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A turn rather than an epidemic mirage for the world?

FRANCE: The parents of the young C (+) of today, may be the hospitalized of tomorrow …
ECONOMY: Solidarity because France is particularly affected
VACCINE: All vaccines lead to humans (continued)!

Evolution of severe cases in the USA & Brazil. Note that the Americas represent 62% of deaths reported last week.

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« All success is collective and I would like to involve the entire Medical team (of course Dr. Bachir Athmani, accomplice for 20 years, Dr. Mohamed Fadel, Dr. Marc Abecassis,….), the Datas Analysis team (Carole Gabay as lead, Laetitia Bernard-Granger,…), the IT team (Richard Coffre our excellent webmaster, Flavien Palero,…).

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—-ANALYSIS” MINUTE —-

A / WORLD DYNAMICS:

25 M cases declared since January, but good news, DROP in C + (242k / day: -5% compared to last week), but especially DEATHS (5.6k / day compared to S-1, or 11% decrease)

A.1 / CHRONOLOGICAL ASPECT:

Stabilization of declared cases (= Dependent test => nearly 250 k / day), and declared mortality slightly down (++), at +/- 5 k deaths per day (6,057 yesterday and 6,311 last week).

Note 3 points:

The roller-coaster trend of mortality, with weekly recurrence, is most likely explained by a less assiduous declaration / reporting process on the WE …
The preventive dynamic: because we test more and more (++), and younger and younger (average age 39 years C+ tested in Italy!)
This explains why 50% of the 25M cases declared to date were observed 7 weeks ago.

A.2 / GEOGRAPHICAL ASPECT:

More than 100 “Wuhans” in the world, and let us note that Mainland China is the space which is the most spared in the world …, and for good reason: fierce restrictions at the borders, adhesion and total respect of barrier gestures, technological solutions ( certainly potentially liberticidal!) used to the maximum for the benefit of Public Health…. This has allowed Mainland China to persevere with its objective of remaining an almost “Covid Free” country for 4 months (less than 50 new cases / day and exclusively imported cases, local clusters closed in 35 days max).

Source John Hopkins University

A.3 / WORLD INCIDENCE – THE INDIAN PHASE WAS ANNOUNCED

3 Current epicenters: As expected for the past 15 days, India is in the epidemic phase (under declaration ++, but fortunately a “young” country). The Americas represent 50% of the new cases reported on the planet.

A.4 / PREVALENCE C + WORLD: USA & BRAZIL POSSIBLY IN “POST PEAK”

(C +, ICU, DEATH)

Caution, the vision of the epidemic that with a “test” indicator is extremely questionable (+++), and therefore I invite you to see, the “country” figures using the 3 indicators having the most meaning: Hospitalization (when available!) – ICU (when available!) – Death

A.5 / AMERICAS FOCUS:

SLIGHT IMPROVEMENT for the 2 most affected countries on the planet: USA (182k deaths) & Brazil (116k deaths)

A.5.1 / USA:

SIGNIFICANT IMPROVEMENT (Hospitalizations and ICU down), but VIGILANCE anyway (still 1,200 deaths yesterday … but we know they represent the situation at S-2) …

A.5.2 / BRAZIL:

Brazil in plateau (slight drop in ICU, slight increase in Hospitalizations, and a number of declared daily deaths hovering around 1000)

Thanks to the Artefact Asia team (Pascal Duriez, Edouard de Mezerac, Mael Deschamps) for the technical support, as well as to Carole Gabay (data analysis expert) for her energy, because to reconstruct the ICU occupancy curve, they had to analyze and crunch a file

of 500,000 rows and 134 columns !!!

For Brazil, let us note the socio-economic-ethnic gradient “East-West”, highlighted by this pathology.

A.5.3 / FOCUS ON INDIA: IN THE EPIDEMIC PHASE

Obviously, a continent country with underreporting (and difficulty in aggregating data), but India’s young population should limit the mortality.

A.6 / GLOBAL IMPACT: DEATH ANALYSIS

The West for more than 83% of declared deaths (820 K to M8)

A.6.1 / TOP 10 COUNTRIES: Cumulative deaths:

The Americas above all (first 3 countries affected)

A.6.2 / RESULTS INDICATOR:

Watch out for shortcuts….

This indicator is interesting if we compare “apples to apples”, which means “homogeneous” definition of the numerator (“Covid death”), and even epidemic environment for interpretation. Next week, we will illustrate our point with the case of “Belgium”.

B / EUROPE:

RELATIVELY POSITIVE situation (less 10% of deaths compared to last week)… but A VARIABLE GEOMETRY: Spain (doubling of deaths / S-1), Switzerland, Holland…

C / FRANCE:

The parents of the young C (+) of today may be the hospitalized of tomorrow …

As in economics, there are many indicators (Hospitalizations, ICU cases, Deaths, test positivity rate, C + incidence, R0 index, SOS C + calls, etc.), which most often come together to identify a trend. No indicator is perfect, and each measures part of the problem. I particularly recommend the first 4, which reflect an indisputable “field” medical reality and the speed of circulation of the virus.

However, knowing that we can make figures say a lot of things, when they are not relativized in time, and in space: thus a simple recent C + curve, can give the impression of an “alarmist” epidemic rebound, whereas the Hospitals hardly register any new patients!

C.1 / WE ARE TESTING MORE (about 100k / day), but the situation cannot be compared to April:

as a result more C + declared (and much younger – cf. tests in April)

C.2 / THE SITUATION CANNOT BE COMPARED TO APRIL:

  • C + hospitalizations (with ICU): 4600 (versus 4925 last week, i.e. roughly 6 times less C + / April)
  • ICU: 410 (versus 384 last week)
  • Deaths: 15 (versus 15 last week)

C.3 / We must reason at the LOCAL level: Vigilance in IDF & PACA

France Info

C.4 / But do not be naive and do not let the embers flare again fire with the returns and re-entry: maintain individual vigilance (“3M”)

  • The virus is circulating (around 3000C + / day currently) at different speeds depending on the region: more than 700 “Clusters”, and 3 regions to follow: IDF, PACA, Guyana, etc.
  • Our “Region Barometer” (analytical innovation by Carole Gabay)

D / GEOPATHOLOGY (section created in February!)


D.1 / ECONOMY: Solidarity because France is particularly affected

  • The IMF does not foresee an economic recovery before the start of 2022 (see natural or vaccine control of the epidemic)
  • Our indebtedness will probably rise to 120% of GNP and some are predicting 1 million more unemployed by the end of the year.
  • We are going to be more impacted than our neighbors, because our foreign trade is particularly dependent on 3 industries : aeronautics (Airbus) – automotive (Renault, PSA, etc.) and tourism (No. 1 worldwide destination)
  • The digital giants GAFAM for the USA, and BAT for the Chinese, will be the big economic winners of this health crisis.

D.2 / VACCINE: ALL VACCINES LEAD TO MAN (continued)!

-A large number of immunologists are confident about the outcome of the success of these vaccines (among other things through the genetic stability of the virus).

-Different vaccine strategies are being evaluated, primarily targeting humoral immunity (antibody production), with different virus-based platforms (eg inactive, attenuated), based on viral vectors (egadenovirus, measles) , nucleic acid-based (eg RNA or DNA), protein-based (eg vaccine subunit or vlp).

-Even if qualitatively, the first vaccine available on the market will probably not be the best (number of injections required,% of effectiveness, iatrogenic risk in the short and medium term), the impact of its “announcement effect” will mark the conscience in terms of “world technological leadership”, particularly in the match between the USA and China.

-Concerning temporality, 3 elements for reflection, on more than 100 vaccine candidates launched (often by international consortia), including 6 officially in phase 3 since July 15 (Africa, Brazil, Middle East, etc.):

. The vaccine (from an adenovirus) developed by the Gamaleya Institute in Moscow is the first to start industrial production, and the first deliveries will be available at the end of August. Are we moving towards a “Phases: 1243” type strategy (instead of the usual 1234 timeline), putting national prestige before health security? In other words “I market first … and I evaluate after”, is a question that some scientists are asking, and in this case if this vaccine comes out first (Russia is still in the epidemic phase), it will be limited to Russia essentially.

..Bearing in mind the validation requirements according to international standards (FDA, CFDA, EU, etc.), the inactivated Chinese vaccine (low tech) developed by CNBG (China National Biotech Group), and having already been administered to 20,000 “volunteers” before getting used abroad (Middle East, Morocco, Latin America), is probably the first that will be authorized at the international level (probably towards the end of November), because if the genetic engineering projects (high technology) developed by the American Moderna or the Oxford team are relatively quick to implement for a phase 3, their validation will probably be slower because of the still unknown side effects inherent in this type of new vaccine. On the other hand, China’s influence at WHO is also a factor to be taken into consideration.

… In my opinion, the Covid is only a catalyst for the change in the center of gravity of the planet, and its displacement towards the Asia-Pacific (and we are already seeing that apart from the military, China is gradually joining the USA in many areas)…

E / Deep Diving:

At all times, you can :

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Thank you again for your trust.

“3M” (Mask-Manual-Meter), and has next week, for this panorama World.

Dr Guillaume ZAGURY,

Medecin Practitioner,

Specialist in Public Health and Medical Innovations

MBA

In China since 2000.


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