A. France and Europe seen from Asia – We are at war and the Asian examples show us the way forward!
This section is produced with discussions with Dr Bachir Athmani in Paris and Mathieu Bouquet in China.
“Put down the masks” and stop half-measures: we must adopt the recipes that work!
1. Wearing a mask (if possible generalized!)
This tactic has proven itself: there are countries that use it and that win … and others!
If our industry is not able to supply this type of product (which shows our extreme dependence on China, already illustrated by the cost hunt in the pharmaceutical industry), we must turn to l factory in the world, which currently produces 100 million masks … per day! (against a capacity of less than 10 million per … week in France). Even if China produces of course with varying levels of quality.
The masks (FFP2, surgical) must initially be reserved for healthcare professionals (around 2 million units per day) as well as for people in repeated contact with the public (Ehpad, police, cashiers, etc.).
2. Massive screening
This is the key to the Korean strategy to detect cases and isolate them immediately.
Note the figure of 500,000 tests per week in Germany, compared with less than 50,000 per week for France.
The development of this type of reagent by our laboratories (human or even veterinary biology) is not, according to some specialists, a very complex element. Chinese, Koreans and even Vietnamese did it urgently, without having a month of preparation before the arrival of the epidemic on their territory.
3. Massive disinfection of public spaces
This is the case in China and South Korea in particular. Note the use of spray robots in these two countries.
4. Identification and management of positive cases and contact cases
This is an essential point.
In China and most Asian countries, a Covid patient is immediately isolated in hospital or in a quarantine center. This measure was initiated in Hubei, after the authorities became aware of the very large number of intra-family contaminations (some families have been decimated).
In France, a patient with little symptoms returns to his family, which creates a great risk of family contamination.
Likewise, in China if a contact person is identified, they are under quarantine. Quarantine is now done in dedicated centers, and much more rarely at home.
If a suspect case is identified, isolation of the entire residence (China, Vietnam, etc.) until the doubt is resolved. If the case is positive, the patient is isolated in hospital, and the confinement of the residence is maintained for 14 days, with temperature monitoring and possibly biological tests.
5. War effort: DIY or deployment in order?
Some hairy people spent months in the trenches. We have to spend 4 weeks (+/- 2) at home.
All industry that can be mobilized must provide solutions for the development of the basic elements of the fight against the virus (protective gear, care materials, etc.).
The lack of beds in public hospitals (eg in Paris: the 1,000 intensive care beds are occupied or about to be occupied) can be compensated by the participation of the private sector.
Reduction of summer holidays for schoolchildren, university students and their parents (solution preferred by China and Vietnam, where classes have not yet resumed).
Our health system must reposition itself in an emergency, when it is above all risk-oriented:
- acute (“White Plan”): mechanical (trauma) or chemical (see recently in the West) or thermal or even nuclear type
- localized (type of attack or major accident) and not throughout the country.
- non-progressive, whereas we have to face an epidemic period of around 2 months days (Wuhan case) with strict containment measures.
This may explain the difficulties encountered by our managers in adapting existing means.
B. France – We are rather following an Italian trajectory – J11 containment
1. Incidence: +3,922 new confirmed cases (2,933 yesterday)
We remain in the epidemic growth phase, the number of new cases does not seem stable over the last 4 days.
Note that general practitioners and the 15th have identified more than 40,000 positive cases since the start of the epidemic, without confirmation by biological tests.
2. Prevalence: 22.5k in observation (20k yesterday)
On this basis alone, the doubling time seems to be getting longer (more than 6 days, compared to 5 yesterday). But the figure of 22,500 does not take into account the biologically unconfirmed cases mentioned in the previous paragraph.
If France continues to follow the Italian model, the peak could end around mid-April.
3. Trend (comparison with Italy)
To date, France’s trajectory remains relatively close to that of Italy, with all the necessary precautions for this comparison, in particular with regard to the testing strategy adopted by each country.
4. Health system: analysis of current capacities and flows
4.1. Figures
Deaths: 1,696, or 6% of cases identified by biological tests (but much lower if we took into account all people carrying the virus in France)
Severe cases (resuscitation): 3,375, or 14% of cases identified biologically
4.2. Testimony of a colleague in the Grand Est to the emergency
“I have never had this experience: we usually have 150 visits to the emergency room and at most we intubate once a day. Today, we have received only 70 patients but we had to intubate 10 “.
4.3. Our system is still capable of absorbing the wave …
… but probably more for a very long time. While Italy has already seen its capacities overwhelmed by the epidemic.
Graph: proportion of severe cases among identified cases
Graphiques : comparaison par pays des cas graves et décès
Note the dynamics of mortality rates (an indicator that is doubtful but its dynamic is a good indicator) on the rise in France, and which only reflects the difficulties encountered more and more frequently by carers, in a similar way to what is happening in Spain.
NB: precautions to take on mortality figures
In France, the mortality figures provided are probably largely underestimated compared to reality, since only the figures for hospital mortality are included and consequently they do not include figures outside the hospital (Ehpad, deaths without biological tests carried out, etc. .).
5. Territorial distribution
NB: the figures for March 26 in the evening were not communicated by region, the map and the table below show the data available on March 25 in the evening.
5.1. Cartography
5.2. Evolution by region
C. World impact: an exponential dynamic
Thanks to Stéphane, a companion from the start, for his participation.
1. Incidence: 63k new cases diagnosed (46k yesterday, 44k the day before)
2. Global geographic vision
There are currently the equivalent of 15 Wuhan type homes around the world, including ten exploded in Europe and which can be joined!
The United States and Spain remain in an exponential phase.
3. Continent / country geographic analysis
3.1. By continent
3.2. By country
There is a high risk of health catastrophe in the United States, where the best technology will not be able to cope with a massive influx of patients at risk, in particular due to co-morbidities. Obesity, with its pathological consequences, affects more than a third of American adults.
Table: evolution by country
D. Prevalence worldwide – In a few days, the United States reaches a number of cumulative cases greater than that of China in 2 months!
The doubling time in the United States is currently 3 days.
1. Time vision (chronological)
At the current rate, doubling of cases worldwide every 5 days (stable).
Figures to be taken with caution given the disparity of testing strategies: the epidemic can spread without it being reflected in the official figures, if the patients are not subject to biological screening and a count official.
2. Spatial vision
Geographical location of countries with more than 10,000 active cases (top 8):
- USA 82k
- Italy 62k
- Spain 46k
- Germany 38k
- France 22.5k
- Iran 16.7k
- Switzerland 11.5k (high density of imported cases)
- United Kingdom 11k
Chart: distribution by continent
Virus Preventions 4 W’s:
Wear a mask, Wash your hands, Watch out for sick people, Wait for new updates from covidminute.com !
Protect yourselves, and above all protect the most vulnerable!
Dr. Guillaume ZAGURY,
Specialist in Public Health and Health Innovations
Consultant at “Health Innovations”
HEC
In China for 20 years“All success is collective”, thanks to:
– the whole “Back Up” team (Mathieu Bousquet, Carole Gabay, Flavien, Marie, Laetitia, Anne-Sophie, …), without whom this project would not have been possible.
– all the “Medical” team (Dr Bachir Athmani, Dr Ibrahim Souare, Dr Taieb, Dr Viateur …) who allow this project to exist,
– all historical financial sponsors (Jerome, Benjamin Denis & B Square, Benoit Rossignol, Arnault Bricout) who work for “Citizen Actions”
If you feel like a patron or of partners to finance IT development, don’t hesitate to contact me (guillaume@covidminute.com).
Also, even if part of the team is based in Shanghai, do not hesitate to come and join us, because there is no shortage of work :-)If you want to find more analyses and infographics, follow our account at:Know the latest updates
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