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Covid-19: how can we explain this high and long plateau in the hospital?


For more than a month, the number of hospitalized patients has been more or less stable, around 25,000, including 2,700 in intensive care. But the admissible

The curves do not drop desperately more, for at least three weeks.

It has been even more than a month since the number of patients hospitalized in France because of Covid-19 has not gone out of a range of between 24,000 and 25,500. Since December 19, between 2,600 and 2,750 of them are in serious condition and under critical care, that is to say in resuscitation, intensive care or continuous monitoring.

"The pressure on our hospitals remains more or less stable but it is at a high level", summed up Jean Castex on Thursday evening during his press conference.

We observe this very high plateau even though, over the same period of one month, the number of new daily cases has climbed by about 50%.

How to explain it?

Regional disparities

First explanation: there is always a gap of around two weeks on average between contaminations and hospitalizations.

Because of this delay, "it seems prudent to us to wait until January 15 to take stock of the progress of the epidemic following the end-of-year festivities", writes the Scientific Council in a new opinion made public this Friday.

In addition, for a month, it is among 20-29 year olds that the incidence has increased the most (+ 75%).

However, young people are less likely to generate severe illness and therefore require hospitalization.

"When the dynamics of the ages are reversed with more young infected, the evolution is less noticeable on hospitalizations", underlines Mircea T. Sofonea, lecturer in epidemiology and evolution of infectious diseases at the University of Montpellier.

Another avenue: this stable figure at the national level hides, of course, regional disparities.

Over the same period of one month, the number of hospitalized patients, for example, decreased by 18% in Auvergne Rhône-Alpes but it increased by 13% in Provence-Alpes-Côte d'Azur.

"The number of hospitalized patients is decreasing, but it is very slow, and that in intensive care remains stable", indicates Olivier Claris, president of the medical commission of establishment of the Civil Hospices of Lyon.

In its establishments, "more than 92% of resuscitation beds are occupied, half of which by Covid-19 patients", he adds.

"There is a high occupancy rate of hospital beds […] with strong regional heterogeneities", also observes the Scientific Council.


Covid-19: how can we exceed 100% occupancy in intensive care in places?

The fact remains that this number of occupied beds is "not the most responsive to changes in the epidemic", emphasizes Mircea T. Sofonea.

Another hospital indicator should be followed with even more attention because it better reflects the situation in real time: the daily number of hospital or intensive care admissions, displayed by date of declaration.

We must calculate it on average over a week, in order to smooth out the variations.

Indeed, there are fewer lifts from hospitals on weekends and therefore catching up at the start of the week.

1300 hospitalizations per day

About 1,300 people enter the hospital every day now, as many as in early December.

The curve had sagged at the end of December before starting to rise again since the beginning of January.

But, as Public Health France indicates, "the increases by date of declaration may be due to the catching up of data which could not be recorded during the year-end period".

During the holidays, some files were not put together in time.

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This can also be seen in the data by date of admission to the hospital, which the health agency indicated in its weekly epidemiological update published this Thursday evening.

Thus, last week compared to the previous one, the number of hospitalizations increased by 19% by date of declaration but by "only" 6% by date of admission.

In intensive care, the increase is, respectively, 21% and 5%.

If the increase is smaller, it does exist.

And this, especially since the data for the first week of January "are not yet fully consolidated," says Public Health France.

Some patients entering the hospital may not yet have been included in the indicators.

There is therefore “an increasing trend to be confirmed in the following days,” SPF told us this Friday during an online press point.


Covid-19: England overwhelmed by the number of patients

In the field, Olivier Claris notes in any case that admissions to the hospital "tend to increase".

He says he is "worried about the English variant", which could lead to an upsurge in infections.

The scientific council also warns that there is "little margin for additional hospitalizations".

Source: leparis

All life articles on 2021-01-15

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