Science

Eric Caumes: “Disturbing people is not a public health policy”

If the wave of Covid-19 is still very high in France, it is beginning to subside. According to Eric Caumes, an infectious disease specialist recently arrived at the Hôtel-Dieu in Paris, it should end by the end of February, unless there is a new variant that escapes our immune defenses even better. And for the future? Optimistic, the specialist thinks that the next waves will be less and less serious. This does not prevent him from criticizing the evolution of the health pass towards the vaccination pass, which he describes as “political policy”, nor questioning the interest of a fourth dose. Interview.

L’Express: The government measures put in place for weeks to fight the Omicron wave are highly criticized and considered of little use by specialists… Why?

Eric Caumes: Since the beginning of December, we let the virus circulate. At that time we already knew that Omicron was going to replace Delta, like in England. We knew that the wave was going to be brutal, explosive. Some countries very quickly decided to implement restrictive measures, such as Germany, which re-established a massive return to teleworking. In France, we have implemented firsts, which save face, but in reality we let it go in the context of testing at all costs… Why? To save the Christmas and New Year’s Eve celebrations? As a result, the virus circulated heavily, with hundreds of thousands of new cases a day for the next two weeks, despite excellent vaccination coverage.

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Even if it means using the Coué method, is there any benefit to this high circulation?

We can always try to see the advantages in the face of fait accompli… Except for the papillomavirus vaccine, natural immunity is generally better than that induced by vaccination, but at what price? Anyway, we can count on the fact that when we get off the Omicron wave, we’ll probably have 10, maybe 15 million people who will have developed natural immunity. I say 10 or 15 because, when the health authorities identify 300,000 cases per day, we can at least multiply this figure by two. Some experts even believe that it could be multiplied by three…

When can we expect the end of the Omicron wave?

The peak of infections has probably already passed in Paris, which is the epicenter of Omicron, with 95% of the new cases registered today. The situation should continue in the other regions, although some arrive very late. This variant, therefore, will continue to spread in the provinces in the next three weeks. But we can estimate that the epidemic will fall everywhere in France before the end of February. Unless a worrying new variant emerges by then. The wave of hospitals should end in mid-March… And I bet Emmanuel Macron will take the opportunity to announce his entry into the presidential campaign. The electoral campaign will have been left out of the campaign for the vaccination pass.

Could we not, during this time, imagine solutions to better control the epidemic, such as better monitoring of contact cases?

When the system is overwhelmed, people no longer want to wait three hours in line at the pharmacy in the rain, especially if they have few or no symptoms. In this context, contact tracing is no longer useful. When the virus is circulating as widely as it is now, even the mass testing campaign can be discussed. It cost a billion euros in December!

And instead of diluting our forces with this vaccine pass, we should focus on people who are not fully vaccinated and those who are frail and have not yet received their third dose. It is the “go to”. In light of the Omicron wave, we should think about changing the paradigm, instead of pitting people against each other.

You were in favor of the health pass, but you are not in favor of the vaccination pass, why?

I was in favor of the health pass but I am against the vaccination pass for the general population. It is humanly divisive, terminologically inappropriate, and unnecessary given Omicron’s out-of-control circulation. The proof is that despite vaccination coverage close to 80%, more than 300,000 new cases per day have been registered and people who have been double or triple vaccinated are still infected. And at the same time, the revives did not explode. Vaccines protect against severe forms, but little against infection. What was audible with Delta (we vaccinate everyone) is no longer audible with Omicron.

And why not call it an immune pass? This is a more appropriate term as people infected and cured for less than six months will be able to validate it. Why lean on the divisive term of the passage of vaccines that directs many people? Why exclude the least contagious from the pass (those who tested negative even if they are not vaccinated) when the vaccinated are free to circulate, but with the virus since vaccination is not very effective against it. Because what serves as a compass is “fuck the unvaccinated”? But “bothering” people is not public health policy. What did we need to change the pass? This sounds more like food for politicians to me.

And then this pass is intended to force the recalcitrant to get vaccinated, except that a single injection is not enough, a second one will be needed 21 days later. With this delay, Omicron’s wave will almost be over. And then will we have to get vaccinated every six months when this epidemic could very well end? And if it is going to last, will the vaccine still be effective with the next variant, which could present other forms of immune escape? [la capacité de tromper les défenses immunitaires générées après une infection ou grâce à un vaccin] ?

We could also ask ourselves about the interest in promoting vaccination, while the epidemic is still very strong and many people are in the incubation period. Because we have little scientific knowledge about the effects of vaccination against an ongoing disease in the vaccinated person? Can vaccination increase symptoms? We absolutely do not know.

Citizens are also concerned about the effects of repeated vaccination and fear that the fourth, fifth or even sixth dose could eventually wear down their immune systems. What does science say about these points?

That’s probably not the case. However, when you have to get vaccinated every six months, it is because the vaccine is not very effective. Compared to the yellow fever vaccine, a single injection would be enough to protect you for life. With Covid, we are already considering the fourth dose after the third. And that would be logical, with the arrival of next winter, in fragile people, as happens with the flu. But it seems difficult to me that it continues like this in the general population, especially since it seems that Omicron causes few serious forms. It is even probably even less serious than we think.

The express

This lower severity is explained by its intrinsic properties, and probably also because it attacks a semi-immune population. [de nombreuses personnes ont déjà été vaccinées ou infectées], but probably also because it is a classic feature of epidemics: over time, the waves become less severe… But we must be careful, there will probably be other waves before the disease becomes endemic.

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