It would take less to get lost. Just two months ago, WHO Director-General Tedros Adhanom Ghebreyesus issued a warning message: the coronavirus pandemic is “far from over” and stay “a public health emergency of international concern”. Back to school came, suddenly he was more optimistic than ever. “We have never been in a better position to end the pandemic,” he declared on September 14, while inviting us not to declare victory too soon: “If we don’t seize this opportunity, we run the risk of having more variants, more deaths, more disruptions and more uncertainty. »
Tweezers with which President Joe Biden did not bother. “If you look around, no one is wearing a mask, and everyone looks pretty good”, he launched Sunday, September 18 during a television interview. And to state bluntly: across the Atlantic, the Covid is ” ended “. “Fini”. In a country where the epidemic still kills more than 400 people a day, his words did not fail to shock. “This speech isall the more surprising since he asked Congress for a budget extension of 22 billion dollars for the fight against Covid-19 barely two weeks ago! », notes Yves Coppieters, epidemiologist at the School of Public Health at the Free University of Brussels. Also the assertion of the American president must be taken for what it is: a message above all ” Politics “ a few weeks before the mid-term elections.
Especially, recalls the Belgian epidemiologist, that the fight against a pandemic cannot be won alone in his corner. “A pandemic is defined as several epidemic foci scattered over several continents at the same time. Talking about the end of the Covid-19 pandemic for a particular country, as Joe Biden did, therefore does not make much sense”. “Ending it would also require investments in less developed countries where access to vaccines and treatments remains very limited”adds Philippe Amouyel, professor of public health at the Lille University Hospital.
“The famous herd immunity seems to be coming”
In fact, the situation on a global scale remains very mixed. “In some countries like China, where the population has little immunity, the virus is still problematic, with lockdowns having a major impact on society,” recalls Yannick Simonin, virologist at the University of Montpellier. Nevertheless, he continues, “the head of the WHO is not totally wrong and his speech is more contrasted than what we remember. In many countries, the situation has never been less unfavourable, to put it more cautiously. Even if that does not mean that we are done with the Covid”, he hastens to add.
The European figures came to remind us of this again a few days ago. Thus in France, where the incidence has jumped after two months of calm: there are currently 27,288 cases per day on average over one week. The incidence rate is up 57% between September 9 and 16, according to Public Health France. Letting predict an eighth wave which, moreover, has never been the shadow of a doubt in the eyes of epidemiologists. “All the models show a rebound in contamination in the fall, even if it remains difficult to anticipate its extent”, explains Yves Coppieters. But unless there is a new variant, the latter believes that “the situation should remain reassuring”. “The population is largely immunized, whether by vaccination or by previous contaminations. »
Epidemiologist and president of the Covid cell of the National Academy of Medicine, Professor Yves Buisson points out two other major reasons for rejoicing. “First, a limited impact on hospital saturation despite the rebounds. Admittedly, this does not prevent the circulation of the virus, but it limits severe forms and therefore hospitalizations. The famous herd immunity that some no longer believed in seems to be coming, ” he savors. Another positive point: the absence of new variants. “We have come out, at least for the moment, of the permanent renewal of variants in which we have been since the start of the epidemic. True, the Omicron sub-variants are different from each other, but behind BA.5 nothing to cause concern is on the horizon. It gives hope… Which does not mean that the Covid is over”, he says in turn.
“If there is one thing we are certain of, it is this: the coronavirus will not disappear and will continue to circulate”, insists Yves Coppieters for his part. Hence the need, according to him, to deliver clear public health messages, while a new vaccination campaign will begin in the fall, with new generation vaccines better suited to new strains. “The message of saying “everything is fine but go and get vaccinated” remains complicated to make heard and risks above all not mobilizing the populations”, fears the epidemiologist.
“We will therefore have to get used to barrier gestures again”
Vaccination remains a strong ally. “In France, the last vaccination against Covid-19 dates back at least six months for more than half of the citizens, calculates Philippe Amouyel. And as vaccine immunity wanes over time, we are very logically going to see new flare-ups. Vaccines, in particular, can to limit these rebounds”. What is at “at hand”it is therefore not the end of the epidemic, but its gradual approach to a seasonal resurgence, such as the flu, « with winter epidemic peaks, and the need to protect the most vulnerable people through vaccines that will be adapted according to the strain of the virus circulating. As such, continues the doctor, the arrival of new vaccines adapted to the omicron variants later this month is very good news, and will allow populations to be better protected. »
In the meantime, Philippe Amouyel beats the reminder of barrier gestures. “With the summer, the French have somewhat forgotten the health crisis and that is quite normal. We will therefore have to get used to barrier gestures again, remember that the virus exists and is still claiming victims. Covid-19 is not a typical winter cold, and just like the flu, people are dying from it”, he insists, while pointing to a public health issue whose magnitude is still poorly understood: that of the long Covid. This epidemic is probably just beginning.
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Bivalent vaccines soon available
In a notice published on September 20, the Haute Autorité de santé (HAS) recommends integrating the two bivalent vaccines developed by Moderna and Pfizer-BioNTech into the fall campaign.
Recently authorized by the European Medicines Agency (EMA), these messenger RNA vaccines target both the original strain of the virus and the Omicron sub-variants, which represent the vast majority of contaminations in France.
“Bivalent mRNA vaccines are not new vacciness but vaccines adapted to the circulating strains, like the vaccines against the seasonal flu”, updated each year, specifies the High Authority.
The people eligible for the booster remain those over 60 and people who are immunocompromised or at risk of a serious form. They can receive either one of the two bivalent vaccines, except for people under 30, for whom the first or second generation Pfizer vaccines remain recommended.
However, the HAS recommends to fragile people who have not yet done their reminder not to wait the arrival of bivalent vaccines, monovalent vaccines continuing to protect against severe forms of the disease.