Science

Prof. François Balloux: “We must differentiate the Omicron wave from the previous ones and downplay the drama”

A few hours before Christmas Eve, Covid-19 is the spoiler again. A dazzling variant of Omicron and the record number of contaminations are pushing the government to accelerate the booster program. On Thursday the threshold of 90,000 daily cases was crossed, with 91,608 confirmed cases. The previous record, 86,852 cases, dates back to early November 2020, at the peak of the second wave. Before reuniting with loved ones for Christmas, the French have put themselves to the test en masse in recent days: the number of tests carried out last week also hit a record, with more than 6.2 million.

Because one thing is certain: the epidemic will not be on vacation during the holidays. Booming for several weeks, it has now taken on the face of the Omicron variant, the spread of which is dazzling. The government hopes that it will soon become a majority in the country, between Christmas and New Years. For François Balloux, a specialist in pathogen genetics and evolution, director of the Institute of Genetics at the University College of London, the decision not to reconfine is not proof of laxity.

L’Express: The Scientific Council raises the alarm for the month of January for fear of “a disorganization of society”, is France paying too lax a policy in recent weeks in the face of the Omicron variant?

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François Balloux: I don’t think so, at least not more than any other European country. The Scientific Council has issued an alert because its function is to project, but it does not raise the alarm. It is not the explosion in the number of cases of contamination with a variant, Omicron, which spreads very quickly that is problematic, but the number of people who, proportionally, will be infected, therefore ill and who, even without developing forms serious, will have to stay home. If people are unable to go to work, there is legitimate concern for certain key sectors (hospitals, schools, supermarkets) that are at risk of experiencing an unprecedented absenteeism rate. So the disorganization in question is more economical than sanitary.

The government reacted immediately and is expected to announce measures on Monday, December 27, after an exceptional cabinet meeting. It is particularly about reducing the duration of the isolation of contact cases …

It is a measure of common sense drawn from the experience of other countries such as Great Britain. Here, the isolation period for a contact case has been reduced from 10 to 7 days. With Omicron everything goes faster: transmission, but also the incubation period closer to day 3 than to day 5. Hence this type of shortening measures. But the explosion in the number of cases is inevitable. In Britain, where I work, we have 120,000 cases a day and that number keeps increasing. There is no reason why in France we should not follow the same slope. There are expected to be three times as many cases as with the Delta variant. But once again, we are not falling into a critical situation: with Omicron it is not the number of contaminations that prevails, but the situation in hospitals where we are far from reaching saturation. You really have to distinguish between this Omicron wave and the previous ones and downplay it. We have never had so many cases, but death rates are decreasing. The same number of hospitalizations and the same number of deaths are not expected in January thanks to vaccination coverage across Europe and the fact that many people have been infected for the first time.

That is to say ?

These are the effects of vaccination. They create antibodies that, if you don’t reinforce them, will go away after five to six months. But during this period, they stimulate B and T cells, which are memory cells. If our body is reinfected, its response to the virus will be faster thanks to the fact that these specific cells remain in a state of latency. And we can expect this protection to last a lifetime. Sars-Cov-2 is a respiratory virus as there are more than 200 worldwide and if we do not get rid of it, we will learn to live with it.

In “living together”, there is also the behavior of the population that has changed a lot. Does this matter for the future?

Without a doubt. And it seems to me that good citizenship is the great achievement of this pandemic. Too often it has been underestimated, particularly by stigmatizing extreme cases. But for most, when restrictive measures were announced, people rather anticipated them before fully respecting them. This is very important because it validates accountability policies more than coercive measures. In hindsight, governments should have relied more on good citizenship rather than imposing or prohibiting. Today, in almost all parts of Europe, the speeches are very cautious because what counts is to be transparent and announce if tougher measures are necessary insisting that they are temporary. Our rulers constantly walk on eggshells. The population has reached a certain maturity in the face of the pandemic but also a degree of saturation that must be taken into account.

Hence the difficulty of imposing forceful measures at the end of the year?

Anyway, in Britain, if Boris Johnson were to take strict measures, people would not want them. This explains the current situation where, unlike in Wales and Scotland, we in London have been relatively quiet, with relatively unobtrusive measures since the summer. In France, thanks to the health pass, we can say that we are in the same state of mind. Things are a bit different with southern countries like Italy and Spain, where bans are increasing. But it must be seen that these countries were more traumatized than in France by the first wave of March 2020 that caused many victims there. After the obligation of the health pass in the company, Italy imposes the use of the mask (FFP2) in the open air and cancels the parties and events, anticipating the participation of many people. All this while having half the pollution than in France. But these strict measures are welcome.

In France, do you think these measures would not be approved?

It all depends on the worsening of the situation, especially if it is tense in hospitals. We are still in a fluid situation compared to the Alpha and Delta variants. I believe that the government has taken all the “soft” measures and that it still has the possibility of calling for teleworking, which would be accepted by the majority. Beyond: lockdown, curfews, school closings, etc. – These are measures that, at the moment, do not seem possible to me. And aside from total containment, I’m not sure both curfews and school closings have been fully tested. In schools, for example, barrier gestures, ventilation and distancing seem to me as effective and socially more judicious than closing establishments.

So isn’t there a French specificity in managing the Omicron threat?

At the European level, political leaders must adapt their measures according to the level of acceptability of the populations, but I think there is a certain homogeneity of the solutions. In France, we remain in reasonable management and without a doubt hope: that the peak of the Omicron variant will arrive soon and that it will experience a rapid decline. In short, make it disappear as dazzlingly as it did. And this movement of acceleration, peaking after rapid decline, seems to be observed in South Africa where there have been no drastic measures taken by the authorities, although the population is much younger there.

Contrary to what we imagined a few weeks ago, could the dazzling Omicron not supplant the Delta variant?

Personally, I don’t think so and it’s a shame because studies show anyway that if it’s more transmissible, it’s still less virulent, or at least causes less severe forms. The least good of the scenarios would be that the two variants coexist, which would imply a lasting modification of the vaccines and therefore consider new booster doses and that would not be good news for the monoclonal antibody treatments that would be ineffective. The last possibility is that the Delta wins the game. But today, it would be dangerous to say which of these three scenarios will prevail.

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In any case, we have to learn to live with this coronavirus because we will not get rid of it. Which begs the question we don’t think about long-term enough: what sacrifices are we willing to make? Not from an economic point of view but from a human point of view. It is a moral and ethical question that we must ask ourselves, especially at this end of the year, in the middle of a period of relaxation.

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