Covid-19: will the rebound in resuscitations cause a new deadly wave?

ANALYSIS

Will the rebound of the coronavirus epidemic that France is currently experiencing result in further congestion in intensive care services?

For Professor Bruno Mégarbane, resuscitator and head of department at Lariboisière hospital in Paris, "there is a discreet rise in cases" but "things remain at an extremely low level compared to the peak that we have experienced " in spring.

According to the specialist, guest of

, Tuesday, a new murderous wave could nevertheless be avoided.

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Coronavirus: follow the evolution of the situation Tuesday, September 15

For several weeks, the daily indicators of the epidemic have deteriorated.

“For the past two weeks, there has been a significant increase in emergency and intensive care admissions, in almost all regions,” observes Professor Bruno Mégarbane.

In France, 615 patients were in intensive care on Thursday September 10, against 410 on August 25 and 396 on August 10.

Better-managed patients?

At Lariboisière hospital, there are 18 intensive care beds and, today, "five patients are in this department, including three intubated and ventilated, with relatively serious forms of Covid-19", details the doctor-resuscitator.

"We have the impression that the number of patients is increasing. At the end of July, there were no new infections. Since then, we have had 17 patients to treat, with 17 new infections."

The saturation level is, however, much lower than in the spring: "At most, we had 56 intubated and ventilated patients."

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Despite this rebound, Professor Bruno Mégarbane does not want to be alarmist, for several reasons: "We will never reach the same number of patients who will suddenly arrive in the care services", he explains.

"The saturation of the beds will be less, so we can admit patients to intensive care earlier and take better care of them."

Lower viral load

For six months, the resuscitation services throughout France have known better how to deal with Covid-19: "We have made progress in terms of adapting oxygen, the best time to intubate and we are giving cortisone fairly early. This reduces the risk of death and improves patient outcomes. Management is better because we know the complications. "

Finally, in a less obvious way, "it is probable that by applying the barrier measures, the contaminations are done with lower viral loads", analyzes the department head.

"Infected people are infected with less amount of the virus and therefore have less serious forms" of the disease.

The Grand Est and Île-de-France regions preserved?

The Bouches-du-Rhône and the Gironde, and more particularly the Marseille and Bordeaux metropolitan areas, are particularly affected by this rebound in the epidemic, with special measures announced on Monday.

These territories had been less affected by the spring wave.

Quite the opposite of the Grand Est and Île-de-France regions, hit by the epidemic.

However, the current epidemic rebound should not spare these regions.

"The first epidemic peak led to a relatively low immunity of the general population, of the order of 5% to 6% at the country level, perhaps up to 10% maximum in the most affected areas", advance the specialist.

"This is much lower than the level where the collective epidemic would slow the circulation of the virus. All regions are susceptible, in an identical way. The risk of developing a rebound depends strictly on the population density and the mixing of people ", he warns.