The delays in the results of the tests distort the count of new contaminations and the high level of contaminations slows down the counting of clusters. Public Health France is forced to diversify the statistical indicators to follow the evolution of the epidemic. Intensive care admissions jumped 40% in one week.
This is what he knew and what we did not yet know. On Wednesday evening, the Minister of Health surprised the French by announcing radical measures to fight against the coronavirus epidemic. These restrictions are however not superfluous in view of the weekly barometer of the epidemic, published Thursday evening by Public Health France. “Intensive care admissions are now increasing exponentially”, writes the agency. In addition, the tools used to track down the virus “Only imperfectly describe the dynamics of the epidemic on the territory”.
The first of these tools is screening. Olivier Véran recognized it himself Thursday during a hearing in front of the Senate, it gets stuck. Too many people are jostling to be tested since it is possible to do it without a medical prescription. And the prioritization of tests imposed on laboratories for a few weeks is no longer the solution, because there are now too many “priority” audiences (symptomatic, contact cases and caregivers).
This threatens the whole “test-trace-isolate” edifice: “The extension of diagnostic times could result in less efficient contact tracing measures due to the delay in identifying cases and their contacts and in implementing isolation and quarantine measures”, writes Public Health France.
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The other armed wing in the hunt for the virus is the hunt for clusters, piloted by the regional health agencies. But there too, “Due to the increase in viral circulation over the entire territory, the number of clusters identified is probably largely underestimated”, Public Health France point. Weekly reports “No longer constitute a relevant indicator for monitoring the dynamics of the epidemic”.
“Oscour” and “Sivic” to the rescue
The case is so serious that the agency has decided to change tools to measure the progress of the epidemic. This is the reproduction factor of the “R” virus, which indicates how many people on average are infected by each infected individual. March’s R was 3, today it’s slightly above 1, which means the epidemic is growing. Until now, Public Health France calculated this effective reproduction factor from screening data. Now, it offers two new “R” which “Are the ones to follow as a priority in the coming weeks”. The first is built from data from emergency room visits (“Reff Oscour”) and the second from hospital admission data (“Reff Sivic”).
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The verdict is no longer the same. Scouting gives an R at 1.06, while Reff Oscour shows at 1.25 and Reff Sivic at 1.28. This is the reflection of the large difference observed in the field in the counting of patients and suspicious cases. During the week of September 14 to 20, the number of new cases confirmed by a test grew “only” by 8%, after several weeks of double-digit growth. On the other hand, emergency room visits rose by 21%, and hospitalizations by 34%, with 3,657 arrivals in seven days.
The 40% jump in resuscitations
And if there is one thing that does not deceive, it is the line of patients who arrive at the hospital or in intensive care, generally a fortnight after being infected. The doubling time for the number of hospitalizations is only 24 days, against 33 days the previous week. Worse, with 600 admissions, critical care admissions jumped 40% in seven days. The “white plan” was launched in several regions, and the public assistance hospitals in Paris began to deprogram certain interventions, in a preventive manner.
The highest ICU admission rates in mainland France are observed in Provence-Alpes-Côte d’Azur (1.94 per 100,000 inhabitants), Ile-de-France (1.52), Auvergne-Rhône-Alpes (1.20) and in Occitania (1.03). The score is dramatically high in Guadeloupe (5.84).
Finally, the number of deaths in hospital returned to the levels of May, with 252 victims in one week.
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The health situation has deteriorated sharply in #Marseille for several weeks, running a major risk: that the health system is no longer able to accommodate and treat new patients in intensive care. https://t.co/HWYlgtOPz1 pic.twitter.com/DxVi4bK4mc
– Olivier Véran (@olivierveran) September 25, 2020