Coronavirus: Why is the Month of November Going to be “Trying” as Jean Castex Foresees?

EPIDEMIC: During the weekly health update on the coronavirus, Jean Castex indicated that the month of November will be very hard for France.

It will not have escaped you, the health situation is worsening in France. More than 40,000 cases of coronavirus recorded in twenty-four hours, a European record, bed occupancy rates in intensive care which exceed 50% in several regions, and now 46 million French people in 54 departments affected by the curfew.

This grim record is further weighed down by an implacable observation: the worst is yet to come. Jean Castex, exceptionally presents Thursday at the weekly health point of his Minister of Health Olivier Véran to support the gravity of the situation, did not say anything else: “The month of November will be trying, we already know that. We explain to you why the Prime Minister is right to warn about this month of November which promises to be difficult.

The positive cases of today are undoubtedly the resuscitations of tomorrow

Let’s start from the simplest and most concrete, the 41,622 new cases of coronavirus this Thursday. Roughly, we can summarize by saying that between the moment of the positive test and the hospitalization takes place about a week, even ten days, and approximately the same duration between the hospitalization and the passage in intensive care. Obviously, not all positive cases will be hospitalized, not all hospitalizations end in resuscitations, and all resuscitations do not result in death. “But each time, there is a certain percentage passing from one box to another, we cannot deny it, slice Hélène Rossinot, public health specialist. So the more positive cases there are today, the more resuscitations and deaths there will be in the weeks to come, it’s a simple mathematical law ”. Deadline which brings us to the month of November.

However, “without saying that all caregivers were in good shape in March or April, they are even more tired now”, supports the doctor. “And the support is not the same, which is just as heavy. This observation applies to hospitals, city medicine, general practitioners, family caregivers… All are exhausted by the first wave and see the second coming, ”she describes.

High numbers that keep increasing

Especially since the numbers are unlikely to decrease. Small illustration of what an exponential is with Hélène Rossinot: “three weeks ago, 79,000 cases were recorded in seven days. Last week, 120,000. This week, 180,000. The numbers are crazy. »They panic all the more in the cold of October-November, where the shivering population naturally favours closed and poorly ventilated places, two actions which amplify the chances of contamination.

And this is also the problem for the emergency physician Mathias Wargon, “there is no reason for the numbers to drop, and there is no reason that it should not continue to increase, which made the situation worse each time three weeks later, again and again. ”

The effects of the curfew will come very late and will be very slow

Yes, but what about the curfew? Even assuming it acts as a super-slowdown in the epidemic – which is far from proven – the above-mentioned lag applies. In other words, it will take another two, three weeks to show its first effects with regard to areas under curfew from Friday 16th October (Paris, Lyon, Toulouse, etc.), and an additional week for the departments concerned by Thursday’s announcements. In short, the month of November will already be well underway. And then, even in the hypothesis where incredible effects occur, “they would be very progressive”, tempers Hélène Rossinot. It suffices to see that even the containment in March took well over three weeks to relieve the epidemic wave.

Figures besides which could be truncated by the holidays of All Saints. Two weeks without schools, more people on vacation so less face-to-face work, some universities also on vacation, this results in less contamination. There too visible effects in several weeks, “and which will require to be careful not to overinterpret the real effect of the curfew”, warns the specialist of public health France.

Fight on two fronts for how long?

However, as we said previously, the situation is already tense in French hospitals. White plans (deprogramming of non-vital operations) have already been set in motion, and with the influx that is arriving, it is difficult to see how the French health service can keep up with the wave. As a result of these overwhelmed hospitals, Hélène Rossinot warns: “there will also be breakage in non-Covid patients”. Operation postponed, doctor occupied elsewhere … “We are for the moment overwhelmed because we have not completely deprogrammed and we are trying to keep a normal situation for the other patients”, indicates Mathias Wargon, who worries about knowing during how long it will be possible to carry out both fronts of Covid-19 operations and other diseases: “We want to try not to fall into the caricature of what was done in March and April, by also taking serious non-Covid patients, with the dramatic consequences that we know. It’s unclear whether this wishful thinking will be achievable in the middle of next month.

Especially since unlike the first wave, the epidemic is no longer localized but spread over the entire territory. As a result, transfers between regions of patients or the provision of staff for the most congested hospitals may be impossible this time. Even transfers between countries (Luxembourg, Switzerland and Germany, in particular, had taken care of French patients during the first wave) may be more complex “because the rebound is taking place everywhere and simultaneously in Europe”, despairs Hélène Rossinot.

And the flu and the gastro in all this?

“Especially since November is usually already a complicated month, with the rest of the winter illnesses,” adds the doctor. Of course, we can hope that with the strict application of barrier gestures, the epidemics of seasonal flu and gastroenteritis will be less violent than in previous winters.

In this regard, Mathias Wargon indicates that gastroenteritis and bronchiolitis, at least as far as Ile de France is concerned, are currently below the levels expected at this time of year. As for the flu, the emergency physician puts forward three “good” news: the start of his traditional epidemic does not begin until mid-November, there has been a rush for flu vaccines as never in previous years, and finally the barrier gestures should reduce the epidemic here too. For example, in the southern hemisphere, which has already passed the winter, the flu has never been so mild.

But you’ll admit it yourself after these 7,000 signs of depression, that doesn’t sound like good news for the impact that lies ahead.