Dr G. Zagury : “Covid Flash” of 01/10/2020

With covidminute.com, live from Shanghai

The news catches up with us, and I was asked, by readers in France and China, to try to “give meaning” to the “Covid” information.

🇫🇷 France : dashboard

Equation to dimensions: have in mind the “maximum figures” observed during the April peak:

  • Hospitalizations C+ no ICU (22.529)  / Versus 5352 today
  • Intensive care (7632) / Versus 1238 today
  • Death (+ 605 at the Hospital) / Versus +85 today

🇫🇷 France : local gestion

The virus circulates in France and in the DOM, and an epidemic phase is observed according to the regions (IDF, North, …)

Source : Santé Publique France

To understand the situation in France, you have to know how to reason about the issue = intensive care beds, in terms of load / capacity.

On a national level:

Resuscitations are filling up: + 800 cases C + this last week (for a maximum current capacity of 5000 beds C + & C-).

The figure below only shows the evolution of C +, and the room for maneuver before “pushing the walls” and considering possible sorting is reduced (see especially the possible decompensations of the flu season are coming soon).

Consequently, everything depends on the evolution, and the effectiveness of the preventive measures to “flatten as much as possible” the curve (act 2 – red), and thus to be able to “live with” (while waiting for a vaccine?).

As such, there should not be opposition, but complementarity between white coats and white shirts, to strictly enforce barrier gestures (see 300 nightclubs have already closed!)

To understand the current issue, from our decision-makers:
 The essential issue of our health system is the absorption capacity of intensive care beds: taking into account the C (-) currently, and to come (decompensation of influenza and other viruses in autumn-winter ).
 Roughly speaking: a threshold (at regional level but +/- extrapolable to national level) at 30% of C + intensive care beds must be considered as an alert threshold: i.e. the figure of 1,500. C + resuscitation increased from 400 to +/- 1250 beds… As a result, we will monitor this figure on a daily basis at the national but also regional level (no longer makes sense, but more complex to have the figures for regional resuscitation capacities).
 Everything that is “dependent test” is very debatable (except in the rapid detection of contact cases, to be isolated): sampling, positivity threshold (++), laboratory response time, and interpretation of the result (contaminating or not )… As a result, we only partially take it into account (apart from the positivity rate).

At regional level:

The system begins to be powered up in IDF, and stabilization in PACA (see appendix).

Note the physical and moral fatigue of many caregivers, with the idea of ​​”putting it back”, while already having “the film in mind”: the number of work stoppages in our Public Hospitals (already in just-in-time before Covid ) will be a good indicator to watch.

⚠️ To go further

1/ Chronological Vision (Time)

2 & 3/ Regional Barometer & DOM TOM

4/ Intensive Care Barometer

🇪🇺 Europe : “Barometer per country”

A North South gradient observed

In terms of “homogeneous” comparisons, let’s not forget that we must reason at 4 levels: local (department) – regional – national – European

8 countries are currently “sensitive” in Europe: Spain and France in the south and some countries in the East (Romania, Czech Republic, Ukraine,…), but also Belgium and Holland are to be watched

⚠️ 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).

Difficulty anticipating the kinetics of this pathology in the short to medium term …

Space: India takes over from the Americas (improving trend to be confirmed)

For the USA and Brazil, it seems that the situation is improving but very gradually (still nearly 1000 deaths yesterday)….

⚠️To go further:

6/ Kinetic deaths for major epidemic countries

Géopathologie : « viral RNA expresses The Cultural DNA of Societies »

💢 Global technology leadership: The little red book turned pink

If we are based on factual facts, China has revealed to the World its technological and “managerial” power (to take care of C + patients in Wuhan: construction of a HEGP + La Pitié equivalent in 3 weeks , and with 5G to communicate!).

When we think that in the year 2000, there were “2 divisions of gap” between the Western World (ex: Nokia…) and the Chinese World, this leaves one wondering, on the observed national consensus and a certain naivety Western …

In addition to our dependence on the World’s factory (protection, medicine, ventilators, etc.), this crisis has revealed that in all the industries of the future, the Chinese are positioning themselves as leaders, most often with the Americans and much more rarely with the Europeans …

The vaccine is one example, among others: electric battery, solar panels, genetics, autonomous car, 5G, GAFAM & BAT, …

Let`s hope that Europe, the cradle of microbiology and vaccines, will meet the challenges of future innovations, and not just make the regulations …

In the age of the “information highways”, relayed by social networks, our goal is thus to “return to the fundamentals”: to bring out daily 5-6 “strong signals”, factual rather than emotional, in the “noise” surrounding, and thus reassure the greatest number, in the face of a pandemic always evolutionary.

« 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.

“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
International Public Health Specialist
In China for 20 years