A few months ago, we wondered: “When can we say that the Covid-19 pandemic is over?” We then witnessed a remarkable decline and crossed our fingers that the figures do not go up. We estimated then that beyond the epidemic indicators, the pandemic would be over… when the media would no longer talk about it and the general public would no longer care.
Today, no doubt because one news item chases another and the front pages of the press are legitimately occupied by the war in Ukraine and, in France, by the presidential election, the Covid-19 has gone backwards. plan. We are also told that in schools, we no longer test. We read on Twitter that Omicron “no longer a public health problem»we understand by this: “It is no longer a problem because the resuscitation units are no longer saturated and the hospital doctors feel less concerned.”
For a little while, we have both been thinking about the risk of “clinging” too personally to the pandemic, because we know well that we are at risk of becoming victims of a form of Stockholm syndrome. Indeed, for more than two years, we have been living and sleeping Covid and we must be wary of a form of attachment to our jailer the pandemic, which would push us not to let go even though it would be behind us. We hear it, even if we remember having formulated this same dilemma at the end of each wave or almost.
The first question we must ask ourselves is whether we can reasonably hope today that the pandemic will finally be behind us? The response of the two hostages who have lived for more than two years with their jailer, the Covid, will therefore not surprise you: we do not think it reasonable to say that the pandemic is over! And we are not the only hostages locked in the pandemic cell. Indeed, the WHO Emergency Committee recently reaffirmed that Covid-19 remains a “public health emergency of international concern”it is the jargon of the International Health Regulations to mean that the pandemic threat still continues.
Let’s look at the epidemic indicators closely. If we are witnessing a decline reported in all European countries, the circulation of the virus is still very strong there, especially in France where the fall in incidence is also quite slow. The incidence rate, after having peaked around 1,300 in early April, still remains at nearly 1,000 during this second half of April, still approaching the 100,000 people recorded as positive each day and more than 100 to die from it daily.
You will understand that we cannot say that it is nothing and that it would no longer be a public health problem. It wouldn’t occur to anyone to say that myocardial infarction, the leading cause of death in France before the pandemic and which kills 90 people a day, would not be a public health problem. Therefore, the question of avoidable loss of human life, the isolation of infected people, that of absences from work or school, or even medium and long-term sequelae are all problems that fall squarely within the public health!
All this without taking into account that the number of cases is very largely underestimated.
Indeed, since it is no longer necessary to be tested, since self-tests are widespread and used, many are those infected with SARS-CoV-2, who pass under the radar of official health monitoring. . They no longer pass through the pharmacy box or the laboratory box to be tested and therefore do not enter the daily counts.
Furthermore, while cases of re-contamination are frequent with Omicron BA.1 and Omicron BA.2, it appears that a infection n‘is counted by health monitoring only if the positive person has not already been positive in the previous sixty days (data retention period on SI-DEP, the secure platform where the results of the Covid-19 test laboratories are systematically recorded).
Finally, the use of self-tests and antigenic tests, the reliability of which has greatly decreased, with Omicron also suggests that many cases are not detected.
Everything therefore leads us to believe – even if we cannot see it – that the virus is still circulating very widely within a population that is no longer naive and which has acquired, thanks to vaccines and possible repeated infections, a certain level of cell-mediated immunity enabling it for the most part and for the moment, to avoid the most severe forms.
So, since the virus circulates massively everywhere on the surface of the Earth, there is no reason to think that it will not mutate again. Moreover, many new variants are already waiting at the gate of international competitions for a qualification that we know is next. No one knows, however, whether the future variants selected will be more or less virulent, nor more or less contagious. No one knows either whether or not they will escape acquired or vaccinal, humoral or cellular immunity. Because if there is a myth that many people want to believe, it is that a virus always evolves towards less virulent variants that are easier to tame!
But, our opponents ask us, like visitors bringing food to their prisoners, is this not yet another catastrophic discourse on the Covid? So look at the last few months, hasn’t Omicron become much nicer? Wasn’t it all our luck in the end? Well no, we answer prisoners of our certainties, it is indeed the vaccine and not Omicron that changed the situation.
Suffice it to note the devastation Omicron caused in Hong Kong, a highly developed territory in China where half of the people over 60 were vaccinated when Omicron arrived. The slaughter there was appalling, with a fatality rate of 5% among those over 60, compared to 0.1% in South Korea or Western Europe, where the elderly are much better immunized. How can we imagine that the Chinese authorities would confine the inhabitants of many metropolises, including Shanghai of 26 million inhabitants, to obsession, if Omicron had become this brave variant leading the population to a common cold for a few days?
It is because its population is insufficiently immunized, possibly by less effective vaccines, that the Chinese government fears a Hong Kong-style scenario. On the scale of mainland China, it would be a far greater tragedy than he is doing everything to try to avoid.
Another element and not the least: the long Covid, on which there remain gray areas. The first cases of persistent symptoms have been described with Omicron and it is unclear what the protective role of vaccines is. Some series evoke long Covid rates of 30%, which seems enormous. Although it is estimated that 10 to 15% of people who have contracted Covid will develop a long form, with the high levels of infections in recent months, this would become a real public health problem and we cannot afford to wear blinders. to please the reassurers!
Admittedly, even if work is accumulating on this subject, we do not yet know everything about the long Covid, but instead of putting dust under the rug, we think it would be wiser to do everything to protect ourselves from an excessive viral infective dose in our closed and poorly ventilated environments, in order to reduce the risks of severe and late forms.
Today, and this is fortunate, apart from China which is struggling as we have said with a strain visibly as virulent as the previous ones in a population at risk and poorly vaccinated, no one recommends taking the strong measures that we experienced at the start of the pandemic. No one in Europe has offered to confine, even at the height of the Omicron-BA.1 wave, last January.
We have acquired high population immunity, especially that at high risk of serious forms. We are experiencing a variant of the coronavirus that continues to respond well to available vaccines, at least in terms of severe forms. And we have a hospital system that is not clogged, even if it seems to come out groggy from this health crisis. All this makes it possible not to have to introduce curfews, store closures or to propose new confinements, and it is to the credit of the management of this pandemic.
But have we not learned any of the lessons of this recent past so as not to mobilize knowledge and skills in order to limit the circulation of the virus by other interventions? –you remember the emmental model, don’t you? Why do individual and collective measures as little freedom-killing as wearing a mask and the ventilation of closed places not become a priority? Why do we accept that there are still more than a hundred deaths per day when we now have effective treatments which should be able to very substantially reduce mortality from Covid?
Do France and Europe give priority to research on monoclonal antibodies and antivirals, so that they can counter new variants and be administered to people most at risk of serious forms and poorly protected by vaccines, that whether for prophylaxis or treatment of infection? Or will we continue to rely primarily on North American research and development? We salute them, we are very happy to have them, but where are the tests, vaccines and treatments for Covid-19 from French and even European laboratories and pharmaceutical groups?
Seen from our think tanks on the pandemic, it seems to us that not many of us are promoting the isolation of positive people while providing aid to those who would be financially impacted. Since even to go and vote, the French government did not consider it necessary to wear the mask to people who knew they were positive.
We may be prisoners of a pandemic that seems to drag on forever, but we believe that we should not let go of testing or monitoring the pandemic: we so badly need reliable indicators to observe its evolution, early detection of new variants and their installation on the territory, and control of the number of contaminations. Epidemiological monitoring today is solely hospital-centered, because we have entered into full fog on the circulation of the virus in the community. We ask that tests be carried out on representative samples of the population, or at least on wastewater and in a rigorous manner.
A country like France deserves to have reliable health monitoring because it is unbearable to have so much margin for error, not to know when it reports 100,000 cases during the day, if in fact it is not It was not a million contaminations that would have occurred in the country on the same day.
We’ve managed to tame the beast through vaccines and population behaviors in recent months, but it’s an armed peace that this is all about, as new variants are lurking on our doorstep and seem to be waiting their turn to attack again. Will it be due to a drop in immunity or an increase in their own virulence? We risk finding out too late because we are not about to sign the armistice, and the sentries are already coming down from their battlements, and the guards from their observation posts. The war is over, they strike us heartily.