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Mass infections and a paralyzed country: how the omicron variant will hit France

With 208,000 cases in the last hours in France, the conjunction of the delta and omicron variants threatens to paralyze French society.

“The symptoms would be mild in January but it would be absenteeism that would cause disruptions in the functioning of society.” This is one of the health scenarios that the prestigious Pasteur Institute in Paris analyzes in a document it has just issued.

The fear is that hospitals will be overwhelmed due to the rapidity of contaminations, the numbers and those infected among health personnel and public services.

The advance of the virus would affect hospitals, trains, bus services, airplanes, market employees, supermarkets and the logistics that supply them due to the infection of the workers.

In a report dated Monday and published online Wednesday, the Institut Pasteur makes public its models for the hypothetical effects of omicron in France.

Researchers paint different stages, adjusted to various levels of severity and transmissibility of the new variant, and advise the authorities on the measures to be implemented to limit the shock.

A “tidal wave”

Health Minister Olivier Veran said the omicron is growing in France “like a tidal wave.”

Since Christmas, the number of cases in France has broken new records every day: 179,000 on December 28, 208,000 on December 29. One million French are now positive for SARS-CoV-2.

“These are figures that give vertigo,” said the Minister of Health during a hearing in the National Assembly.

“This means that twenty-four hours a day, day and night, every second in our country, two French people are diagnosed positive for the coronavirus,” he added. “We have never experienced a situation like this.”

An intensive therapy room in a hospital on the outskirts of Paris, where they treat cases of coronavirus. Photo: AFP

Possible scenarios

The idea of ​​the Pasteur Institute is to review -thanks to a mathematical model- the different scenarios that could cause the appearance of the new variant in the country, associating the latter with different levels of severity, transmissibility and imagining the response of the authorities.

For the Pasteur, the omicron episode could still be “manageable” if it really turns out – as various foreign experiences show – “more contagious but less dangerous than the delta variant”, provided that the “intermediate intensity” measures are determined.

The scientists call for “an acceleration of the campaign of the third dose” and that the contact “between the citizens” be reduced.

But before reaching this conclusion, Pasteur’s experts were careful to surround his documents with the usual precautions.

Reduce contacts

“Given the significant uncertainties regarding the severity and transmission benefit of the omicron variant over the delta variant, it is not possible to accurately quantify the impact that the omicron wave will have on the health system,” they admitted.

Experts call for acceleration of the third doses of vaccines against the coronavirus in France.  Photo: AP

Experts call for acceleration of the third doses of vaccines against the coronavirus in France. Photo: AP

By relying on studies from South Africa and Great Britain, omicron severity is 80% less than delta ferocity, and it is moderately more contagious than this.

In such a situation, they could see spikes of 2,700 daily hospitalizations if nothing more is done to curb the circulation of the virus.

But that total could be reduced to 1,900 or 1,400 hospitalizations with a reduction of the order of 10% and 20% respectively in contacts between the French.

If Omicron turns out to be slightly more contagious than its predecessor, the daily peak of hospitalizations would not exceed 1,700 in the worst case, according to the researchers.

They then envisioned another possibility: an omicron that had the same severity as the original strain but a 54% reduction compared to Delta. “A very clear increase in transmissibility from one variant to another could lead to the hospitalization of 5,000 people every day in the absence of measures,” says the document.

On the other hand, a reduction in person-to-person contact would keep this peak at around 2,500 in the event that “the omicron transmission advantage is intermediate or low.”

The third dose

Apart from a reduction in interactions between people, the Institut Pasteur suggests another tool to round off the Pandemic peaks of the coming weeks a bit: a significant strengthening of the campaign for the third dose of the anti-covid vaccine, or “booster.”

If the number of these inoculations increased from 800,000 to 1.2 million per day, the specialists consider possible a decrease in the expected daily hospitalizations between “9 and 17%”. A reduction that could even range between “17 and 35%” when convincing “90% of unvaccinated adults.”

In any case, Pasteur therefore stops at the following perspective: “When comparing different scenarios, we believe that the omicron wave could still be manageable with measurements of intermediate intensity if the intrinsic severity of omicron is approximately 80% weaker. than the delta variant “.

As “manageable” as it may be, the crisis promises to be painful and the researchers do not hide it. Thus, they suggest that “hundreds of thousands of French people could be infected daily in January.”

If they cut French-to-French contacts by 10%, that peak would rise to 1,900, the level reached in the third wave.

“It will not be much,” said Simon Cauchemez, a modeler at the Institut Pasteur and a member of the scientific council, who referred these analyzes to the Executive before the defense council on Monday.

“In this case, even in the absence of stronger measures, a change in the behavior of the French may be enough“, he insists.

People with chinstraps on the streets of Paris.  Doctors and scientists ask to reduce personal contacts to stop coronavirus infections.  Photo: EFE

People with chinstraps on the streets of Paris. Doctors and scientists ask to reduce personal contacts to stop coronavirus infections. Photo: EFE

Questions

As of December 28, just over 17,000 people were hospitalized with a Covid-19 diagnosis (24,000 as of the same date in 2020), including 3,400 in intensive care (2,600 in 2020). The peak of this delta-bearing wave was expected by the end of the year. But with the arrival of omicron all the scenarios are back on the table.

To narrow their range, epidemiologists are waiting for more data, especially from the UK, where omicron appeared slightly earlier than in France.

But its characteristics are difficult to capture, insofar as it spreads in a population vaccinated or already immunized by a first infection.

“Comparing the two variants is very complex, because you have to take this history into account and correct it, since some people, including those who are not vaccinated, are protected,” said Simon Cauchemez.

Comparisons with the UK are also limited, given differences in vaccination coverage by age group, especially with a booster dose.

“It is more advanced in the United Kingdom than in France among the elderly (who are at higher risk of being hospitalized). Therefore, the hospitalization curve may not follow the same path in the two countries,” observed Florence Débarre, a specialist in biology. evolutionary of the National Center for Scientific Research (CNRS).

“The proportion of people protected by the immunity developed after an infection can also be different,” added the scientist.

Although some data already deny the most pessimistic scenarios, a wave greater than those of 2020 is still in the realm of possibilities, if it turns out, for example, that omicron is even more contagious than expected.

“We will know in a week or two which curve we are in,” said Cauchemez, “more optimistic” than two weeks ago.

Little time to act

In case of bad news, the time to react will be short: in the scenario of a variant 80% more contagious but only 50% less severe than Delta, “waiting until January 10 for the implementation of these measures would lead to a peak. Hospitalization of around 5,000 daily hospitalizations, undoubtedly exceeding the current capacity of the hospital ”, warns the note delivered to the authorities.

The vaccination rate It could also affect the size of the wave. In their scenarios, the modelers assume that 800,000 booster doses are injected each day. But since the start of the school holidays, injections have collapsed, from an average of 670,000 to 390,000.

A year after the arrival of the first doses, among the unvaccinated there are also very few who have been convinced, in recent weeks: according to the latest data from the Directorate General of Health (DGS), 930,000 people aged 50 to 64 years, 630,000 people from 65 to 79.

Paris, correspondent

CB

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