For Olivier Véran, “the situation is not good”. Three new departments are added to the sixteen already subject to increased restrictions.
For the “Return to a more normal life” hoped for by the government “From mid-April”, we will still have to wait. Doped in particular by the English variant, which is more contagious, the coronavirus is now progressing throughout the country. “The situation is not good. (…) The trend is almost everywhere to accelerate the epidemic ”, recognized Olivier Véran on Thursday evening during his weekly press briefing. A “Convergence of dynamics which is not very reassuring”, notes Mircea Sofonea, lecturer in epidemiology of infectious diseases at the University of Montpellier. The incidence rate reached 313 cases per 100,000 inhabitants over a week at the national level, well above the maximum alert threshold, set at 250. It exploded in some departments such as Seine-Saint-Denis, with more than 700 cases per 100,000 inhabitants, well beyond the peak of last October.
The specter of “triage of patients”
The government is currently sticking to its territorialization strategy, in particular because “The virus does not circulate in the same way everywhere” and “Finistère is ten times less affected than Seine-Saint-Denis”, said the Minister of Health. Several departments such as Ain, Isère or Vaucluse are placed in enhanced vigilance. In addition, the Rhône, the Nièvre and the Aube – where the incidence approaches or exceeds 400 cases – will be added from Saturday and for four weeks to the sixteen departments already subject to the closure of shops and the ban on move beyond 10 km, confirmed the minister. In these territories, “it is too early” to judge the effectiveness of the measures put in place since Saturday, estimates Olivier Véran, who recalled that in these areas a new call for teleworking had been launched as well as a stricter supervision of outdoor gatherings: no more than six people, under penalty of verbalization. If they are fully implemented, these rules “will have an effect on the incidence”, wants to believe the government, which counts especially on a rise in power of vaccination in the weeks to come.
Whether or not they are enough, these restrictions will not have an immediate impact on hospitals, where resuscitation beds are already more than 90% occupied by more than 4,700 patients. In Hauts-de-France, where this rate reached 135%, hospitalizations exceeded the levels of the first two waves, according to the regional health agency. On the side of Ile-de-France hospitals, where the “sheaves” are filled to 121% of capacity “Normal” by the only patients of Covid, the specter of “Sorting of patients” resurfaced. “We will do our utmost to accommodate all patients who need resuscitation, by deprogramming, by reducing the care of other patients who are less urgent, tells AFP Stéphane Gaudry, professor of intensive medicine and resuscitation at the Avicenne hospital in Bobigny. If that is not enough, the next step, it must be said, is to have to limit access to intensive care by sorting out the patients who can benefit the most. We don’t want to do that. “
Mircea Sofonea anticipates for her part of the days “Very violent for hospitals” : “On hospitalizations and intensive care admissions, we are respectively on a reproduction rate (R) of 1.09 and 1.07, and these two indicators are increasing. In forty days, we double the number of admissions at the national level, which is quite dangerous because we never really came down from the second wave. At this rate, if nothing is done and if the measures taken ultimately have a marginal effect, we can reach at the beginning of April the peak of 5,000 patients in intensive care of the second wave, or even above 6,000 in May. “
Deprogramming is accelerating
Olivier Véran knows it, “The sanitary pressure will increase” on hospitals in the next few days. And the room for maneuver is narrow: deprogramming is accelerating at the expense of non-Covid patients and could, according to him, reach 80% in Île-de-France. As for medical evacuations, they are much less numerous than hoped (less than 40 since mid-March in metropolitan France).
Can we therefore hold on without going any further? The hypothesis of strict confinement, national or targeted, has been threatening for weeks: neither privileged nor definitively ruled out. And the question of schools is once again on the table. The president of Île-de-France, Valérie Pécresse, suggested bringing the April school holidays forward by two weeks, “In order to close the schools on April 2”. A solution of “last resort”, recalled Olivier Véran, adding that reinforced protocols were being studied in schools.