Towards a second wave of coronaviruses in July in France?

• Controlled in appearance, the Covid-19 epidemic could experience a more rapid rebound than expected in France according to certain infectious diseases specialists.
• Several signals show that the virus is starting to circulate a little more actively, especially in Ile-de-France.
• A relaxation on the barrier gestures, in particular social distancing, worries then that the summer holidays hardly start.

Two hits that freak out when you have to endure this early summer without Thibaut Pinot and Kylian Mbappé. Renaud's new song and the unpleasant little music of a resumption of the epidemic long before the famous second wave that we are promised for the fall, when the temperatures will drop and the humidity will rise. Serious warning this Thursday in Le Monde by the president of the scientific council Jean-François Delfraissy, even more alarmist than Jérôme Salomon the day before in Le Figaro : “Summer could be spent in optimal conditions, provided that the measures of social distancing continue. However, I am struck to see that this is not the case. Social distancing measures are eluding us. Everyone must understand that without even talking about a second wave, we are at the mercy of a recovery in France ”. Bigre.

A rebound in the # Covid_19 epidemic in France is possible in October / November, or even outright this summer if the barrier measures are abandoned, warns the president of the Scientific Council responsible for guiding the government, Jean-François Delfraissy, in an interview with the # AFP pic.twitter.com/uHkIjQtLJi

A seemingly stable situation?

The president of the scientific council is not crazy. If the latest bulletin from the Directorate General of Health (DGS) still mentions a calm sea, with a stable national positivity rate (1.4% including Guyana and Mayotte for 3,406 new infections during the last week of June) , several more recent data show a tremor of the epidemic on the metropolitan territory, in an unfavorable international context. Many countries which experience significant heat waves, such as Israel or Australia, have however had to confine part of their territory because of a less controlled circulation of the virus.

"We have talked a lot about the influence of rising temperatures on the neutralization of the virus," says Jean-Daniel Lelièvre, head of the infectious diseases department at Henri Mondor hospital in Val-de-Marne. But even in the most southerly countries, it is clear that the epidemic still appears. So maybe UV rays produced naturally by the sun have an effect on the virus, but that is not enough to stop its circulation. ”

Traces of the virus in Ile-de-France wastewater

The most serious alert of the moment? The latest reports from the Obépine project, which has a network of sensors placed on five treatment plants in Ile-de-France, the region most affected by the first wave. The latter can detect genomes of the virus in wastewater even before the first symptoms appear, since the virus is present in the stools of infected people as soon as the infection appears, even when it is underground. A valuable indicator since it allows us to guess in advance the curve of hospitalizations.

The Covid-19 is making its timid return to the wastewater of Île-de-France: the sensors, "silent" since the deconfinement, have detected a greater presence of the #coronavirus, especially in Paris. "Do not panic", say the health authorities https://t.co/Tggm9DtAki pic.twitter.com/pwf7lhZjHW

Thus, on March 5, the epidemiological observatory of wastewater already detected substantial traces of the virus when only 91 people had tested positive throughout the Ile-de-France. Traces possibly already old: Two months before the first patient was officially registered in Italy, the coronavirus was for example already present in the wastewater of Milan and Turin, according to a retrospective analysis of the Italian Higher Institute of Health.

Let's actually come. While the virus disappeared from wastewater in the Paris region in mid-May, it reappeared during certain surveys in the week of June 20, at levels "incommensurate with the levels observed at the height of the epidemic in early March, ”reassures the ARS. "These results deserve confirmation over a longer period before sounding the alarm," says one side of Obépine. But that necessarily means that the virus is still active. " This is particularly true in Paris, where several infectiologists are worried about seeing patients disembark in greater numbers than in recent weeks.

Hospitals that see patients return

At La Pitié-Salpêtrière, Professor Eric Caumes, interviewed by Le Parisien , no longer hides fearing a second wave this summer: "my Covid unit is full, I had to open another at the start of last week. Cases continue to happen. We are all worried. " Xavier Lescure, a doctor specializing in infectious diseases at the Bichat hospital, noted on France Info “a small resumption of activity with acute Covid-19, very recent Covid-19, either contamination on French soil, or travel returns ”. Several French travelers have returned contaminated from Algeria, creating a mini-cluster situation that risks repeating itself with the reopening of airlines to vacation spots.

Coronavirus: "There has been a small resumption of activity with acute Covid-19", alerts a doctor at Bichat Hospital in Parishttps: //t.co/ObVIlD52wf pic.twitter.com/Mdyjkomgna

According to the latest epidemiological bulletin from Public Health France, the continuous decrease in hospitalizations observed since April 7 in the Paris region ended the last week of June, with 30 hospitalizations for Covid-19 each day. The same is true of Covid's suspicion calls to SOS Médecin, which went up again for the first time (+ 24%). At Henri-Mondor, Professor Lelièvre has not yet seen landing the sick en masse. But the establishment "again completely bans consultations, except for people who really need it." Visits for short hospital stays are also prohibited in order to avoid population shuffling and limit transmission to the frail. ”

"It can't be open bar all summer"

To get out of Paris, the specialist observed, like everyone else, the outbreak of the epidemic in American coastal cities, where the youth cocktail on vacation + open bars and nightclubs quickly led to disaster. Will the seaside resorts of the Côte d'Azur and elsewhere be able to escape the same fate, while the French are going to storm the beaches? "We can see that everyone wants to say" OK we're going to live as we lived yesterday ", but we can't do anything. People have to take responsibility a little bit. In closed places, it can't be an open bar, if I dare say so. On the terrace it's the same. If people are stuck 50 cm from each other around a table, that will not do it, because we now know that a large part of the contamination is made by asymptomatic people. ”

Coronavirus: a quarter of people infected with coronavirus have no symptoms according to a summary published this morning by Santé Publique France. Jérôme Salomon calls for caution and the maintenance of barrier gestures pic.twitter.com/whw9x9MgLT

The latter represent around 25% of patients, according to the latest summary from Public Health France on the subject, which also specifies that half of the transmissions occur in the presymptomatic phase. Suffice to say that it makes a few holes in the racket. "It would not be problematic if people stuck to barrier gestures and respected social distancing, continues Jean-Daniel Lelièvre, but we can clearly see that there is a general relaxation". An impression validated by the figures from the most recent survey by CoviPrev for Public Health France. On March 30, 92% of those polled said they would greet each other without shaking hands or kissing, only 73% three months later. They were 85% to keep a distance of at least one meter on the same date, they are only 55%, while the wearing of the mask caps for its part around 50%.

Local adjustments in boxes

Bad signals which make Jean-François Delfraissy say "that it is fundamental that the state services remain in a situation of high alert during this summer period, in order to avoid a new confinement that citizens do 'would probably not accept'. On the same line as his scientific advisor, Prime Minister Jean Castex indicated on RMC that his government was considering targeted measures in the event of loss of control in July-August: "It has always been said, planned, envisaged, that it it was time to prepare for a second wave of the epidemic. Except that we are not going to make a possible reconfiguration as we did in March because absolute containment has terrible consequences. So we will target by preserving as much as possible the economic and social life ”.

Understand localized reconfigurations, as in Spain? Before reaching this point, the health authorities want to give themselves all the means to contain the outbreaks. A massive Covid screening plan will thus affect 300,000 people in Mayenne next week after the ARS noted a doubling of the number of positive cases over two consecutive weeks. "Above all, we mustn't end up with the dropout that we had in March-April," says Professor Lelièvre. Today, hospitals are full of patients who did not come to the hospital when they should have. It's the same for my cancer colleagues, we have to take care of the other patients. The caregivers are exhausted and will not have the means to re-mobilize themselves up to what they did during the first wave ”. Might as well simplify their lives, right?

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