"Let's prevent our hospitals from a big flu epidemic plus a 5th wave"

• The incidence rate of Covid-19 now exceeds 100 cases per 100,000 inhabitants in France.

  A threshold that had not been reached since mid-September.

• Faced with this fifth wave, France has strengths: high vaccination coverage and citizens generally respectful of barrier gestures.

• Recall campaign, caregivers' discomfort, effects of Ségur de la Santé… Olivier Véran answers our questions about the epidemic and its consequences on our health system.

The Covid-19 indicators fly away ... and the anguish thermometer with it.

France has entered a fifth wave even as the hospital shows signs of exhaustion.

To the point of having to tighten the screw again in the face of the epidemic?

The Minister of Solidarity and Health, Olivier Véran, answers the questions of

.

Where are we today on the Covid-19 front?

The fifth wave in turn hits France, with more than 10,000 cases per day, nearly 20,000 in the last 24 hours [Tuesday].

Contaminations are rising quickly now.

For the moment, hospitalizations remain contained thanks to the massive vaccination of the French, 90% of eligible people being vaccinated.

But the virus manages to sneak in and it primarily affects the unvaccinated.

The fourth wave this summer was short and didn't come with massive hospital overload.

But climatic conditions are much more favorable for viral circulation.

It's cold, humid, we find ourselves more indoors.

It is difficult to estimate in advance what the magnitude of the wave will be;

initial models show a risk of exceeding 1,000 hospitalizations per day by January.

Why is France doing better than its neighbors?

Germany has more than 40,000 cases per day, a record, the eastern countries are reinstating hard partial containment measures.

In France, we delayed this fifth wave by several weeks.

Thanks to better vaccination.

We also put in place early and maintained the tools that reduce contamination, such as the health pass.

Most of the countries facing a sudden resumption of contamination did not or no longer have this health pass.

Some are replacing it or expanding its use.

Others go further, notably the Austrians, with a containment of the unvaccinated, but it is not our choice.

"The Delta variant is so contagious that even when a small minority of the population is not vaccinated."

With 74.8% of the population fully vaccinated, how can this rebound be explained?

Vaccination has two main objectives.

First, save lives.

The largest study in the world on the question is French.

It shows that with the vaccine, we have 12 times less risk when we are at least 50 years old of having serious cases of Covid-19 and of being hospitalized.

The second objective is what is called collective immunity, that is to say to prevent the circulation of the virus.

However, the Delta variant is so contagious that even when a small minority of the population is not vaccinated, it circulates.

Especially since it can contaminate - most often without symptoms or with few symptoms - people who have already been vaccinated.

Do you notice a relaxation of barrier gestures?

I hear that we would relax since the first day of this pandemic!

Contrary to what many suspected, the French were extremely solid, respectful of barrier gestures.

You can understand less vigilance when the risk is lower.

On the other hand, when we enter a period very conducive to the circulation of the virus, like today, it is really fundamental that we all do this additional citizen gesture: wear the mask, keep your distance, wash your hands or have it tested in the slightest doubt.

Germany is preparing for a massive return to teleworking.

Is this an avenue being explored by the government?

Currently, the circulation of the virus is accelerating, but we do not have a hospital wave.

Teleworking is a tool we have used when needed.

We are not there yet today, but it is part of the measures that we could mobilize if necessary.

“Under the current conditions of circulation of the virus, (…) confinement would be disproportionate.

"

Government spokesman Gabriel Attal assured Saturday evening that "nothing can be excluded", including a re-containment.

Are we in danger of getting there?

We are clearly not there yet.

In the current conditions of circulation of the virus, massive vaccination, use of barrier gestures, confinement would be disproportionate.

But let us remain very careful, because this virus and its variants have already shown us that they can foil the prognosis and force us to take urgent collective braking measures.

No one expected the current epidemic wave in the Netherlands, which has just barely less vaccine coverage than ours.

Would there not be a problem of acceptability if restrictions had to be imposed after twenty months of the crisis and a few weeks before Christmas?

The World Health Organization predicts that by the end of winter, there could be up to half a million additional deaths in Europe, especially if vaccination does not progress there, especially in the East.

It is normal to be exasperated, to complain, to tell yourself that you have already made a lot of effort, because it is true.

But we are facing an enemy that forces us to adopt this vigilance over time.

I know the French understand how the virus works.

At Christmas, for example, it is more prudent, to find your grandparents, that everyone is vaccinated and up to date, to maintain barrier gestures and ventilate the rooms regularly.

Emmanuel Macron last week urged French people over 50 to receive a third dose.

Has the recall campaign taken off?

First, more than half of French people over the age of 65 eligible had made their recall before the intervention of the president.

And she has further enhanced this dynamic with more than 115,000 injections per day on average.

We even saw an impact on primary vaccinations, with a 20% increase in appointments.

However, we still have 6 million eligible French people who have not received the slightest dose.

These French people absolutely have to protect themselves.

From December 15, those over 65 who have been vaccinated for six months and five weeks will have to have a reminder under penalty of losing their health pass.

Some do not understand why the effort weighs on the "good students", while this wave mainly affects the unvaccinated ...

The answer is the facts.

Because 83% of people in intensive care for Covid-19 are over 50 years old, and after a certain time, vaccination protects older or more fragile people less.

“Let's prevent our hospitals from a big flu epidemic, plus a fifth wave of Covid-19.

"

Is childhood vaccination possible?

The question arises from a scientific point of view.

The United States and Israel have started vaccinating 5-11 year olds, which will give us information on how this is done in real life.

Studies used by the US Medicines Agency show that the vaccine in children is effective and safe.

In the coming weeks, we are awaiting transparent, objective and exhaustive instruction from the European Medicines Agency.

It will then be up to the French scientific authorities, probably by early 2022.

Is this new wave likely to be as deadly as the previous ones?

Vaccination protects against excess mortality, as we saw with the 4th wave.

But what the first models tell us, with all the conditionalities possible, is that this epidemic wave could extend into December and January and have a significant health impact.

Probably less than during the first two waves.

But if you add to that the bronchiolitis, the flu, the gastric diseases, we arrive at a fragile situation for our health system.

How well do hospitals have the capacity to cope?

French hospitals held out.

In France, we have not seen patients with oxygen cylinders in their cars, in the parking lot of a hospital, which was the case with our Italian neighbors.

Hospital workers do not want to face a fifth hospital wave.

But if the situation required it, they have already shown that they are courageous, solid and united.

So, let's prevent our hospitals from a big flu epidemic, plus a fifth wave of Covid-19.

Some leave the public hospital, and according to an opinion of the Scientific Council dated October 5, 20% of beds in French hospitals could close for lack of personnel ...

I have already said that this figure is unfortunate because it is wrong, and it has been overexploited.

The French Hospital Federation made a survey and spoke of 5 to 6%, more or less as in 2019 at the same period.

A study on 15 CHUs [outside Ile-de-France] shows that there are even in reality a little more caregivers today than two years ago in our hospitals.

Some beds have been transformed to maintain high resuscitation capacities.

Others have been temporarily closed to transform double rooms into single rooms during the Covid period.

We are gradually redeploying them.

This does not prevent there from being tensions, in particular in the emergency services and certain operating theaters.

How do you prevent the bleeding in the hospital from continuing?

There is not a flight of caregivers.

Fortunately, there are hospitals that do not face particular difficulties, but also, it is true, weakened services.

Sickness leaves have increased slightly, by only one point, caregivers also legitimately recover postponed leave, numerous overtime hours for a year.

“Everything is in place to improve working conditions and to restore meaning.

"

Isn't this proof that the Segur was insufficient?

Ségur is a new deal for the hospital and the health system: we have increased salaries by 183 euros per month for everyone in the hospital.

And on January 1, 2022, all caregiver salary scales will increase again.

We have also simplified the internal organizations at the request of caregivers, we are investing in new buildings.

Everything is in place to improve working conditions and to restore meaning.

But that does not take away from fatigue, wear and tear, impatience.

Because there are a lot of backlogs.

It takes years to train doctors, years to renovate a hospital.

But you can see this fatigue in any country that has experienced waves of Covid-19.

Did the vaccination obligation not accentuate the discomfort of certain hospital workers?

Objectively, there is a very strong understanding of why the vaccine obligation was adopted by Parliament.

The number of suspensions was very limited: 0.6% of professionals in establishments.

And suspended caregivers return to their jobs once vaccinated.

I have not yet seen a hospital unit closed because of the vaccination requirement.

Even in Guadeloupe, where we started from afar, we rose to vaccination rates of 93% of caregivers in some hospitals.

Another news, that of the PLFSS 2022, under consideration in Parliament.

It plans to authorize orthoptists to prescribe glasses, access to physiotherapists without prescription ... But the delegation of tasks makes some doctors cringe.

Should we continue along this path?

With urgency, to make up for our delay.

France is a country which stands out for the lack of recognition of experience.

Here, a nurse for twenty years cannot prescribe paracetamol to a patient who has a headache… when she can give it to her child at home.

A physiotherapist cannot see a patient with a sprained ankle without being referred by a doctor.

I assume to fight against medical deserts by giving more missions and skills to those who, legitimately, are waiting for that.

I see that there is resistance.

Parliamentarians who tell me yet fight daily against medical deserts are opposed to any touching of a precinct.

And it's a doctor who says it!

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• Vaccination

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• Olivier Véran

• Coronavirus

• Health

• Anti-covid vaccine

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