Dr G. Zagury : “6 Minutes Covid” of 14/10/2020

Live from Shanghai since January 28 th.

“Living With”: neither reconfinement, nor generational conflict “

🧭  🧭 60 ’’ Summary of the day (“Take Home Message”)

Asian Vision :

💢Rising tide

💢💢While waiting for a strong possible vaccine (validation in the coming months)

💢💢💢3 elements in parallel (more than in reaction) to prepare:

1 Protection of fragile land✅

2 Health structures by anticipating tight flows (to be prepared!)

3 Compliance with the 2 main types of measurement:

-individual (barrier gestures: “3M” ✅) and let’s be positive, very many lives have already been saved, thanks to this type of

-collective (“3T”: Test ✅ mais: Digital tracking and Triage-isolation to improve)

💢💢💢💢Thanks to the barrier gestures (and also to the vaccines on fragile grounds), probably less influenza decompensations to be expected.

💢💢💢💢💢 Above all, maintain a winning morale, essential to the “Mental Health” of the Country, by “living with”:

  • 100% of the 1082 C + sailors of Charles de Gaulle are unharmed – & only one has spent 10 days in intensive care!
  • We are not in Ebola (50% mortality): a priori more than 99% survival of C +, in the general population.
🚀 6 ` Minutes Flash : Objective: Contain the tide  

🇫🇷 France : dashboard

We are in an epidemic phase, and we consider this to be a “new epidemic”, which cannot be compared to the previous one, because the ecosystem has completely evolved in terms of the physical environment and preventive measures ( following new knowledge). Taking into account the probable correlation with the season (see absence of “summer outbreak” in Europe), we call it: Covid 19 – Season 2, and reset the counters to zero.

🇫🇷 France : THINK GLOBAL BUT MANAGE LOCAL

GEOGRAPHICAL VISION: the virus circulates in a diffuse manner in high-density metropolises

Source : Santé Publique France

THE SSF (French Health System) FACING COVID Season 2

💢SSF (“French Health System”) –NATIONAL: a rising tide

The 3 indisputable types of indicators (C + hospitalizations, C + resuscitation, C + deaths) are rising relatively linearly.

💢💢REANIMATION BEDS – at national level: the KEY to understanding

💢💢💢 REANIMATION BEDS – REGION-DEPARTMENTAL DISPARITIES: “Be sanitary, without being military” (social acceptability ++)

In public health, what counts are: 1 / The “tolerable” thresholds 2 / The trends (generally 3 days minimum)

⚠️ To go further

1/ Chronological Vision (Time)

2 & 3/ Regional Barometer & DOM TOM

4/ Intensive Care Barometer

🇪🇺 Europe : “Barometer per country”

Europe in epidemic phase with observed South North gradient

With the “social distance” effect, the “countries of the embassy” are probably on the front line….

⚠️ To go further

5/ “Space-Time” Table

World : “World pandemy”

Time : A 5 kinetic viral phase

Have the few key figures in mind: 5k deaths / day and +/- 300k new officially declared C + / day (beware of everything that is “test dependent” in terms of measurement and interpretation).

Space: 4 epicentres (more than 500 deaths / day)? – India… Europe and the two Americas

  • Note that in Singapore, first day or absence of a local case (even in the dormitories where certain populations of workers are grouped together).
  • Decrease in figures in the USA and Brazil, for 2 days… to be continued.

⚠️To go further:

6/ Kinetic deaths for major epidemic countries

« Out of the box » (weekly zoom)

“The more we test and the more we find…., And the more sensitive the test, the more we also find”

For those under 50:

For those under 70:

Note that in terms of sensitivity, the positivity of the PCR test is attested after 37 replications in Israel, 34 in the USA, 30 in Germany…, or certain reservations with international comparisons not using the same tools.

———To come up——-

  • Epidemiology: Italian study with% of asymptomatic cases according to age
  • Geopathology (“Patho-Geopolitics”): barrier gestures depending on the country, vaccine update, trends in the USA & Brazil, the Israeli case (tomorrow), Covid illustrating the end of the illusion of supremacy in the Western World, …
  • Strategy: A centralizing structure for C + in epidemiologically at risk regions (such as Val de Grace or other in IDF)

“Live with” while protecting the most vulnerable with a “citizen” attitude

  • 3M for the general population (70%)
  • 4M for populations at risk and the most exposed (30%)
  • 4M for places at risk of exposure (case by case and common sense: visiting a church alone is not at risk, conversely, risk if a crowded place and “proximity” rituals).

See you tomorrow

Dr Guillaume Zagury
Specialist in International Public Health (DES)
HEC
Practitioner
Consultant in Medical Innovations (France, Israel, China)
In China for 20 years

« All success is collective and so thank you to our teams (Dr. Bachir Athmani, Carole Gabay, Richard Coffre,…), as well as to our patrons, and of course to the Paul Benetot Foundation/Matmut Group.

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