should we fear a third wave of epidemic?

France resumed the deconfinement process this week and the expected arrival of vaccines in 2021 gives renewed optimism.

But the risk of a third wave of Covid-19 is very real and the government has its work cut out on the issue of testing and isolating positive cases.

Thanks to the cumulative effects of the curfew, then of childbirth and the All Saints’ Day holidays, French public health has finally observed a “significant decrease in the circulation of SARS-CoV-2”. For the health authority, the peak of contamination was exceeded the week of October 26, then that of hospitalizations in the following week.

As a result, the French Hospital Federation (FHF) was able, for example, to announce that public hospitals were beginning a “very, very careful rescheduling” of surgical activities outside of Covid-19, even though the load remains. high, with about 29,000 patients admitted, of which 4,000 in intensive care. And the limit of 50,000 dead has been exceeded.

“Psychologically we will not be able to resist a third wave and a third imprisonment, with tired people who can no longer take it”, warns the professor of public health of the University Hospital of Lille, Philippe Amouyel. However, “the risk exists”, he immediately adds, identifying “two critical events: Black Friday” on Friday 4 December, which causes fear of a rush to the shops, then the period “from 24 December to 1 January”, with the Christmas and New Year celebrations. . “Because you won’t be able to stop people from seeing each other, especially as they are coming out of containment and have suffered as a result.”

The third wave could come soon enough

“If the restrictions are lifted on January 20”, as Emmanuel Macron announced, “and the level of circulation of the virus, at that time, is close to that of October, it is likely that the third wave” They come fast enough “, he analyzes. also Mircea Sofonea, professor of epidemiology at the University of Montpellier.

From this weekend, businesses such as bookstores, toy shops or hairdressers will be able to reopen. “This is a first unknown. In all likelihood, this will have the effect of slowing down” the number of new cases, estimates Mircea Sofonea.

According to the plan rejected on Tuesday by Emmanuel Macron, on December 15 it will be possible to lift the prison sentence if the situation continues to improve. Museums, theaters and cinemas will once again be able to welcome the public and travel between regions will be authorized. But the government is counting on maintaining a curfew and closing bars and restaurants, which puts this profession to the test, to keep the epidemic under control.

“Fragile” situation

In all cases the situation remains “fragile” and “we must not confuse the peak and the end of an epidemic”, underlines Laëtitia Huiart, scientific director of Public Health France, where we insist on the need to maintain barrier gestures and social distancing.

In addition to these protective measures, there is an urgent need to improve other levers, in particular to better detect and isolate positive cases, say health experts.

As evidence of this difficulty, just over 23% of new Covid-19 cases are now cases already identified as contact from a previous positive case, according to weekly data from Public Health France.

Philippe Amouyel regrets that the government does not launch a screening of the entire population before the Christmas holidays, although the Ministry of Health does not rule out a targeted operation at the local level. “We know the virus will necessarily circulate faster at Christmas, which would allow it to start from a lower level,” he said.

Another tool, the Tousanticovid application, has been downloaded by 9.8 million users so far, a better record than its ancestor, StopCovid. But to date, the app has only sent 14,000 notifications to potential contact cases – a relatively low number.

Finally, the government has promised to make the isolation of positive cases more effective, but it has yet to present a bill on the matter and find the right balance between coercion and patient support.

Isolation, tests, barrier gestures …

“If we want to avoid a third wave, everything else must work: we help patients to remain isolated, that we accelerate the tests, that we keep all the barrier gestures, that we make people responsible”, enumerates Philippe Amouyel, for whom “is more than ever the time to implement “at the same time” dear to the president “Emmanuel Macron.