- For more than a month, every day, information has been pouring in on this new epidemic of coronavirus which comes from China and worries the whole world.
- Unmatched scale, enduring epidemic, drastic measures, this Covid-19 has already done a lot of damage.
- Mortality, treatments, vaccine… 20 Minutes answers five questions that you are probably asking yourself.
Inordinate worry, adequate management or communication intended to avoid panic? Difficult to see clearly after weeks of continuous more or less reassuring information on the coronavirus epidemic, which now has its official name: Covid-19. Since the beginning of 2020, the world has been holding its breath to know what will be the scale, the health and economic damage and the duration of this new epidemic. 20 Minutes takes stock of the situation.
Find the live of this Tuesday February 18, 2020
Is the epidemic contained?
Unsurprisingly, China is suffering the most from the epidemic, with 72,300 people infected on Tuesday, many of them in Hubei province. Elsewhere, almost 900 cases have been confirmed in around 30 countries. An encouraging sign announced on Tuesday: in mainland China, the number of new 24-hour contaminations (1,886) is at its lowest since the beginning of the month, and that of additional deaths (98) is down for the fourth consecutive day. WHO warned on Monday that the spread of the coronavirus remains "impossible to predict".
And for France? During his first press point on the coronavirus, the new Minister of Health, Olivier Véran, announced Monday evening that of the twelve confirmed cases of infection, six people remained hospitalized. This Tuesday, representatives of hospital staff and liberal doctors are received at the ministry to provide an update on the organization in the face of a possible epidemic.
Because if the health authorities try to reassure, this coronavirus surprises more than one. "There are about 2,000 new cases per day, which means that we are not at all at the end of the epidemic, warns Frédéric Tangy, professor at the Pasteur Institute and director of the vaccine innovation laboratory . For the moment, it is contained in China at the cost of enormous efforts: city and airport closings, canceled events… But for how long? What surprises this specialist is the duration of the epidemic, but also of the pathology. “It seems that patients die late, sometimes a month after infection, which is new compared to other coronaviruses. "
What is its mortality rate?
The balance sheet of the epidemic rose Tuesday to nearly 1,900 dead in mainland China, and to 5 deaths elsewhere (Philippines, Hong Kong, Japan, Taiwan and France). Citing a study by the China Center for Disease Control and Prevention involving more than 72,000 people, WHO director Tedros Adhanom Ghebreyesus said Monday that more than 80% of patients currently infected suffer from a mild form of disease.
"This coronavirus has exceeded in duration and scope the SARS [severe acute respiratory syndrome, which killed 800 people for 8,000 cases between 2002 and 2003] and the Seas, coming from the Middle East, [449 died for 1,219 cases in 2012 -2013]. It is more contagious, but has a lower lethality - around 2.5% - when the mortality rate for Sras was around 9% and that of the Seas 30%. But it's still forty times more than the flu… ”, says Frédéric Tangy.
What is the patient profile?
According to this same study by the Chinese Center, up to 39 years of age, the mortality rate from Covid-19 remains very low, at 0.2%, then increases gradually with age. Another Chinese study, that of the State Key Laboratory of Respiratory Disease in Guangzhou, identified by Sciences et Avenir , was carried out on 1,099 patients. Infected and critically ill patients often combine this disease with other pathologies: hypertension (in 23% of cases), diabetes (16.2% of cases).
This is not surprising for Frédéric Tangy, since it is always the most fragile people who die first during epidemics. "At first, we thought it was the elderly and very young who would be the most affected, but this is not really the case, nuances the researcher. In fact, there are few cases of sick children. " What are the symptoms ? "Respiratory distress," he replied from tick to tock. Difficulty all the same: some patients are asymptomatic or have mild clinical signs. According to Sciences et Avenir , the latest study lists "three major symptoms of COVID-19 coronavirus: a body temperature above 38 ° C (87.9% of patients), coughing fits (67.7%), and a strong fatigue (38.1%). "
What are the treatments ?
At present, there is no specific treatment, but therapies to relieve the symptoms. Some patients are given a cocktail of antibiotics, anti-inflammatories, corticosteroids and doliprane - for headaches - and oxygen for better breathing. Pharmaceutical companies are engaged in a race against the clock to develop a treatment. The 48-year-old infected patient who left CHU Bordeaux on Thursday, February 13, after 22 days of hospitalization, was treated with remdesivir, a "promising" antiviral, said his medical team on Friday. Remdesivir, from the American Gilead, which had been tested during the Ebola epidemic, "acts directly on the virus to prevent its multiplication," Denis Malvy, head of the disease unit, told AFP. tropical. "But he is only a patient, we cannot draw conclusions, he was able to heal for other reasons," explains Frédéric Tangy, of the Institut Pasteur. Furthermore, it is an excessively expensive product. However, this drug is a source of hope: Rembdesivir will be the subject of a comparative therapeutic trial in China with the coordination of the WHO.
The doctor at the Bordeaux University Hospital mentioned a second drug: lopinavir. Used against HIV-AIDS, combined with ritonavir (an antiretroviral also used against AIDS), it has been the subject of a trial in China, the results of which are awaited.
In addition, the Chinese health authorities asked on Monday those recovered from the coronavirus to donate their blood, in order to extract the plasma to treat the sick who are still in serious condition. It contains antibodies which could reduce the viral load in severely affected people.
When is the vaccine?
The Coalition for Epidemic Preparedness (CEPI) has announced that it will fund at least three programs: two in the United States (Innovio and Moderna) and one in Australia (University of Queensland), in an attempt to point a vaccine. "Some American laboratories assure that they will be able to market these DNA-based vaccines in three months. But on the one hand, these vaccines have never worked on humans, and on the other hand, these delays are untenable, ”corrects Frédéric Tangy. Which specifies that the Institut Pasteur launched a program a month ago to adapt the measles vaccine to this new virus. And the researcher put into perspective: "Unless this epidemic sets in, all the vaccines that will come out risk arriving too late. The one from the Institut Pasteur is not expected… for a year.
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