One could believe in two opposite movements. On the one hand, the number of hospitalized and serious patients in intensive care is still falling. And on the other, mortality figures that continue to rise. A trend that should last several more days.
With 761 dead in 24 hours this Friday, the number of deaths in France blackens the table of good news delivered by Jérôme Salomon in recent days. The overall excess mortality also gives little reason to hope, with a number of deaths 23% higher than that recorded at the same time in 2019, for the week of April 4 to 10, according to figures that were published by the Insee this Friday.
But according to William Dab, epidemiologist, and former director general of Health, "it is not relevant to compare the figures from one year to the next, for the whole of France. Because these data can be biased by other factors, such as the decrease in road mortality. On the other hand, it is useful to look at the evolution of mortality in certain departments which were very affected by the Covid-19, in particular in Île-de-France and in the Grand Est, to have a fair picture of the situation ” .
Above all, as INSEE notes, the figures have experienced a slight inflection compared to the previous week. "It is very clear in the Grand-Est, we note 16% decrease over this period compared to the previous week, and in Ile-de-France, it is 9%", assures Sylvie Le Minez, demographer at INSEE, even if these data still need to be consolidated.
"We must above all see who dies and in what condition," recalls Jean-Daniel Lelièvre, head of the infectious diseases department of Mondor hospital, in Créteil (Val-de-Marne). Like him, Doctor Dab distinguishes the situation in nursing homes from that in hospitals.
"Patients don't die in 24 hours"
“The increase in mortality in nursing homes, despite the confinement, is probably explained by contamination of residents by the staff who take care of them in their everyday life. Despite all their efforts, we know that they were poorly endowed with masks, overcoats, and hydroalcoholic gel, and this surely played a role in the massive spread of the virus in these establishments where people are fragile, he. "Resuscitation is not magic, especially for the elderly," also notes the head of the infectious diseases department at Mondor hospital.
In hospitals, where caregivers "have been better equipped with protective equipment", a "decrease" is starting well according to Professor Delfraissy. “We are rather going in the right direction, you know, this is both true in the East and in Île-de-France. The figures we have show a decrease, "rejoiced the president of the Scientific Council before the Senate law commission on Tuesday. Before resuming. “Not in terms of mortality. This is the complexity, since there is a gap between the start of intensive care and the time when unfortunately we can die. The mortality figures are there, and they will not budge within 15 days, "he said.
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“Patients who go into intensive care do not die within 24 hours. Sometimes it can be 15 days after their arrival, ”confirms Jean-Daniel Lelièvre. "A recent study by Imperial College London calculated this difference to 23 days," recalls Jean-Stéphane Dhersin, deputy scientific director of the National Institute of Mathematical Sciences and their interactions at the CNRS.
"A catch-up phenomenon"
Why have to wait 15 days before you can see an inversion of this curve? "To confirm the effects of confinement, which are already making it possible to see a drop in the number of hospitalizations in services, a real factor in the development," says Jean-Daniel Lelièvre. An orientation is already there, notes Public Health France.
“In the absence of a re-increase in new infections, a reduction in the hospital burden linked to Covid-19 should soon be observed. New deaths from Covid-19 tend to stabilize. The increase observed in recent days is very likely to be associated with a catch-up phenomenon after the Easter weekend, ”notes the organization.