Resuscitation, death, contamination... Almost 15 days after deconfinement, these indicators are rather positive. However, the authorities judge that it is too early to draw conclusions. And this, despite the opinion of scientists who no longer hesitate to say that the Covid-19 epidemic is behind us. All the more so as new studies point to the possibility that a much larger than expected part of the population is already immune. A laborious end to deconfinement, which promises an outbreak of controversy and revelations about the nature of the relationship between certain scientists and politicians.
All indicators down
The first critical indicator is resuscitation admissions. Their "their" daily number (...) is still decreasing since April 8« The French Public Health Agency (Agence Santé publique France) said in its latest bulletin, published on 21 May.
Currently, about 1,700 patients are hospitalized in intensive care units for a severe form of Covid-19, according to the latest figures from the Ministry of Health. They were 2,200 one week earlier, and 7,148 on April 8 for the highest total ever (we were then in full confinement, applied from March 17 to May 11).
Similarly, deaths are steadily decreasing. Between last Thursday and Friday, 74 Covid-19 patients died in hospitals (not counting deaths in Ehpad and institutions for the disabled). We are very far from the daily balance sheets of early April: between April 5 and 6, there were more than 600 deaths in hospitals alone.
In total, more than 28,000 people have died in connection with Covid-19. Everywhere in France, this epidemic was accompanied by an excess of mortality, underlines French Public Health. It has been " particularly marked in the Grand Est and Ile-de-France regions "and during the period from March 16 to April 26, with a peak during the week of March 30 to April 5. This excess mortality " tends to return to normal levels« according to the health agency.
She also noted a decrease in emergency room visits for Covid-19, which " reflects a decrease in new contaminations"
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Caution or overcaution?
These indicators, which have turned green, should make us happy, but according to the health and political authorities, it is premature to claim victory. « All we can say is that today, we have no warning signal but that it is too early to draw from this observation that everything is going to be fine...« Daniel Lévy-Bruhl, head of the Respiratory Infections Unit at Santé publique France, told AFP. « There is a discrepancy between what is measured today and what it corresponds to: what is measured today is still the benefits of containment.« he continues.
Mechanically, the lifting of the containment since May 11 must inevitably lead to an increase in the number of infections since contacts between people are multiplying, the authorities warn. « The whole issue is to keep this increase within the limits of what is acceptable...« says Dr. Lévy-Bruhl.
The government's spectre is a return to the pre-containment scenario, with an explosion in the number of cases that would saturate the health care system. To avoid it, it relies on a device combining testing, identification of people in contact with a positive case (or "contact tracing") and isolation of patients.
For the moment, French Public Health has identified 46 outbreaks of infection (or "clusters") throughout the country. For the most part, the first cases date back to before the lifting of containment.
" The optimistic view is that the identification of a cluster is good news because it confirms the ability of the device to identify them and break the transmission chains.« comments Dr. Lévy-Bruhl, stressing the importance of " physical distancing and barrier measures"
" The risk of a second wave exists, it's up to all of us collectively to make sure it doesn't happen.« he adds.
For some, it's almost the end
Contrary to the dominant discourse, a few scientists, a minority but growing in number, believe that the epidemic is coming to an end. Proof of this is the steady fall in the number of deaths. Professor Toussaint, director of the Institute for Biomedical Research and Epidemiology of Sport (Irmes), believes that in order to observe a health trend, mortality is the least uncertain value in all countries, regardless of the difficulties in collecting data. Whether the disease is infectious or non-communicable, health systems and surveillance agencies count deaths less poorly than new diseases, with the consensus often being more consensual. The specialist told UP' Magazine: "The consensus is often more consensual. The number of Covid-19 deaths worldwide has been declining on average since 16 April. "He goes on to say: « The reduction in the number of daily deaths worldwide is 50% compared to April 16. It is 85% in Europe (95% in Belgium and Switzerland, 85% in Germany and France, 70% in the United Kingdom) and 60% in the United States. ".
A view held by other experts that the epidemic has affected everyone it could affect. Their central argument is that it is wrong to consider the entire population as a target. « A significant portion of the population may not be susceptible to coronavirus because non-specific antibodies to coronavirus can stop it.« said to the AFP the epidemiologist researcher at Inserm Laurent Toubiana. Based on data from SOS Médecins, he believes that Covid-19 has in fact struck many more French people than is believed, nearly 18 million (including 5.5 million without symptoms).
An outbreak that's coming to an end? An opinion shared by Professor Yonathan Freund, an emergency doctor at the Parisian Pitié-Salpêtrière hospital. He is struck by the spectacular drop in the number of contaminations among his colleagues compared to the beginning of the epidemic. « In the emergency room and in the hospital, we are particularly exposed. If the virus was circulating as much as before and we were all likely to be affected, we would have been infected among ourselves or by those who were sick." he explained to AFP. " However, a large majority of doctors were not affected at all. This is pure speculation, but it could mean that people have natural or acquired immunity...« he says.
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Cross-immunity: the coronavirus would not have many more people to infect.
This hypothesis, which remains to be verified, was raised by American researchers in the journal Cell They suggested that 40 to 60 % in the population could be immunized against Covid-19 without even being exposed to it. These individuals may have acquired this protection through past exposure to other coronaviruses that cause common colds (this is called "cross-immunity"). In this case, the new coronavirus would not have many people to infect.
One of the consequences of this cross-immunity is a heterogeneity in the spread of the virus: some people would be more vulnerable than others, and others would be more contagious for no apparent reason. But the more we learn about the virus, the more epidemiologists realize that the global models taken in the emergency, without taking into account these heterogeneities, need to be refined. This is the case of a British mathematician, Gabriela Gomes, who believes that in a post that the herd immunity would only be 10 to 20 % and not 60 to 70 % as previously thought.
This difference changes everything. Indeed, it would mean that the virus has contaminated everyone it could reach in France and that the epidemic is coming to an end. It also means that there can be no second wave, so feared by the French public health authorities. « This virus is not a marathon runner, it's a sprinter: it gets exhausted very quickly...« Jean-François Toussaint, who does not believe in a second wave either.
These scientific controversies are still rare to make their voices heard in the mainstream discourse. They refute assumptions on which some of the measures taken by governments to combat the epidemic on the advice of scientific experts have been based.
At low noise, revelations gradually appear. We learn that the models of Professor Ferguson of Imperial College London, models that have played a decisive role in public policy on the coronavirus, are simply false or even rigged. In mid-March, the prestigious British scientific institution published the results of a computer modeling study predicting millions of deaths in Europe and the United States. It was these projections that created a climate of fear in public opinion and within governments; there were references to the Black Death, the Spanish flu, in short, the end of time. The drastic measures that had to be taken became obvious and necessary. They were taken, everywhere, as a matter of urgency, with the economic and social consequences that we are currently experiencing for the generalised containment.
Now we learn today that Professor Ferguson's modeling programs were buggyThe first of these was written in Fortran, a computer language that has not been used for decades. Prompted by his scientific peers to communicate the data and methodology of his predictions, Dr. Ferguson confess used an undocumented model designed to model influenza epidemics thirteen years ago.
More recently, the study by the École des Hautes Études de la Santé Publique (EHESP) which allowed the French government to justify a posteriori its policy of generalized containment is reconsideration by several experts in epidemiological modelling. Other revelations will undoubtedly follow and will not fail to raise the question of the nature of the relationship between scientists and political power during this period of major crisis.
Sword of Damocles and Frigidity
In the face of these beginnings of controversy over the appropriateness of measures taken by public authorities on the basis of more or less sound scientific advice, the official message is one of caution, or even caution. The government is stalling, repeating that it will take at least two weeks to begin to get a clearer picture of the spread of the virus.
" Maybe next week we'll have some elements« says Dr. Levy-Bruhl. « The Sword of Damocles "of a" renewed epidemic momentum "is still present, which could even lead, " at worst case scenario« , à « a need to reconfirm« he warns.
This doctor, in charge of the Respiratory Infections Unit of Public Health France judges " premature to base hope on cross-immunity« hypothesis". far from being unanimous and far from being supported« . According to him, " we should not send the message to the population that everything is fine because we realized that everyone is protected."
" I understand that we are very cautious about making a new prophecy, because everyone has screwed up so badly in the beginning and I was the first one« ...argued Professor Freund. After having detailed on Twitter his hypothesis of the end of the epidemic, he sweeps away irresponsible lawsuits: " It's not about stating truths, but I say my impression as a scientist, researcher, professor, and I don't see why I wouldn't say it." . " We have to stop infantilizing everyone...« he says.
Header image: Aerial view of Dolores Park where circles have been drawn to enforce social distancing in San Francisco, California, May 22, 2020 - AFP / Josh Edelson