• From this Monday, all travelers from the UK will be subject to mandatory seven-day isolation.

  • Faced with the spread of the Indian variant, which has caused a real massacre in India, France is trying to limit the danger of seeing a new wave sweeping over the country.

  • Limitation of arrivals, monitoring of diffusion by screening and sequencing and especially acceleration of vaccination are the responses that could allow to continue on the path of deconfinement without disappointment.

They may sound exotic, but the variants that come from South Africa, Brazil and now India are worrying Europe.

Number one is the United Kingdom, which has a large Indian community and has seen coronavirus epidemic figures rise.

Indeed, it is the country in the world where the epidemic is accelerating the most (+ 74%, 2,600 new cases per day) over the last week.

The Indian variant represents between half and three quarters of new cases and threatens deconfinement.

What makes France fear to relive the disaster scenario experienced with the British variant during the third wave… Should we really fear this Indian variant?

What risk weighs on France?

The latter worries in any case the French scientific council.

Who unveiled a new notice on Friday.

First precision: there is not one, but three Indian variants.

The one that spreads in Europe and therefore in France, named B.1.617.2 "could be up to 50% more transmissible than the UK variant", already 60% more contagious than the initial strain.

On the other hand, nothing proves for the moment that it would cause more serious forms and deaths.

More fundamentally, this variant would not reduce the effectiveness of the vaccines used in France, except for a few points.

A British study shows that the Pfizer serum goes from an effectiveness of 93% against the British variant to 87% when we meet its Indian cousin.

For AstraZeneca, we go from 66% to 59%.

How is France preparing?

Two levers have been activated. First of all, to prevent the variant from spreading, the border with our British neighbor will become more difficult to cross. From this Monday, the British and citizens of countries not belonging to the European Union will again have to prove a compelling reason to enter France. Importantly, all travelers arriving in the UK must self-isolate for fourteen days. And those from the UK for seven days upon arrival in France. Until then, 16 countries were subject to mandatory quarantine, including Brazil, India, Argentina and Turkey. On paper, this means that the police can unexpectedly check the presence of travelers at their quarantine location and impose a fine of 1,000 to 1,500 euros in their absence.

But things got complicated because Thursday, the Ministry of Foreign Affairs finally clarified that "systematic home control will not be applied to them" ... "It is an essential measure, it could have come sooner", breathes Philippe Amouyel , professor of public health at the Lille Hospital Center and director of the Alzheimer Foundation. Will it be sufficient? “It's a different story,” he says. Until now, even isolated, we have a right to go out from 10 a.m. to 12 p.m. Isolation and its control is one of the concerns today. "

Second issue: surveillance. According to the latest epidemiological update from Public Health France (SPF), as of May 25, 46 episodes (outbreaks, i.e. around 100 patients in all) involving at least one case of a variant of the B.1.617 lineage have been reported. The majority of the episodes are related to returns from a trip to India or a neighboring country. For now, these outbreaks have not broadcast and have been contained, according to SPF. Not sure this continues. Because France has much less means to sequence than the United Kingdom. Still, the next Flash surveys, which sequence a number of tests every two weeks, should make it possible to track the progress of this variant.

[# COVID19] Dr Sibylle BERNARD-STOECKLIN from Public Health France, answers the questions of the week:


➡️ Where is the circulation of the different variants in France?


➡️ How are variants monitored in France?


➡️ Is the so-called "Indian" variant a source of concern?

pic.twitter.com/1YZdvFl9nP

- SantépubliqueFrance (@SantePubliqueFr) May 28, 2021

But another technique allows simpler monitoring: the screening of PCR tests.

If today the result specifies if you have the British variant, this is not the case for all variants.

"But in the days to come, things will change and these tests will make it possible to know if it is the Indian variant," assures Philippe Amouyel.

In addition, back-tracing is now being carried out to go back to the origin of the infection.

"

Vaccination, the only effective weapon

But what reshuffles the cards is of course vaccination. When the first cases of the British variant appeared in France in January, it was barely starting. As of May 28, 37% of the total population had received a first dose and 15% had been fully vaccinated. However, as we have said, the good news is that this Indian variant is sensitive to vaccines. With one detail. According to the scientific council, “the first real-life data available in the United Kingdom suggest a vaccine efficacy preserved against all clinical forms of infection with B.1.617.2 after two doses of Astra-Zeneca (60 %) and Pfizer (88%), but not after a dose (33% for each vaccine). "

Which has something to worry about across the Channel. Because on the one hand, the United Kingdom has favored its national serum: two thirds of injections are therefore done with Astra. Another problem: "the strategy of the English to move away the two doses of twelve weeks for all vaccines", insists Philippe Amouyel.

In France, it's not the same story. In fact, messenger RNA vaccines are in the majority, AstraZeneca is prohibited for those under 55 and shunned by others. “There is no point in playing to be afraid!, Nuance Benjamin Davido, infectious disease specialist at the Raymond Poincaré hospital in Garches (Hauts-de-Seine). The problem is not the variant, but how some people escape vaccination. We must act before contamination. In this hubbub hovers doubt about the effectiveness of vaccines in the face of variants. I hear some people say that they want to wait for a new vaccine that is more effective in the face of new variants. “However, many doctors cry out to explain that the fewer vaccinated there are, the more variants will be able to emerge and spread. "Hence the importance of massively and quickly vaccinating", insists Philippe Amouyel.And therefore to convince the recalcitrant.

A sizeable stake, while the vaccination opens for all adults on Monday.

“Today, the story of variants is over,” Benjamin Davido says.

The enemy is already there, why give him a nationality?

What is likely to change is that we are moving towards an advantage of messenger RNA vaccines to become the universal vaccine.

"Because they are more efficient, but also because" they can do an update in six weeks to adapt to a new variant ".

Whether it comes from India, Vietnam or elsewhere.

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