No one knows exactly how high it will go. Since the beginning of June, the seventh wave has been spreading in France and the Omicron BA.4 and BA.5 variants are rapidly spreading among the population. The consequences in terms of mortality and impact on the health system are still limited, but the numbers are soaring, and the hospital is more fragile than ever. At the end of last week, the president of the scientific council, Professor Jean-François Delfraissy, estimated on the antenna of RTL that tensions could emerge in the hospital system towards the end of July. According to the latest government data, as of July 1, 960 people with Covid-19 are in critical care, with a recovery initiated since June 20. More than 16,000 people are hospitalized, with now nearly a thousand daily admissions. That’s a 31% increase in the last seven days compared to the previous week.
On the threshold of summer, this new wave also occurs in an atmosphere of scientific and political holidays. The scientific council will cease its activities on July 31 and on June 23 issued a final and minimalist opinion (of five pages) to the government. The latter, twice overhauled in six weeks, was hardly proactive in managing the health situation. This seems to have fallen into a pit of disinterest, devalued by weariness but also competition from other crises: the war in Ukraine, inflation and purchasing power, drought, the recomposition of the political landscape. Few prevention messages, no strong measures, all against a backdrop of scientific uncertainty: the management of the pandemic has gone from directive paternalism to great vagueness.
For the first time since the start of the epidemic, no team of epidemiological researchers has made public projections for the current wave, the seventh of the name. In question, the difficulty of the exercise. “There are now many different immunity profiles with different effects which make modeling this wave more difficult than that of previous waves, explains the side of the Institut Pasteur. If we try to model all the effects, given the uncertainty on certain parameters, the system is unstable. “A new generation of models is under development but the outcome is not for now, according to the Institute. “This explains why the Institut Pasteur has not published projections for BA.4/BA.5 for the medium term. We hope to be able to offer short-term projections again soon with regard to the hospital load. »
The team of epidemiologist Mircea Sofonea (University of Montpellier) has not published any projections either. The scientist from Montpellier also points out the difficulty of the exercise, as well as the disengagement of the State in the financing of his work. “In the spring of 2021, the calls for projects on the Covid of the National Research Agency stopped, and four of the five projects that we submitted to different funding bodies were rejected, sometimes without solid scientific reason, explains Mr. Sofonea. Via our only project selected, we will only have enough to pay for the only additional position compared to our pre-pandemic composition until October 2023. In the end, we are only two permanent staff in my team working on the Covid . It is absolutely disheartening. »
Discouragement competes with bitterness. “I worked for almost six months on the report by ANSES [National Agency for Food, Environmental and Occupational Health Safety] on the transmission of the new coronavirus by aerosols, says the epidemiologist. No consequences were drawn from this work, which just earned me compensation of 242 euros. Researchers are no more immune to frustration and fatigue.
“It is difficult to say what the impact in France will be in terms of deaths and hospitalizations of the BA.4/BA.5 epidemic wave which is beginning. In its opinion sent to the government on June 23 and made public on Monday July 4, the Covid-19 scientific council makes no secret of the uncertainties of the new wave. One thing is certain: as epidemic indicators climb, hospitalizations for Covid-19 are in turn increasing in medical services and now in critical care. “It continues to go up slowly”, summarizes Professor Rémi Salomon, head of the conference of presidents of the medical commission of establishment (CME) of CHU.
“It is likely that hospitalizations will continue to increase, since the number of cases is still increasing, recalls epidemiologist Mahmoud Zureik. Given current trends, we should reach 2,000 entries per day, it’s a little higher than the sixth wave, it would be less than the fifth… we see that we still benefit from the immunity acquired thanks to vaccination . Compared to the last summer wave – the fourth -, which mainly affected tourist and coastal regions, in the first place Provence-Alpes-Côte d’Azur, this seventh wave appears for the moment “more diffuse”, unfolding in a relatively “homogeneous” way in all regions, Ile-de-France in the lead.
“If the subject was limited to Covid-19 for the hospital, the impact would be significant but moderate, but we are above all concerned that this will precipitate the rupture”, continues the professor of public health at the University of Versailles-Saint-Quentin -en-Yvelines. Because the figures may still be far removed from the epidemic rebounds which have saturated hospital services, it is impossible to be serene in a hospital in crisis. The summer is always a tense period in terms of human resources, due to the leave of caregivers, but even more so this year, with a shortage of personnel which forces many services to close more beds than usual. Not to mention the emergency services, which are already operating in a degraded manner in several establishments, such as in Bordeaux or Grenoble.
“Everything must be done to limit the spread of the epidemic, in particular with the mask in confined spaces, even though it is no longer a question of “life or death” because of Covid and the hospital impact remains relatively low. , because it is everyone’s health that is at stake”, points out Doctor Thierry Godeau, of the conference of presidents of CME of hospital centers, recalling “the difficulties which already exist to treat those who need it”. “We have seen an increase in absenteeism among staff due to Covid-19 for the past fortnight, this worries us a lot, abounds Rémi Salomon, at the Assistance Publique-Hôpitaux de Paris. We also have more and more patients whose operation we have to cancel because they are positive for Covid-19. »
Faced with the seventh wave of Covid-19, the government intends to take only minimal action. Without constraints or repression. At the time of taking up his new duties as Minister of Health, Monday, July 4, François Braun may well have described “a health system out of breath”, this one will have to resist, year after year, the rise expected hospitalizations related to the spread of the BA.5 variant. The first piece of legislation to be considered by Parliament this week is related to the “health emergency”. But it only has two articles. The first intends to ensure the continuity of the monitoring of the epidemic, in particular via tests, and the second must allow the establishment of health control at the borders of France, including with Corsica and the overseas territories, if the situation required it. A transitional regime after the scheduled end of the state of health emergency, on July 31.
After two years of pandemic, the government has already ruled out the idea of imposing excessively coercive measures, which are difficult for a weary population to accept. Without an absolute majority in a Parliament that is now full of antipasses and antivax, the government seems resigned to keeping a low profile. An attitude that has already been reflected in the issue of wearing a mask in transport: a recommendation that is, for the time being, not accompanied by any obligation. “The government is responding modestly because the new composition of the Assembly does not allow them to force their way through, although they still have a lot of means of action at the regulatory level, without having to go through the Assembly until the July 31, ”said Ugo Bernalicis, deputy for the North for La France insoumise.
Government minimalism responds to a return to a form of feverishness in the streets. The number of antigen and PCR tests is a good indicator. It now crosses the 2 million per week mark again, to curl with 2.5 million the week of June 27. Very far, of course, from the records of more than one million daily tests at the end of 2021, when the Omicron variant of SARS-CoV-2 was sweeping over France, but similar to the level of July 2021, when the extension of the health pass triggered a rush to laboratories and pharmacies. This time, with an increase of more than 25% in PCRs over the past two weeks, the laboratories are “not yet under tension”, tempers Jean-Claude Azoulay, vice-president of the national union of medical biologists.
With a more than 50% increase in antigen testing, pharmacies are still on the front line. “Some people go so far as to be tested two to three times in the same day, changing pharmacies, to be sure not to be false positives”, testifies Doctor Azoulay. In front of the pharmacies or the barnums installed on the sidewalks, the queues begin to reform and lengthen. “Every four to five months, we find ourselves under pressure,” says the Union of Community Pharmacists. The union is waiting for an “impulse” from the new Minister of Health to “relaunch vaccination” at a time when vaccine protection is coming to the end of its cycle.
If the lifting of restrictions linked to the Covid-19 pandemic allow employees to go on vacation abroad, those who stay are rediscovering the joys of wearing a mask in the office. The number of new cases started to rise again in June, with the end of the obligation to work masked. And companies see it every day.
On June 28, the Prime Minister, Elisabeth Borne, encouraged the population to respect social distancing and the wearing of masks in “promiscuous places”, “enclosed spaces” and in particular “public transport”. But since employers have not received new instructions from the Ministry of Labor, the national protocol to ensure the health and safety of employees in the workplace in the face of the Covid-19 epidemic has not been reactivated.
The reaction of employees is rather muted: the demand for telework has not increased. “They learned to manage. We see some who put the mask back on during the day out of caution. Others ask us if we can organize the vaccination. Without new instructions from the public authorities, we just recommend taking the third dose, if it hasn’t already been done,” explains Benoît Serre, vice-president of the National Association of HRDs, which brings together some 5,000 companies from all the sectors.
But the HRDs communicate lip service: “We just recalled the rules in the event of contamination and contact, because the employees no longer knew what to do, comments Benoît Serre. Employers do not want to cause panic. Held responsible for the health of their employees, they had integrated the rules of distancing into their use of “risk prevention”. They did not remove them with the end of the application of the health protocol on March 14.