In Brazil, more than 350,000 people have died from Covid-19 since March 2020. -
FABIO TEIXEIRA / SIPA
After 48 hours of controversy, Paris has decided to suspend flights with Brazil.
The country is going through a new wave of very deadly coronavirus, with 4,000 deaths in 24 hours and a significant rejuvenation of patients in intensive care.
Blame it on the Brazilian variant, called Voc 3 or P1.
But not only.
Because we must not forget the differences in context, containment policies, vaccination…, recalls Benjamin Davido, infectious disease specialist at Garches hospital.
After 48 hours of controversy, alerts from doctors and critics of the opposition, Paris has finally decided: France is suspending "until further notice" all flights with Brazil.
This Latin American country, the second most bereaved country in the world because of the coronavirus pandemic, is going through a new dramatic wave.
With a change in size: 52% of intensive care patients are now under 40 years old.
The fault, among other things, to a variant, said Brazilian.
Now in the majority, it is wreaking havoc in neighboring countries and distressing the whole world.
But what exactly do we know about him?
One or more Brazilian variants?
Not easy to follow the multiplication of variants, more or less known, widespread and dangerous ... The World Health Organization therefore proposes a classification.
The Variant Of Concert (understand worrying) are currently three in number (in addition to the initial strain): Voc 1 for the British, Voc 2 for the South African and Voc 3 for the Brazilian.
But we find this same Brazilian variant under another name: P1.
A second variant, dubbed P2, has also emerged in this country.
On the other hand, it is part of the Variant of interest (VOI), therefore less present in the world.
How much more dangerous is it?
If we still know very little about this P2, the information coming to us from Brazil on the P1 is scary.
Santé Publique France has published an analysis of the risks associated with the emergence of variants: this P1 would be between 40% and 120% more contagious than the initial 2020 strain of the coronavirus.
Is it more deadly?
For the moment, there is no impact described on the severity of the disease.
He is in any case responsible for a real massacre in Brazil.
But Benjamin Davido, infectious disease specialist at the Raymond-Poincaré hospital in Garches (AP-HP), warns against hasty catastrophic forecasts.
Because there are still a lot of unanswered questions about this variant.
"The goal is not to panic people, warns the medical director of crisis and referent on vaccines.
It is obvious that it is very complicated to compare Rio and Paris ”
Because the political decisions were not the same [Jair Bolsonaro, the Brazilian president, notorious antivaccine, denies the gravity of the disease and refuses to confine the country for months].
In addition, the vaccine distributed in Brazil is CoronaVac, produced by the Chinese company Sinovac, whose effectiveness is estimated to be around 50%.
While France has relied on the vaccines Pfizer (95% efficiency), Moderna (94%) and AstraZeneca (70%).
With 4,000 dead in 24 hours, crowded hospitals and cemeteries where people are buried even at night, the images of the country serve as a foil.
But the infectious disease specialist also qualifies the vision of a “cataclysmic epidemic for young people.
There are waiting lists in hospitals.
The average age in intensive care, between 40 and 50 years, is explained, because when you have 500 patients on the waiting list, we prioritize the youngest.
Sorting between patients is what they experience.
And that's an unfortunate possibility for us.
So prevention is better than cure.
Is it already present in France?
Yes, P1 was detected in February 2021. But its distribution remains very limited.
According to the latest epidemiological update from Public Health France, published on April 8, suspicions of variant V2 (South African) or V3 (Brazilian variant) had remained stable at 4.2% of contaminations in the country.
Another good news: this V3 or P1 would only be responsible for 0.5% of contamination, according to the latest flash survey on variants, dating from March 16.
We are very far from 20% of contaminations in Portugal, percentage published by
“Like bacterial competition, there is competition between variants,” explains Benjamin Davido.
The British variant is one step ahead and seems to protect us against other variants.
What about P2?
Public Health France, to date, 22 cases have been detected in mainland France, and 72 in Guyana.
Are vaccines effective against the Brazilian variant?
“That's the big question,” says Benjamin Davido.
Which alerts on an important point: unlike the strain of 2020, it seems that this P1 does not immunize the patient.
“These significant re-infections pose a problem,” continues the infectious disease specialist.
So far, international studies have shown that only 0.3 to 1% of patients are re-infected between six and nine months after the first infection.
In Garches, we followed 236 caregivers, infected as of March 2020, and we did not find any reinfection.
These re-infections after natural immunity question the effectiveness of vaccines.
"There is a lack of scientific study to know whether the three vaccines authorized in France are effective against this Brazilian variant," continues the infectious disease specialist.
It is also the only variant, for the moment, for which we have no answer.
If it spreads quickly in France, if it is as deadly as in Brazil, if it creates reinfections in the 20% of French people who have already fallen ill, it will be a disaster scenario.
But Benjamin Davido recalls that solutions exist.
“The WHO should send doses of the Pfizer and Moderna vaccines to Brazil to test their effectiveness in real life.
If there is really any doubt, it can be easily removed two weeks after the vaccination.
And find a parade.
“The head of Pfizer assures us that in six weeks, the laboratory can make an update to counter a variant.
Coronavirus: Paris suspends all flights between Brazil and France until further notice
Coronavirus: Majority of intensive care patients in Brazil under 40