It is unknown to the general public, and yet it is the figures of its services which, as a ritual, are announced every evening, since the beginning of the Covid-19 epidemic in France, by Jérôme Salomon, the director general of the Health. They who give the pulse of the crisis and guide decisions at the top of the state.
Rare in the media, Professor Geneviève Chêne has been the director of Public Health France (SPF), the national public health agency, since November. Investigation of the number of people infected with the coronavirus in the country, deaths at home, new outbreaks of Covid-19 epidemics… eight days after the end of strict confinement in France, this researcher gives us the latest data on an unprecedented crisis.
Are you worried about hospitals, colleges, slaughterhouses… the multiplication of clusters in France?
GENEVIÈVE OAK. Today there are around 30 of them and their identification is a good sign! This means that we are able to detect them quickly and implement anything that breaks the chains of transmission. We have a broad strategy of testing and researching contact cases. Surveillance is at the heart of the fight against the Covid.
How does it work?
Concretely, we receive a continuous flow of data coming from general practitioners, SOS doctors, emergency visits as well as those of hospitalizations and mortality. Behind these figures, there are patients, but also teams who work seven days a week. These are epidemiologists, statisticians who will collect, verify and analyze them. In short, make them speak. They will tell us how the epidemic is behaving, which allows us to take the best measures to protect the population according to the territories.
Is the virus going up again?
Today, we have no signal of a resumption of the epidemic. But beware, the virus is still there. We have to wait until the end of next week (Editor's note: the week of May 25) to find out if the contaminations are starting to rise again. It is the time between incubation, first symptoms, medical consultations and the collection of reliable information. We will then know if all the measures taken (tests, traceability, continuation of barrier gestures and physical distance) have had the expected impact to control the epidemic. We give ourselves all the means to succeed. Nearly 60 people came to strengthen the already strong agency of 600 agents.
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Are you a bit like the virus police?
Our investigative capacity has adapted to the spread of the epidemic. Initially, cases were identified one by one, much like virus hunters. Then, at the beginning of March, when it gained ground, we had to evolve, monitor the number of hospitalizations and make sure that our healthcare system kept up. Today, thanks to general practitioners and Health Insurance, we are tracking the chains of transmission, but on a very large scale.
Today 350,000 tests are carried out per week, far from the 700,000 announced. Is it a failure?
The question is not how many tests are done, but whether the patients who need them have access to them. And the answer is yes. Capacity is not limited. There is a crucial message to convey: in case of symptoms, you must consult your general practitioner in order to obtain the prescription for screening. With respect for barrier gestures, this is a major element in controlling the epidemic.
Why did it take so long to announce the figures for deaths in nursing homes, dependent elderly accommodation establishments?
The virus particularly and severely affects older people. However, when the first cases appeared, we realized that our reporting system was not sufficiently precise. We had to invent a new one. Since March 1, this collection of information allows both to know the number of deaths in each nursing home and to identify the sources of contamination. We did it as soon as possible.
Why is the death toll at home still not known?
In France, death certificates are, for the most part, written on a paper document in which the causes of death are entered. Only 20% are electronic. It therefore takes longer to enter and scan all the data. We are analyzing them. According to our first information, deaths at home represent 1% of the deaths of Covid, but it is too early to give a final assessment. It will be published before the end of June.
However, these electronic certificates were to be generalized after the heat wave of 2003…
Yes, but their implementation was not enough. In this crisis, they would have been extremely helpful. We have to generalize them.
What impact did confinement have on the health of French people?
A quarter of smokers report having increased their tobacco use. On alcohol, the signals are less alarming. Regarding food, one in four people claims to have gained weight. The French were also more anxious, especially at the start of confinement, two thirds suffered from sleep disorders. This alerts us and gives us leads on the next prevention campaigns to be carried out.
Will we ever know how many French people have had coronavirus?
Yes, we are announcing it to you, we are completing a vast survey of 3,500 people with serological tests. They are used to detect antibodies to the coronavirus in the blood. These figures will be revealed soon, so we will have a photo, by age group and by region, of the number of people who have been infected. But research must continue to find out if these antibodies protect us from a new infection.
R0: the epidemic thermometer
Tell me your "R0", I'll tell you where the epidemic is. Monitored like milk on fire, it is the rate of reproduction of the virus, that is to say its level of contagiousness. Without a barrier measure, the R0 of the coronavirus is 2.5. Clearly, a sick individual may infect two to three other people, who in turn will infect as many and so on.
Thanks to confinement, this mathematical value dropped to 0.6, allowing the epidemic to be controlled. But beware, the deconfinement can make it burn again. It has already increased very slightly, to 0.7, according to Geneviève Chêne, the patron saint of Public Health France, who warns: "He would worry us if he was close to or above 1."