why the situation in France is not improving, despite more than two weeks of confinement?

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why the situation in France is not improving, despite more than two weeks of confinement?




At Tours CHRU, March 31.

A period of at least fifteen days is necessary before being able to observe the first effects of the quarantine measures. However if these appear for the moment hardly perceptible, the figures seem to show a stabilization of new hospitalizations. But the number of deaths is still increasing.

Question asked by dam on 04/01/2020

Hello,

While France has exceeded, since Tuesday, April 1, the two weeks of confinement, some are surprised to see no improvement in the health situation in the country, whether in terms of resuscitation or death. This is despite a commonly accepted incubation period of 2 to 14 days for the Covid-19, an average of one week.

Health director Jerôme Salomon explained this on Monday, March 30. Hinting at a next improvement, he detailed the different stages of a patient with Covid, leading to the gap between the implementation of confinement and the impact on the health situation.

“We have a very important indicator, which is not that of the dead, not that of confirmed cases, but that of hospital arrivals, which reflects contaminations that occurred approximately 15 days before. You were infected just before the containment was put in place, you have about a week of incubation, you start to be sick, you are possibly worse, and it is from this moment that you will address to the hospital […]. So 15 days after this contamination, we observe in particular the transition to intensive care. This is the impact of the epidemic, but it is also a reflection of this famous development that we should see by the end of the week, which is linked to the fact that confinement should considerably reduce the number of contacts. . […] From this weekend, we should have fewer people arriving at the hospital, especially those arriving in intensive care. “

It would therefore take a week, on average, between the contamination and the onset of symptoms, then another week before any hospitalization. The confinement having taken place a fortnight ago, the situation in the hospital, while remaining tense, could therefore, on average in France, begin to clear up. This does not mean that the indicators will go down overnight. The APHP, for its part, expects a “plateau” – which should last several days – around Monday, according to the Parisian. In the Grand-Est, the tension, extreme until then, seems to have come down a little for a few days, according to the Express. A situation in very slight improvement, which begins to be reflected in the figures.

Starting with the number of new cases confirmed each day. As imperfect as it is, depending on the number of tests performed, this data, despite a start on March 31, seems to have stabilized for a few days already.






If we look at Italy, we can also see a plateau of contaminations about ten days after confinement.






Regarding the daily number of new hospitalizations, this has not been made public as such. It is however possible to reconstruct it from the cumulative figures of hospitalized, deaths and recovered, delivered each evening by the general directorate of health. And this indicator, essential for hospitals, also seems to be starting a – fragile – plateau for the past few days. Without any promise, however, on the start of a recession.






If the trend – which remains to be confirmed – seems to stabilize on the contamination front and, on average in France, for new hospitalizations, what about the number of resuscitation admissions and the number of deaths?

Regarding the start of resuscitation, Jerôme Salomon had suggested a slight decrease yesterday, citing 382 entries Thursday, against 452 Wednesday, 458 Tuesday, and 475 Monday. Problem: the claim was based on a misreading of the statistics. Contrary to what the Director General of Health suggests, the data he cites – to be exact – do not correspond to the number of new entrants, each day, in intensive care, but to the number of additional beds occupied at a given time in resuscitation, resulting from the balance between new entrants on the one hand, and the number of deceased and resuscitated exits on the other hand. According to the latest epidemiological bulletin from Public Health France (which ended on March 31), there were, for example, 767 new admissions to resuscitation of Covid-19 patients on March 31, 694 on March 30 and 543 on March 29.

Friday evening, during his daily update, Jerôme Salomon, following our inquiry in the afternoon, corrected himself, and for the first time gave the number of new admissions to intensive care: 641 Friday, against 729 the Eve. Again indicating a slight decrease, or at least a stabilization of the number of new entries.

The death toll, if it appeared to have stabilized in the past few days, rose again on Friday, with 588 additional hospital deaths in the past 24 hours, a record since the start of the health crisis. This is alas logical: if almost two weeks separate the contamination from the possible hospitalization, it is still several days before a potential death. “The French must understand that the death toll, which is still very impressive, ultimately reflects the contamination that occurred several weeks ago”, Jerome Salomon recalled on March 30.

How soon can we expect improvement on the death front? Hard to say. In China, following the establishment of the quarantine, a dozen days had been necessary before being able to observe a stabilization of the number of new cases each day, and approximately 10 additional days to reach the peak / plateau of the number of daily deaths . Or three weeks in all, and as many, then, to bring the curve down. But confinement was then much stricter than in France.

Listen to the weekly behind the scenes podcast from CheckNews. This week: Do Italians and Spaniards count their Covid-19 deaths better than France?

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