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“With Omicron, we are witnessing more of another form of epidemic than just a new wave”
January 17, 2022 2.31pm EST
Author
Karine Lacombe
Infectiologist, Head of the Infectious Diseases Department at Saint-Antoine Hospital, Sorbonne University
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Since the spring of 2020, France has experienced five waves of contamination due to SARS-CoV-2 and its different variants (since 2021). What is the situation in the country today? What effect does the arrival of Omicron have, both on hospitalizations and for children? And how has the hospital adapted the care of patients with Covid? Analysis and perspective by Prof. Karine Lacombe, infectiologist and Head of the Infectious and Tropical Diseases Department (Saint-Antoine Hospital, Paris).
The Conversation-France: In France, where are we at with the waves linked to the different variants of SARS-CoV-2?
Karine Lacombe: Since November 2021, we were in a fifth wave where the Delta variant was the majority. It was manifested by an increase in contaminations, which was coupled 15 days to 3 weeks later with an increase in hospitalizations. Until reaching a high plateau, slowly rising, of hospitalizations and passages in intensive care during the Christmas period . There were 245 admissions per day in critical care in mid-December, 285 at the end of December and 345 currently.
And, specific to the present sequence, even before we had a change in contamination and especially in the occupation of intensive care units, we saw the emergence in mid-December with the arrival of Omicron of a kind of sixth wave coming to overlap the previous. Since the end of December, we have witnessed a meteoric increase in contamination, but this has not yet translated into hospitalization : for the time being, the patients who arrive in our services are mainly Delta patients.
We carry out, in hospitalized people, combined PCR tests which detect, among other things, SARS-CoV-2 and influenza viruses. For now, the flu is not yet too present but it will inevitably go up. And in case of co-infection , how will Omicron behave? Influenza ? Will both viruses cause symptoms? We can not know.
TC: It's still early, but what can you already observe regarding the Omicron variant?
KL: It is possible that this variant has different properties from those of its predecessors, such as extreme contagiousness and clinical signs that are not exactly the same. We thus note specificities at the level of the patients: on the one hand we have patients carrying Delta who arrive with a clear Covid at the hospital... and others who arrive with various pathologies and in whom we discover, by testing them upon their arrival in the ER, Omicron's presence went unnoticed. In their case, we cannot really speak of a Covid, since Covid is a disease with well-defined symptoms (the main one being hypoxemic pneumonia, that is to say requiring high oxygen requirements) and here absent, but rather an asymptomatic carriage.
So we have for the moment more another form of epidemic than a simple new wave. But we are at the very beginning of this sixth sequence, so it is difficult to see where it will lead. However, we have the examples of England and South Africa, which have already passed their peak and where it seems that Omicron has caused fewer serious Covid forms. In England, currently, out of ten people who arrive in Emergency for Covid, one goes to intensive care; usually it's one out of five… That's why we sometimes hear that it's twice as pathogenic.
What is it due to? To the intrinsic properties of Omicron… or to the fact that 75% of the population is vaccinated (90% in France)? It is still too early to tell, we will have precise statistics within a fortnight.
TC: Is there already data regarding the symptoms of Omicron?
KL: The first clinical observations that we make are that Omicron would rather give "high" forms of affection: of the pharyngitis and laryngitis type, sore throats which evoke angina, runny nose... things rather affecting the ENT sphere, and not the deep lung unlike Delta. In vaccinated people, especially those who have received three doses, we have many carriers who are asymptomatic or who develop rare symptoms over two to three days – like a kind of flu, with a little sore throat, sometimes a little fever, aches and then it passes.
We must nevertheless remain cautious: the last week of December, 14% of people hospitalized for Covid in intensive care with us had Omicron.
Another point, we have 500 children hospitalized in France for Covid (we don't yet know if it's Omicron or Delta), the highest number we've had – and 80% have no comorbidities. Which is proportionally normal: with several hundred thousand people becoming infected every day, children are inevitably affected. But in this case, it is an epidemic that has been meteoric among them and young adults.
And there is the question of PIMS ( pediatric multisystem inflammatory syndrome ) which can affect children three to four weeks after their Covid. We had a few cases with the other variants, what about Omicron? It is something that worries, and we will not know more before February-March. ( Between March 2, 2020 and December 26, 2021, 826 cases of PIMS were reported, including 745 related to Covid-19. The number of cases has been increasing since the end of November indicates Public Health France , editor's note )
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France had its worst-ever day in terms of new COVID-19 cases on Thursday, with more than 91,000 new cases being recorded while the number of deaths also climbed, as the country battles against a fifth wave of the virus.
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"Today's figures are not good," said Health Minister Olivier Veran.
Veran had earlier told reporters that the case number would stand at around 88,000 for Thursday, but the final official tally from the health ministry showed 91,608 new cases.Leave a comment:
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Omicron variant: the propagation map in France up to date
Benoit Deshayes ,Updated 12/21/21 5:46 PM
Linternaute.com
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[Updated December 21, 2021 at 5:46 pm] The Omicron variant continues to be of concern. And for good reason: its spread in France and around the world is extremely fast. The new coronavirus mutant represents, in Paris alone, at least one in three Covid-19 contamination, Gabriel Attal announced on Tuesday, December 21, in Matignon, after an interview with Prime Minister Jean Castex . On France 2, the spokesperson of the government had also noted, this December 21 in the morning, that the cases of Omicron doubled "every 2 to 3 days". And to specify that, if it represented "10% of the contaminations this weekend, we are probably beyond today and very beyond in certain regions, in particular in Ile-de-France, in particular in Paris" . At the risk of causing a 6th wave, while the 5th, due to the Delta variant, has still not fallen and in a context where "we are beating records of incidence rate" (537 positive cases per 100,000 inhabitants according to the last digits) and where "the situation in the hospital is tense".
This strong contagiousness of the Omicron variant could however, according to several immunologists, be partially thwarted by the booster dose of the anti-Covid vaccine. This Tuesday, it was the turn of the head of the Virus and Immunity unit at the Institut Pasteur, Olivier Schwartz, to assert that the "patient antibodies are capable of neutralizing the Omicron variant", one to three months after injection of the booster dose, on BFMTV . A speech already widely taken up by part of the scientific community, which therefore calls for its recall as soon as possible.
How many cases of the Omicron variant are there in France?
Since mid-November, Public Health France has listed in its epidemic dashboard the number of proven cases of coronavirus with the Omicron variant. 748 cases have been officially identified over one day , as of December 19, according to the latest available data. They were barely 200 a week earlier according to the corrected data and less than 100 on December 9. Several observers nevertheless believe that these official data are well below reality, the screening of the variant not yet being systematic. Guillaume Rozier, founder of the CovidTracker and ViteMaDose sites, has started publishing figures and maps placing Omicron far above what Public Health France can report. Other experts are even more pessimistic. Florence Débarre , researcher in evolutionary biology at the CNRS, indicated on Twitter on December 20 that the Omicron variant could have already passed the 50% of new cases in Ile-de-France and that the doubling time of the mutant was "of the order 2 days ".
In order to try to identify more effectively the propagation of the Omicron variant in France, these specialists are based in particular on the proportion of tests screened not exhibiting the "L452R" mutation, present in the Delta variant, but absent in Omicron. In the graph below, we have reproduced the number of suspected cases per sliding week since October 1, according to this method, from data available on the Data.gouv site . During the week of December 11 to 17, the last sliding week available, there were 7334 cases with a strong suspicion of the Omicron variant in France. All - it should be remembered - on a relatively low proportion of screened tests.
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Emergence of the Omicron variant in France
170 Omicron variant cases have been detected
to 12/14/2021
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Omicron: 133 cases in France, Jean Castex warns
"We must prepare" for the deployment of the variant, said the Prime Minister. And this, while Gabriel Attal took stock of the number of referenced cases.
By Le Point.fr , with AFP
Published on 12/14/2021 at 9:24 am - Modified 12/14/2021 at 12:38 p.m.
The Omicron variant is on everyone's minds in the executive. While France is facing a fifth epidemic wave still dominated by the Delta variant, Jean Castex warned, Tuesday, December 14, on France Bleu Provence , about the evolution of Omicron on the territory. "We must prepare, because the variants always end up being essential", declared the head of government, during the second day of his trip to Marseille , in the Bouches-du-Rhône. At the same time, on France Info , the spokesperson for the executive, Gabriel Attal, announced that 133 cases of the Omicron variant have been detected in France, citing "more than 10,000 sequencing per week".
"Most of the cases are screened and then there is the sequencing," he also added. According to him, “in reality, we have a sieve that is quite tight”, which could mean that there are “probably” more cases than those which are screened for sequencing. "There is particular vigilance" on the part of the authorities, he said. "The truth is that we do not yet know exactly when this variant will unfold, but experience has led us to say that we must prepare for it, because in the end the variants always come to dominate" , for his part developed the head of government.
No alert on the start of the school year
"Even if the circulation (of Omicron) today in France remains weak, our duty is to anticipate on the basis of what we know", pleaded Jean Castex. "The British say that it is much more contagious than Delta, which itself was more contagious than its predecessors, but that it does not necessarily lead to more serious forms and that it cannot withstand the third injection" , he also noted.
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Isere
Covid-19: a first case of the Omicron variant detected in Grenoble
While a dozen cases are currently identified on the national territory, a first case of Omicron variant has been detected in Isère, and precisely in Grenoble.
By GM - Today at 17:26 | updated today at 17:31 -
“This is a patient who came to be tested on December 2 in one of our laboratories and whose PCR test, which turned out to be positive, was then subject to emergency sequencing on our technical platform. of Saint-Martin-d'Hères ”, specifies Olivier Vidon, president of the group of medical biology laboratories Biogroup / Oriade-Noviale, leader in the region.
The man in question was returning from the United States.
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Covid-19 in Reunion: identification of a 2nd positive case for the "Omicron" variant
Article created on 12/03/2021Updated on 12/03/2021
Following the sequencing of three suspected “Omicron” cases, the prefecture and the Regional Health Agency today confirm the contamination by the “Omicron” variant of a second patient in Reunion Island. This case is unrelated to the previously identified case.
The patient infected with the “Omicron” variant was tested negative on arrival at the airport, as part of the systematic screening system for passengers arriving from abroad.
This person was returning from a trip to Southern Africa. She exhibited symptoms several days after arriving in Reunion. Following a new test, which was positive for Covid-19, this person was defined as a suspected case with the "Omicron" variant. The health isolation protocol was immediately implemented.
Investigations are still underway with the identified contacts. Contacts were asked to self-isolate and get tested immediately.
The patient is currently isolated at his home and is the subject of regular follow-up by the ARS.
Faced with Covid-19, the best prevention remains vaccination and respect for barrier gestures.
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Omicron variant: a 3rd case identified in Reunion, the 1st indigenous
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LH • Posted on December 5, 2021 at 11:00 p.m.
According to the authorities, this 3rd case is unrelated to the 2 other identified cases, nor to a stay abroad. The patient infected with the omicron variant would be an indigenous case.
First indigenous case, another possible
This case was identified following the latest sequencing results. Contact tracing made it possible to identify a contact person at risk, whose screening is in favor of an Omicron variant. This person is therefore an additional possible case, whose sequencing results are pending. It would not have any relation with a stay abroad either.
Stella high school under surveillance
The 3rd identified case and this possible case of the Omicron variant are educated at the Stella high school in Saint-Leu. The authorities indicate this Sunday evening that it appears desirable to retest all the students of the 2 classes concerned, given the emergence of the Omicron variant.
Classes are not closed
However, classes will not be closed pending results. All the students in the classes concerned have already been tested when the positive cases were discovered, without knowing at the time that it was the Omicron variant, the authorities explain.
Symptomatic but do not cause concern
They specify that positive people are symptomatic without their state of health causing concern. The sanitary isolation protocol was immediately implemented, as well as the screening instruction for contact cases. Investigations are still ongoing.
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Covid-19: the first case of the Omicron variant detected in Indre-et-Loire
Saturday December 4, 2021 at 5:19 PM - By Adrien Bossard
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The Regional Health Agency confirmed this Saturday that an inhabitant of the Touraine agglomeration was carrying the Omicron variant. This is the first case in Indre-et-Loire and even in the Center-Val de Loire region.
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The 29-year-old man, living in the greater Tours area, tested positive on December 2 . The sequencing of the sample revealed, this Saturday, December 4, confirmed that it was indeed the Omicron variant.
The carrier of this strain did not return from Southern Africa, where the variant was detected for the first time, but from a trip within the European Union. The Regional Health Agency specifies that he is not hospitalized and that "his condition does not cause concern" . He is in strict isolation, as is another contact person , the only one identified.
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Coronavirus: twelve cases of the Omicron variant confirmed in France
Friday December 3, 2021 at 6:24 am - Updated Saturday December 4th, 2021 at 7:08 PM - By the editorial staff of France Bleu , France Bleu
Twelve cases of the Omicron variant of Covid-19 were detected in France according to Public Health France on Friday, at least in six different regions in addition to the island of Reunion.
The number of cases of infection with the Omicron variant detected in France now stands at twelve, according to the latest report updated this Friday evening by the health authorities. "As of December 3 at 4:00 p.m., three new confirmed cases of infection with the Omicron variant have been reported in France" , without anyone knowing in which region, the French public health agency said. The majority of those infected were returning from Africa.
At least six metropolitan regions and Réunion affected
So far, cases have been detected in France in the following territories: Réunion, Auvergne-Rhône-Alpes, Provence-Alpes-Côte d'Azur , Ile-de-France, Pays de la Loire , Grand Est and Center region -Val-de-Loire . We know in particular that there is one in Seine-et-Marne, one in Vendée and one in Haut-Rhin . " These cases and their contacts are closely monitored by the local authorities, " says Public Health France. The patients are isolated at their home " even before the results of the sequencing ", specifies the DGS.
Omicron present in around 30 countries
First spotted in November in Botswana and South Africa, the Omicron variant is now present in around thirty countries on all continents. The new variant has sent a wave of panic blowing across the world, but it's too early to say what impact it will have on the pandemic, experts agree. On paper, the unprecedented number of mutations it contains leads to fears that it is more transmissible and more resistant to vaccines.
But that remains to be confirmed and it is not known whether he is able to replace Delta, currently responsible for a fifth wave of the epidemic in France , which is reflected in a clear deterioration of the indicators. On Friday, 49,858 cases were identified, an average daily over 7 days of 38,890, against less than 6,000 a month earlier.
More worryingly, this increase is having repercussions on the hospital: this Friday 11,103 Covid patients were hospitalized in France, including 2,058 in critical care services, against around 6,600 and 1,000 a month earlier. A new health defense council will take place on Monday to " see whether it is necessary to take additional measures ", Prime Minister Jean Castex announced on Thursday.
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First detection of cases of contamination with the Omicron variant in France
published on 03.12.21
Press releases and press kitsCoronavirusCOVID-19Health
The French health authorities confirm the detection by the laboratories of the Emergen consortium, on December 3, 2021, in metropolitan France, of 9 contaminations with the Omicron variant of the Covid-19 virus (lineage B.1.1.529).
Point position :
At this stage, 9 cases have been detected in France in the following territories: Reunion, Auvergne-Rhône-Alpes, Provence-Alpes-Côte d'Azur, Île-de-France, Pays de la Loire and Grand Est. As soon as the results of the RT-PCR tests of the patients were known, and even before the results of the sequencing were obtained, the patients isolated themselves at their homes and the measures for identifying and isolating the contact persons at risk were carried out. been implemented.
Confirmed cases of the Omicron variant have also been reported in several European countries (Germany, Netherlands, Belgium, Italy, Denmark, Austria, Spain, Norway) and in the United Kingdom, as well as in the United States, India or in Brazil.
Reinforcement of border screening and measures:
The ministry has today disseminated several messages to health professionals, health establishments and regional health agencies on the instructions relating to the strengthening of screening and border measures in the current context of dissemination of the Omicron variant.
In order to orient the investigations and the conduct to be taken around the cases, Public Health France has published on its site a case definition, differentiating among the people tested positive for Covid-19:
suspected cases (with a history of travel to a country at risk in the last 14 days or being contact at risk of a person having made such a stay)
possible cases (suggestive screening or person at risk of contact with a confirmed case of Omicron variant infection)
confirmed cases (confirmation by sequencing of the presence of the Omicron variant) of infection with an Omicron variant.
Any suspected case must be the subject without delay of a screening RT-PCR, a rapid technique consisting in looking for mutations found in particular in the Omicron variant. As part of this strategy, a positive screening makes it possible to suspect the presence of the variant in the sample. Only sequencing, a technique consisting in analyzing the entire genome of the virus, makes it possible to confirm infection with the Omicron variant. As such, any possible case must now be sequenced without delay.
While waiting for the results to be obtained, it should be remembered that all suspected, possible or confirmed cases of the Omicron variant must observe strict isolation for a period of 10 days, regardless of their vaccination status. All of the risky contacts of these cases are carefully monitored by the Health Insurance and the Regional Health Agencies.
All flights have been suspended since November 26 and until December 4 (00h) from South Africa, Botswana, Eswatini, Lesotho, Mozambique, Namibia, Zimbabwe, Malawi, from Zambia, Mauritius. As of this date, new border measures will be put in place for travel from these countries in order to limit the introduction of the Omicron variant into the territory. They were the subject of a communication from the Government spokesperson and will be summarized shortly.
The ministry monitors with particular attention the overseas territories of Réunion and Mayotte which are directly linked to these countries. Since November 28, any person coming from Mayotte or Reunion to the rest of the national territory must be provided with a negative test result carried out less than 48 hours before boarding.
The health authorities are mobilized to identify as early as possible each infected patient to isolate him, quarantine all of his contact persons regardless of their vaccination status and test these people in order to fight against the spread of this variant of SARS- CoV-2 on the national territory.
The authorities recall the importance of screening and absolute respect for the isolation of any positive person or presenting symptoms suggestive of the disease, regardless of their vaccination status.
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