Science

Omicron: Should France Expect a “Tsunami”?

“No one should doubt it, the Omicron tidal wave is coming.” The fight in the UK, where Prime Minister Boris Johnson, who lifted all injunctions last July, suddenly changed tune … and strategy. It is no longer a question of “living” with the virus, teleworking is making a comeback, as well as the use of masks in closed places. The third dose injection campaign is intensifying and a health pass could even emerge. Arriving from South Africa just two weeks ago, this new variant has already been detected in more than 3,100 samples across the Canal, up from 1898 last week, an increase of + 65%. The number of Omicron cases now doubles every 2-3 days, confirming its ability to gradually replace Delta. In the UK, it is expected to become a majority before Christmas.

“The progression of the number is even more dazzling than during the first wave”

“In England, we already have around 30% of Omicron, things are going very, very fast,” confirms Marc Baguelin, professor of infectious disease epidemiology at Imperial College London (ICL, England). It has an advantage. Obvious compared to Delta, either because it is inherently more transmissible than it, or because it partially escapes natural immunity and vaccines. [et est donc capable de provoquer plus de réinfections ou d’infections post-vaccinales, NDLR], or thanks to a combination of the two factors ”. The scientist recalls that data is lacking to correctly assess Omicron’s capabilities, but suggests that it could be 1.5 to 2.5 times more transmissible than Delta. His colleagues and he, that We see “an increase in the number of cases even more dazzling than in the first wave”, therefore, expect the worst.

“Containment is not ruled out”

Given the magnitude of the phenomenon, Boris Johnson announced a set of restrictions aimed at delaying the advance of Omicron, including the possibility that all adults receive a third dose in late December in England, a month ahead of schedule. Scotland, Northern Ireland and Wales are also stepping up their respective campaigns. New vaccination centers will be created with extended hours and soldiers will even be deployed to strengthen the process. The authorities’ goal is to achieve one million injections daily, which would restore declining immunity in the general population in about two months.

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In fact, the first available data on Omicron indicate that it would almost completely circumvent the protection conferred by a double injection of AstraZeneca. A double vaccination with Pfizer or Moderna, if the last injection is not more than three months old, would still be somewhat effective: around 70% against hospitalizations, against 93% with Delta, and only 33% against infection, against 80% with Delta, according to a recent study not reviewed or validated by peers. Other studies suggest that natural infection followed by RNA vaccination would be somewhat more effective, which makes sense since natural infection, while causing potentially serious harm, offers more complete protection against Sars-CoV-2, where Vaccines induce an immune reaction directed at the protein S of the virus, the famous Spike which has particularly mutated in Omicron. “And the British Health Agency report also suggests that a booster dose [une troisième dose, ou deuxième en cas d’infection naturelle avant, NDLR] it would provide effective protection against Omicron ”, adds Marc Baguelin.

But what exactly will be the level of this protection? And how long will it persist? “There is great uncertainty about the exact impact of Omicron, vaccines can help us, but the third dose campaigns have just started and we still have little retrospective, continues the epidemiologist. But one thing is certain: cases are increasing and will continue to increase. The big question now is whether our health care system will be overwhelmed and, if so, whether we will have to reconfigure … Here we are. ”

Because one unknown about Omicron refers to the severity of the cases. If it could be suggested at first that this variant would cause much milder cases, the progression of hospitalizations in the areas of South Africa affected by Omicron, a country that nevertheless has a very high natural pollution rate, tends to balance this assumption. In addition, Omicron has caused many reinfections: would it be less serious in itself or because it affects people who are already partially protected? Asks the researcher. In any case, although it causes fewer serious cases in proportion to Delta, if there is an explosion of contaminations, then in absolute terms there will be more hospitalizations and therefore a risk of saturation of the health system ”.

In the South African province of Gauteng, where Omicron has a strong presence, new hospitalizations for Covid, even if they are increasing, still lag behind the growth of new cases compared to previous waves.

In the South African province of Gauteng, where Omicron has a strong presence, new hospitalizations for Covid, even if they are increasing, still lag behind the growth of new cases compared to previous waves.

AEI / National Institute of Communicable Diseases, South Africa

Is a French tsunami coming?

In France, Omicron accounted for less than 1% of the sequencing from November 15 to 29, 2021. Over the next fortnight, from November 29 to December 13, Omicron’s share increased to 5%. “At this stage, we can only explain this difference with hypotheses, warns Marc Baguelin. But it is possible that this is linked to the fact that there are more links between South Africa and the United Kingdom than with France, not forgetting that there was Cop 26 in Glasgow until mid-November and that, since last July, our level of restriction is very low compared to that of France ”. On the other hand, it could be that the French situation is more serious than you think, since the sequencing number, the ability to determine which variant is present in a sample, thus the ability to detect Omicron, is in fact more limited in France. than in the UK.

So what can we expect? Current data suggests that “the French Omicron” could reach its potential behind the UK in one or even two weeks, because strictly speaking, the two countries have more in common than differences. So the advancement of the third dose campaigns will likely be a determining factor. “I’m not sure the situation in France is that favorable,” says Marc Baguelin. Because if there is good vaccination coverage, there were more infections among British youth during the summer, so the overall immunity of the population could be better. ”

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Other factors could tilt the dynamics of the next epidemic and, in particular, the impact of year-end celebrations and respect for barrier gestures, the use of masks or even adherence to more restrictive measures. “I do not want to speak for governments, warns Marc Baguelin. Here, the authorities have not mentioned the closure, but if the health systems are overwhelmed, new restrictions may be considered … And we know that containment is effective. “So is the curfew. As explained by the epidemiologist John Edmunds, a member of the British government’s scientific council, on Thursday at a Royal Society of Medicine conference, the dissemination of Omicron seems in any case to mark a “real setback” in the hope of controlling the pandemic.

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