He still hasn’t decided to be forgotten. A week before the start of the school year, the Covid-19 is remembered with more vigor in our good memories. “We have indeed an increase in cases”, confirms to 20 minutes Professor Yazdan Yazdanpanah, infectiologist, head of the infectious and tropical diseases department at Bichat Hospital in Paris. In question, a circulation of the virus favored by the summer holidays and the progression of the new variant of the Omicron family, EG.5.1, which is more transmissible.
Faced with the resurgence of the Covid-19 epidemic, “the priority is to understand the new variant and to prepare the vaccination campaign”, judged a few days ago Brigitte Autran, the president of the Monitoring and Anticipation Committee for health risks (Covars). Majority variant, vaccination campaign, epidemiological surveillance, 20 minutes looks at the Covid-19 back-to-school program.
A new variant in progress
Since its update in November 2021, Omicron has become firmly established and has grown. A new variant of this family, BA.2.86, is being carefully monitored by the WHO because of a “greater number of mutations” making it “likely to evolve more significantly and to spread more easily”, recalled -a few days ago Brigitte Autran. But if it has been “detected in Denmark, Israel and the United States, it is not yet present in France”, she added.
For now, it is rather the EG.5.1 variant, nicknamed Eris by some scientists and resulting from the XBB.1.5 branch, which is in the viewfinder. “The first evaluations of this new variant show that even if it is perhaps a little more transmissible, it does not seem to be more dangerous or more severe, reassures Professor Yazdanpanah. Furthermore, although it may be accompanied by a slight immune escape, in terms of vaccine susceptibility and treatments, it does not significantly affect their effectiveness. This is why the WHO has classified EG.5.1 as “variant of interest” [ou variant à suivre], considering that it does not present an increased risk to public health. From now on, we have to follow its evolution over time”. An opinion shared by the Covars. “We do not exclude that it will become the majority”, but “we have no signs of particular gravity”, commented Brigitte Autran.
A virus still in circulation
If the Covid-19 virus circulates in France in a “weak” way, “we must remain vigilant” in the face of possible developments in the epidemic, estimated in mid-August the Minister of Health, Aurélien Rousseau. To date, the epidemic rebound has “a small impact on hospitalizations and pre-hospitalizations”, noted the General Directorate of Health (DGS) during a press briefing, referring to the increases in emergency visits and acts of SOS Médecins on “small numbers”.
The incidence remains at low levels: “It has gone from 6.2 to 7.7 per 100,000”, insists the same source, while noting that “this rate should be interpreted with caution and not compared with those of previous years”, following changes to the monitoring system. However, “the indicator on which we are very vigilant – and for the moment not too worried – relates to hospitalizations, underlines Professor Yazdanpanah. However, for the time being, there are few patients hospitalized for Covid, thanks to the protective effect of vaccination against serious forms”.
A targeted vaccination campaign
To maintain this momentum, the Minister of Health thus underlined that this fall, we can “also count on the vaccination corresponding to the virus as it has been identified. And we will have to protect in priority the fragile people ”. The vaccination campaign, scheduled “from mid-October”, will thus couple Covid-19 and seasonal flu, said the DGS. A calendar deemed “coherent” by Professor Yazdanpanah. “But it will be necessary to follow the evolution of the circulation of the virus to estimate whether it is necessary to accelerate the vaccination of the people most at risk”.
“But we mustn’t fall into alarmism either,” he continues. Faced with the Eris variant, paxlovid is a priori no less effective”. Other reassuring news about the progression of this variant, “the first scientific data suggest that it is sensitive to the new vaccines which will be available at the beginning of the fall”, added Brigitte Autran. And for this vaccination campaign, three vaccines will be available and offered to populations at risk: “two messenger RNA vaccines developed during the spring by the Pfizer and Moderna laboratories, as well as a recombinant particle vaccine, developed by Novavax in according to WHO recommendations.
Lighter but still active monitoring
However, the Covid-19 surveillance system is no longer what it was at the height of the pandemic. Most of the states that had set up specific surveillance systems have generally dismantled them, considering that the threat was now less severe and no longer justified the expenditure. A “disarmament” deplored by the WHO, which continues “to call for better monitoring, sequencing and notification of Covid-19”, which “continues to circulate in all countries, to kill and to change”, recently underlined its managing director, Tedros Adhanom Ghebreyesus.
In France, the surveillance system for the virus has been lightened and is currently “close to that of the flu”, indicated Brigitte Autran. “We no longer have the same data as before, the follow-up is no longer as fine,” confirms Professor Yazdanpanah. However, we must continue to monitor the circulation of the virus. However, there is still active surveillance of the virus, with in particular the flash investigations of Public health France, which also made it possible to establish the proportion of this new variant. Moreover, in addition to the question of the means of surveillance, we screen ourselves much less, which contributes to the decline in the data we have”. Between the drop in contamination and the partial reimbursement of tests, screening has indeed become anecdotal.
However, “the health authorities have not lowered their guard, they are vigilant”, but “the monitoring methods have been adapted to take into account the evolution of the situation”, pleaded the DGS. But to adapt to the evolution of the health situation, “it is planned that during the autumn, the system will be readjusted to optimally deal with an amplification of the risks”, specified the president of Covars.
Living with the virus and the mask
Because in practice, “we will have, for several more seasons, to live with the resurgence of this virus”, recalled the Minister of Health Aurélien Rousseau. Thus, if the return of the wearing of the compulsory mask is not on the agenda, “it will be considered if we go back to an intensive epidemic phase, but for the moment we are not there”, declared the president of Covars.
At the same time, the Minister of Health insisted on barrier gestures, which must remain reflexes to protect themselves. “When you have symptoms, the mask reflex must prevail,” he insisted.
It’s a matter of common sense, adds Professor Yazdanpanah: “If we have symptoms suggestive of Covid-19 or another respiratory infection, we must protect the people around us, especially the most vulnerable, elderly or immunocompromised. We have to live with the Covid-19, and remain vigilant. But fortunately, thanks to the vaccines and effective treatments available, we are no longer facing the same disease today as during the first wave, ”he reassures.