The epidemic with the new coronavirus is changing its face. For two days, the number of new cases recorded in China (400 in the last 24 hours) is lower than those counted in the rest of the world (800 new patients in the same period). And the difference is only increasing: the epidemic is clearly slowing down in all the Chinese provinces, a sign that the peak has been crossed, while it is experiencing rapid growth in several countries, South Korea, Italy and Iran at the head.
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Another significant symbol, the Sars-CoV-2 virus which causes Covid-19 disease is now present on all continents, except Antarctica. Among the new countries affected, we now find Brazil, as well as Algeria, both contaminated by travelers arriving from Italy.
The WHO still refuses to use the word “pandemic”, but this oratorical prudence seems more and more inappropriate with outbreaks exceeding several hundred cases in several countries. Beyond a few dozen patients in a country, it becomes indeed illusory to be able to block the virus, and the only viable strategy is to try to limit its progression.
With 26 dead and 245 confirmed cases (a figure probably far below the reality given the very late reaction of the authorities), Iran appears to be the most important center outside of China. The situation is hardly better in South Korea, which recorded a much larger number of sick people, 1,766 Thursday evening, but "only" 13 deaths. Statistics that indicate that the death rate from the disease in South Korea is 0.7%, much lower than the 2 to 3% observed in the Chinese province of Hubei, the starting point of the epidemic. Difficult to explain at the moment, but it could be due to better care by Korean hospitals, or to a much smaller number of people escaping detection.
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In Europe, Italy, with 528 cases and 14 deaths on Thursday, is still in an increasing phase of the epidemic. And the country has become one of the main platforms for the spread of the disease in Europe, a sign that the draconian measures taken by Rome came too late to prevent the spread of the virus. The list of European countries that have detected cases from Italy is already long: Greece, Spain, United Kingdom, Croatia, Austria, Denmark and Germany.
"At this stage, it is likely that Europe will experience developments comparable to what happened in Italy, with variations depending on the country," warned the latest bulletin of the European Center for Disease Prevention and Control (ECDC), an agency that advises the European Union on the progression of the epidemic. Some, such as France and Germany, are beginning to detect foci with no apparent link to the identified areas of spread of the coronavirus. This seems to have happened in the Oise, where investigators from the Regional Health Agency did not find an immediate link between the two new patients with the affected Asian countries or with Italy. In the absence of an identified link with the countries placed under surveillance, patients who present suspicious symptoms are in fact not considered to be eligible for coronavirus detection tests, and are therefore treated by the usual emergency procedures, at the risk of transforming hospitals into centers of contagion, as was apparently the case in Lombardy. France has recently decided that patients with severe forms should be tested, even without a clear epidemiological link.
Whatever their desire to contain the epidemic, health authorities are also constrained by reality. The High Council for Public Health (HCSP) has just issued new recommendations for caregivers working in hospitals and returning from an area where the virus circulates. Those who attended a care facility during their stay must stay at home for 14 days, as before. On the other hand, the systematic eviction of hospital staff returning from a risk zone is "not justified" , considers the HCSP. Students who have "no direct activity in terms of care" will undergo quarantine. The others, "including the interns" , "must strictly apply standard hygiene measures (...) and wear a surgical mask during all working time, over a period of 14 days." Why this difference in treatment? A systematic eviction “would be impossible, explains Professor Didier Lepelletier, medical officer of health and vice-president of the Commission system of health and patient safety at the HCSP who participated in the opinion. It would cripple the system. ”
