Covid-19 is “far from over”, doctors in France have warned, as more than 140,000 cases continue to be reported each day, although some medics say we are passing into ‘a new stage’ of ‘living with it’.
Dr Michaël Rochoy, a GP in Outreau (Pas-de-Calais), told Le Monde: “The current discourse around Covid is incomprehensible. People are surprised that they are getting infected, as the dominant discourse is saying that Covid is over.”
This is despite cases rising to 140,000 per day (a rise in 30% compared to a week previous), and more than 100 people dying each day.
France has seen a similar “rebound” effect in infections as other European countries, as governments lift most health restrictions against the virus. France lifted most measures at the start of March.
Read more: Coronavirus: Daily updates on the situation in France
Read more: French Covid case numbers highest in Brittany – and still rising
Hospital admission levels are currently at 20,000 - the same as in late-December 2021 - but figures from l’Institut Pasteur suggest that there will be a “rise in hospital admissions over the next few days”.
Dr Simon Cauchemez, at the Institut Pasteur, has predicted that the current wave will peak in mid-April, shortly followed by a peak in hospitalisations.
Since the beginning of January, more than 17,000 people have died from Covid in hospital, plus 1,400 deaths from elderly care homes. This means that there have been more than 18,400 deaths from Omicron alone.
This compares to the usual flu epidemics, which annually see around 10,000-15,000 deaths.
Dr Rochoy said that Covid cannot yet be called “just another epidemic”. He asked: “What other epidemic causes so many deaths in France?”
He highlighted that Covid can cause longer-term issues that eventually lead to severe illness or death, but which will “never be counted as a death caused by Covid”.
He cited the example of one of his patients, in her 90s, who was vaccinated, but who caught the virus in January. She suffered several falls caused by fever, and later died without being hospitalised.
He also said one of his younger patients, who used to be very athletic, now still suffers from persistent shortness of breath and cannot do the activity she used to.
He said: “This worsening in the quality of life often goes unnoticed.”
Dr Cauchemez at l’Institut Pasteur said that the rise in cases cannot be attributed to the extra contagion of Omicron alone. He said: “Other factors are at play: the relaxation of behaviour and the decline in immunity over time.”
Dr Yannick Frezet, a GP in Rive-de-Gier (Loire), feels similarly.
He said: “For us, it’s far from over.” He is still seeing cases among people aged 35-50, whose entire family is infected; and older people aged 70 getting the virus despite being vaccinated.”
He said that he regretted that hospital numbers were the main benchmark being used to measure the pandemic, and that the situation among community medicine practitioners is not being sufficiently taken into account.
He said: “To live with the virus, we will have to put in place [better] prevention measures and learn to work together.”
Change in care patterns
Clarisse Audigier-Valette, from the Toulon hospital centre, also said that the dominant Omicron strain is causing a range of different symptoms, beyond the “traditional” respiratory issues seen among previous variants.
She said that this is “requiring hospitals to change our care patterns and prioritise older people”.
Immunocompromised people, of which there are around 300,000 in France, also continue to be in danger, experts warn. Their bodies do not produce antibodies against the virus, even after vaccination, and they are especially susceptible to Omicron.
In a report published on March 28, vaccine strategy advisory board le Conseil d’orientation de la stratégie vaccinale said: “According to data from the Agence de la biomédecine, 25% of all deaths of kidney transplant patients due to Covid occurred in the last three months.”
The report continued: "For people who are profoundly immunocompromised, each reduction in barrier measures in the general population increases the danger of taking part in everyday activities." It said that it would continue to encourage mask-wearing in closed environments.
‘Learning to live with Covid’?
However, high-profile infectious diseases specialist Karine Lacombe this weekend said that “we are in the process of moving away from Covid exceptionalism” (seeing it as new or different).
The head of infectious diseases at the Hôpital Saint-Antoine, Sorbonne Université, said in an interview with Le Journal du Dimanche: “The Omicron BA.2 variant, has never disappeared... Its transmission has never been interrupted.
“However, in spite of the wave of positive cases, there is no parallel increase in hospitalisations and especially in the number of passages in intensive care.
“Clearly, the epidemic is taking on a different look than when it began. Massive vaccination has had a major impact in this sense, in less than a year.
“We now have scientific articles, notably in the New England Journal of Medicine, which show that even if the vaccine protects less from Omicron, there is still a reduction in transmission among those vaccinated. As it is a highly contagious virus, there are still infections - but fewer.”
Dr Lacombe continued: “The profile of people who are currently hospitalised, who go into intensive care and who die, is completely different from what was observed at the beginning of the epidemic: they are mostly very old and immunocompromised people.
“In these people, Covid does not appear to show up as a respiratory problem as previously noted, but more as a downturn, a deterioration of the general state…They do not usually develop severe respiratory disease…It does appear that the profile of the epidemic is changing.”
This change in presentation and treatment appears to be especially true as the flu epidemic continues to worsen across France.
Guilaine Kieffer-Desgrippes, from at-home medical service SOS-Médecins, said: “Today, I would tend towards treating Covid like flu. There is a lot of it about, but less aggressive than before.
“In contrast, we are seeing an explosion of flu, as soon as people started taking off their masks, with severe symptoms.”
Dr Lacombe added: “We are seeing a lot of [flu] cases, especially of severe influenza (influenza pneumonia). I am very surprised by the number of cases requiring hospitalisation. We haven’t seen such levels for a long time.”
She said that in contrast, “there are quite telling signs that Covid has entered a kind of... routine. We no longer have a sector specifically dedicated to it. When a patient arrives at the hospital with an infection, he goes to the infectious disease department, of course.
“But if he arrives with a digestive haemorrhage and is found to be positive after a test, he will remain under the care of gastroenterology. Just like ‘before’.
“We are in the process of moving away from the Covid exceptionalism, and that is extremely important. We are passing into a new stage. We are finally no longer in a perpetual catastrophe: we can see the way out.
“This doesn’t mean the disappearance of Covid; it is about mastering the situation rather than being overwhelmed by it.”
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