France - The simultaneous circulation of Covid, bronchiolitis and influenza is "completely unprecedented"

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An unprecedented "triple epidemic" of uncertain evolution, according to Public Health France

Published on :02/12/2022 - 13:56
Modified :02/12/2022 - 13:54

The simultaneous circulation of Covid, bronchiolitis and influenza is "completely unprecedented" and its evolution still difficult to predict, according to Public Health France

Paris (AFP) – The "triple epidemic" facing France, with the simultaneous circulation of Covid, bronchiolitis and influenza, is "completely unprecedented" and its evolution still difficult to predict, underlined Friday Public Health France.

The flu hits the metropolis early, adding to a rapidly rising Covid and bronchiolitis at record levels for more than 10 years in infants. This situation hits an already tested health system, as in other countries, notably the United States.

“The situation is completely unprecedented” and filled with “uncertainties”, summarized Didier Che, deputy director for infectious diseases, during a press briefing from the public health agency.

"In previous years, there were more respiratory viruses that followed one another: a first circulation of rhinoviruses gave way to RSVs (main virus involved in bronchiolitis, editor's note), which, very generally, gave way to the flu. There, we have co-circulations”, detailed the epidemiologist Sophie Vaux.

This situation is "worrying" because the addition of these pathologies can lead to "a fairly strong clinical impact, especially on hospitals", she added. And this, even if these viruses do not affect "exactly the same populations", the flu and the Covid mainly affecting the oldest and most vulnerable, bronchiolitis mainly infants.

It is "difficult to predict the occurrence of the peaks" of the three epidemics, in particular a possible simultaneous peak of Covid and influenza, or even bronchiolitis, at Christmas.

One of the big unknowns is a possible competition between the influenza and Covid viruses which could make it difficult for them to coexist and limit the risk of simultaneous peaks.

"It still takes a little time to know if this notion of viral cannibalism is confirmed", judged Mr. Che for whom it is also "too early to draw conclusions from the American situation".

But, he insisted, France is "not yet completely helpless" and has "a preventive arsenal" in the face of this triple epidemic.

Public Health France has insisted more than ever on vaccination against Covid but also the flu, as the end of the year celebrations approach with family gatherings conducive to the transmission of viruses.

Barrier gestures (mask in closed places, hand washing, ventilation, etc.) are also strongly recommended.

https://www.france24.com/fr/info-en-...ublique-france

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TRIPLE EPIDEMIC, MASK, VACCINES: WHAT TO REMEMBER FROM FRANÇOIS BRAUN'S PRESS CONFERENCE

Hugues Garnier
the 09/12/2022 at 18:01

The Minister of Health and Prevention held a press conference this Friday as France faces a triple epidemic of respiratory viruses.

The Minister of Health and Prevention François Braun spoke this Friday afternoon to discuss the health situation in France while several epidemics of respiratory viruses.

“Particularly strong” winter epidemics at this end of the year period. "We are seeing an early circulation of three epidemics in France," said the minister.

• Ninth wave of Covid-19: a situation "not specific to France"

The beginnings of a new wave of Covid-19 have been confirmed in recent days. This epidemic resumption, carried by the BQ.1.1. , is however "not specific to France and is also observed in our European neighbors" according to François Braun.

"Some days this week recorded up to more than 100,000 French people contracting the disease", indicates the minister, "more than 1000 people are now hospitalized for Covid in critical care".
François Braun nevertheless argued that the epidemic “shows no sign of racing”

• "The flu is not a bad cold"

The Minister of Health and Prevention spoke of an "early" and "very active" circulation of the flu epidemic in France. Nine metropolitan regions and three overseas territories are already strongly impacted according to François Braun.

"The flu is not a big cold", warned the minister, while recalling that it "kills and mourns families".
A doubling of emergency visits and hospitalizations for influenza, "particularly marked among those over 65", was also noted last week in France.

• "Active circulation" of bronchiolitis

Another respiratory viral disease that is actively circulating in the territory: bronchiolitis . This particularly affects infants and young children.

“Since October, this virus has generated an unprecedented flow of visits to the emergency room and a large number of admissions of infants and young children to hospital”, notes François Braun, specifying that the pediatric critical care services are occupied “almost full capacity".

72 children have also been transferred in recent weeks to other regions to ensure their care.

• Vaccinations: François Braun calls for a "start"

François Braun calls for a "jump" in vaccination against Covid-19 and influenza.

“Vaccination against the flu and against the Covid is open to all”, clarified François Braun, urging the French to be vaccinated before the end of the year celebrations. Invited this Friday morning on BFMTV / RMC, he hammered home that "everyone can get vaccinated" with a reminder against Covid.

“The recall reinforces protection against infection and against the transmission of the virus”, added Brigitte Autran, president of the Committee for monitoring and anticipating health risks (Covars).
"Vaccination against influenza and against Covid can be done at the same time," said the Minister of Health.

• "We must wear the mask in public transport"

A strong recommendation that is almost like an injection. While again launching a call for vaccination, François Braun recalled the importance of barrier gestures, including that of wearing a mask in closed places.

"You have to put on your mask on public transport, on trains", said the minister, "let's be united"
The minister, however, rejected the idea of an obligation to wear a mask and said “trust the French”.

• Streptococcus A: "we are ready to react"

15 children have died in recent days in the United Kingdom from infections with the bacteria streptococcus A. While concern is growing across the Channel, the French Minister of Health and Prevention has been rather reassuring in this concerning the health situation in France.

"These are serious infections, which we know [...] we are unfortunately used to deaths which usually occur after several days, there it is very fast", underlines François Braun, "we have enough antibiotics.

“The intensity has nothing to do with the other epidemics we are talking about”, added the minister, “we are ready to react”.

Hugues Garnier

https://www.bfmtv.com/sante/triple-epidemie-masques-vaccins-ce-qu-il-faut-retenir-de-la-conference-de-presse-de-francois-braun_AV-202212090589.html

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"It's the triple epidemic, we're really in it": at Bichat hospital, all the beds are occupied in the infectious diseases department

Nearly 24,000 Covid patients are currently hospitalized in France and congested hospitals must also manage epidemics of influenza and bronchiolitis, which severely affect newborns and the elderly. Example at the Bichat hospital in Paris.

Article written by
Solenne Le Hen
French Radio
Postedon 16/12/2022 10:03

The Christmas tree in the hallway may brighten up the infectious disease department of the Bichat hospital in Paris, but all the beds are occupied. Dr Nathan Peiffer-Smadja makes the visit : “In this room, there is a patient with flu, we have another room with a Covid patient, lists the infectiologist. We have two Covid patients also in the area of opposite, we have three Covid patients downstairs.”

Today, nearly 24,000 Covid patients are hospitalized in France, a number obviously on the rise with the ninth wave of the epidemic which is raging. But in fact, since the arrival a year ago of the Omicron variant, there has never really been any calm : at least 13,000 patients are hospitalized. “We still have a background of patients with Covid-pneumonia, we still have severe Covid patients including in intensive care and deaths linked to Covid” , explains Dr Peiffer-Smadja.

Overcrowded services, less effective drugs

Again and again Covid patients, unvaccinated or vaccinated but very fragile, immunocompromised for example. Patients who stay longer than before in the hospital. "It is no longer the same profile as before, very acute, very severe Covid which passes in a few days or then worsens very quickly, explains Dr Peiffer-Smadja. There, these are people who will have a Covid and several complications such as cardiac decompensation . It's very rare that they stay less than a week."

Another problem is that the drugs used so far against Covid for these patients, monoclonal antibodies, are less effective. "With the current variants, these antibodies no longer work much, admits Dr. Nathan Peiffer-Smadja. We are really in difficulty therapeutically because there is not much."

Finally, while a wing of the service is still closed due to staff shortages, patients continue to arrive. Hospital beds are being opened bit by bit in this department for an increasing number of adult patients.“There is a lot of pressure on severe flu and as we have had a lot of adult patients in recent weeks, with this bronchiolitis virus, there are fragile patients who have had pneumonia. the triple epidemic.We are really in it and we are opening beds beyond our capacities in several hospital departments to try to admit patients to the emergency room, " laments the infectious disease specialist.

Against these three respiratory viruses, doctors are asking the most fragile French people to respect barrier gestures during this holiday period and to be vaccinated against the flu and Covid . Vaccines against the virus responsible for bronchiolitis are planned for the elderly.

https://www.francetvinfo.fr/sante/maladie/coronavirus/reportage-c-est-la-triple-epidemie-on-est-vraiment-dedans-a-l-hopital-bichat-tous-les-lits-sont-occupes-au-service-des-maladies-infectieuses_5547636.html

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TRIPLE EPIDEMIC: WHITE PLAN IN TEN HOSPITALS AND CLINICS IN SAVOIE AND AIN

GA with AFP
the30/12/2022 at 0:05

“For the past ten days, the hospitals in the Savoie-Belley territory have been facing significant tension, affecting in particular the emergency services”, explain the establishments in a press release.

Ten hospitals and clinics in Savoie and Ain announced this Thursday the activation of the "white plan", due to the triple epidemic (bronchiolitis, Covid, flu) affecting "in particular" the emergency services , a decision which leads to "partially deprogramming" certain interventions.

The “epidemic context (bronchiolitis, Covid, flu)”, leads to “strong tension on beds and human resources, increased this week by a lower availability of city medicine”, which translates into “waiting times important in the emergency room, sometimes longer than 10 hours, and difficulties in hospitalizing medical patients".

Until January 3

Faced with this situation, these establishments, nine in Savoie, including the Chambéry hospital, and one in Ain, are therefore "forced to trigger the territorial white plan".

“This means” that they “will partially deprogram, in a way adjusted and adapted to the reality of each establishment, their activities of surgery and programmed medicine (without loss of immediate chance), in order to absorb the influx of patients at the emergencies and to free up beds in the services", they explain in this joint press release.

This measure will apply until January 3, when it will be “reassessed”. The ARS was not immediately reachable for comment.

Traveling to Annecy on Wednesday, the Minister of Health François Braun had mentioned a "week of all dangers" for the health system, in the face of this triple epidemic. However, he praised the "absolutely complete mobilization of personnel", making "the system manage to hold".

https://www.bfmtv.com/sante/triple-epidemie-plan-blanc-dans-dix-hopitaux-et-cliniques-de-savoie-et-de-l-ain_AD-202212290497.html

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The triple epidemic of Covid-19, influenza and bronchiolitis ebbs in France, but tensions persist in hospitals

More than epidemics, it is the beds closed for lack of nurses and nursing assistants that are undermining the hospital system.

By Delphine Roucaute
Posted today at 4:00 a.m., updated at 10:19 a.m.

The triple epidemic that marked the end of 2022 seems to be coming to an end. The ebb began with the ninth wave of Covid-19, which gradually gave way to the flu during December. After reaching exceptionally high levels, the share of hospitalizations for flu-like illness continued to decline sharply between January 9 and 15, dropping from 22 to 9 hospitalizations per 1,000 inhabitants in one week. All of the metropolitan regions remained in the epidemic phase despite everything, according to the epidemiological bulletin published by Public Health France (SPF) on January 18 . "The flu often has a fairly unpredictable profile so we remain vigilant about the possibility of a rebound, but we currently have very few positive samples", nuance Romain Hernu, head of emergencies at the Croix-Rousse hospital, in Lyon.

At the same time, the huge wave of bronchiolitis cases – caused mostly in infants by respiratory syncytial virus (RSV), but also by rhinoviruses – have fallen back to low levels after the peak in early December 2022, the highest of the last ten years. The epidemic is officially over in Ile-de-France, while six metropolitan regions have moved into the post-epidemic phase, according to the latest data from SPF .

Thanks to the immunity acquired by the population, the health impact of the wave of Covid-19 carried by the BQ.1.1 sub-variant remained relatively moderate compared to the previous ones. But hospitals had to manage the side effects of two years of barrier gestures: a higher than usual number of people who had not contracted viral infections for a long time, and therefore more likely to catch the usual cohort of viruses. wintry.

“While we expected the flu and RSV to come back in force, we had not anticipated that the resurgence of winter viral infections would also promote invasive bacterial superinfections” , adds Anne-Claude Crémieux, professor of infectious diseases at the Saint-Louis hospital in Paris. In this respect, the increase in serious cases of infection with streptococci A should serve as a warning.
...

https://www.lemonde.fr/planete/article/2023/01/19/la-triple-epidemie-reflue-mais-les-tensions-persistent-a-l-hopital_6158432_3244.html