From the state of the English variant to that of vaccination through the management of the crisis in September: Decryption of the health crisis on the eve of the start of the school year with Professor Ousmane Traoré, head of the hygiene service – determining the origin of the viruses and the protocol to follow – at the Clermont University Hospital.
“The situation in Auvergne, and in particular in Clermont, is today rather calm. We have seen a small increase in the number of positive cases and hospitalizations at the end of June and early July, but it remains very moderate all the same. However, we had the same situation last summer and we observed an explosion. ”
“The impact of the virus will be less important than the explosion of last October thanks to the vaccination”
ED: Is the risk of spread greater during the holidays or at the start of the school year?
OT: Last September, at the start of the school year, we saw an intense circulation of the virus with the tourist influx. When all these people return to their place of residence, there is a risk of reintroduction and massive transmission of the virus. This is what we fear at the time of the start of the 2021 school year. The huge difference will be vaccination. Last year, there was no vaccine and today we still have a fairly large proportion of the population vaccinated. We think that the impact of the virus will be less important than the explosion of last October, but it still remains the great unknown in Auvergne as everywhere else. Many models predict it, but they can’t really anticipate what will happen in the weeks and two months to come.
ED: Currently 71% of the French population has received their first dose …
OT: When you get one dose you should get another one within 3-4 weeks. Within three weeks, this population will have received a complete vaccination schedule and the rate of people having received a dose will be 75%, which is already honorable. It remains to be seen what impact this will have on the circulation of the virus and at what level.
ED: Could people at risk who were vaccinated in January receive their dose as early as September?
OT: This week, we received instructions from the ministerial authorities. First, we will start to vaccinate for the 3th doses over 80, then over 65 and immunocompromised people (those who have few antibodies because they have had transplants or have leukemia, lymphomas or have chemotherapy) which have very serious forms of infection. This plan would be put in place from September 13, but we are ready to vaccinate patients from the nursing home at the CHU next week.
“The challenge is to always have resuscitation beds because there are plenty of people who do not have the Covid and who need them.”
ED: What feedback do your colleagues give you working with people with covid and in the intensive care unit?
OT: In the intensive care units, as I told you, the number of hospitalized cases has increased since the end of June at the beginning of July. In two months, we went from 3 people in intensive care to 10 people at the moment. Currently among all the people hospitalized for covid, it is observed that there are many young people hospitalized patients who stay a few days. There is therefore a “turn over” which is much more important.
We have around 80 intensive care beds. The challenge is to always have it, because there are plenty of people who do not have the Covid and who need it. In the management of the crisis, it is as important as the care of patients with this virus.
ED: In your department, you pay a lot of attention to determining the variants that infect patients, is the Delta variant in the majority?
OT: Yes, for 90% of people it is the Delta variant and for more than a month. The English variant has almost disappeared. It is a request from the national authorities to determine the variants with precision to also see if there are any new ones.
“We try to talk to people who are refractory and understand why they are refractory.”
ED: What is the percentage of staff vaccinated at Clermont University Hospital?
OT: We are currently calculating these figures. We have not yet recovered all the vaccination certificates but we must be around 75% of people who have received both doses.
ED: So it’s more than the national average. How do you react then with the staff of the unvaccinated CHU?
OT: This is currently the mission of our hygienist service. We try to talk to people who are refractory and understand why they are refractory. Many people are also hesitant. We also try to make internal press releases to explain what an RNA vaccine is, how they work, to talk about side effects and benefits… as was done in 2009 with the H1N1 flu. The law says that as of September 15-October 15, health workers who do not have a complete scheme are exposed to sanctions, as was recalled by the Minister of Health on Thursday. I know that the arsenal will be to no longer be able to exercise his profession and that there will also be salary suspensions
ED: Why not also do popularization beyond the CHU?
OT: It is true that we have done mostly intra at the CHU. Working with the communications department, we answered questions and made videos. Some of my colleagues went to TV or radio sets to do outside interventions, and especially at the start of the crisis. We also work in retirement homes, centers for the disabled, and businesses to provide information on disease, prevention and vaccination.
“Once the recovery has passed, it will take 10-15 days to know the impact of the fourth wave.”
ED: Did the peak of the 4th wave is currently reached?
OT: It is still far too early to define it. We will be in the coming month. We must wait until everyone has returned to resume these social and professional activities, with all the “opportunities” for the transmission of the virus. Once the recovery has passed, it will take 10-15 days of hindsight to confirm it.
ED: On the eve of the start of the school year, would you say that you are calm?
OT: Yes, I would say I am rather. It is especially at the level of the protective effect of the vaccination of the population. At the end of 2020, in the retirement homes it was a health disaster. We settled that in April with the January vaccination. Vaccination coverage of the general population is certainly less important than in nursing homes, but this will have an impact at the start of the school year that may limit the height of the peak. Without being overly optimistic, we can trust that. The vaccine limits severe cases of contamination even if it is not fully effective as seen in immunocompromised people.
ED: In his conference on Thursday, August 26, Jean Michel Blanquer, Minister of National Education, also says he is calm and foresees a “return to school as normal as possible” and in higher education the return to school will be 100% face-to-face as envisaged by Frédérique Vidal, do you think this makes sense?
OT: Provided that we also keep the barrier gestures and the wearing of the mask. Last winter we saw a very significant decrease in influenza thanks to barrier gestures. They have had an undeniable impact to such an extent that one might wonder whether we should not keep them in our daily reflexes, as in some Asian countries.
Going back to face-to-face is very good news and achievable. With students, the spread is certainly important, but the risk is above all outside the university.