement of one variant by another. The BA.1 has exhausted its tank, so a new one appears with the ability to escape human control. We are going to experience a new wave with, according to projections by the Institut Pasteur, a peak at the end of March or the beginning of April, which will surely be of less intensity than the previous peak. But there is still a concern linked to this variant because, when we observe other countries which are two weeks ahead of us, such as England, there is a very rapid growth of the epidemic which suggests a stronger contagion than BA.1. The repercussion on the hospital will depend on the importance of the wave in terms of contamination and the intensity of the peak.
There is some hope with spring and its temperatures which favor outdoor life and the opening of windows, but the lifting of sanitary restrictions a little too early constitutes an unfavorable element. We should put the mask back on if we stick to the epidemic figures and if we want to have as few cases as possible. So the return of certain temporary constraints is not excluded because spring will be associated with a new wave, we have been saying this since January.
With the context of a fairly high overall immunity, it is likely that we will go towards a drop in hospital pressure, except in the event of a disaster linked to the emergence of a new recombinant. The question is mainly about the end of the summer and what will happen in the other hemisphere. As long as the virus circulates abundantly, it is a variant factory and it is not known if there will be any that will escape human control and pose risks. We cannot predict it. Regarding people at risk, it is important not to lower our guard on wearing a mask, or even wearing FFP2 because surgical masks provide relatively good protection only when everyone is wearing them. Everyone wants to get out of this epidemic but as long as the virus circulates in such an abundant way, it will be necessary to manage it.
Etienne Decroly is a virologist at the University of Aix-Marseille.