COVID-19 Epidemiological Update, July 1, 2021 - Promoting vaccination in the face of increased circulation of variants: a key challenge for continuing to contain the epidemic
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Published weekly, the epidemiological update on COVID-19 surveillance provides a detailed analysis of the indicators established by Santé publique France and its network of partners to track the progression of the epidemic and inform public policy decisions.
In week 25 (June 21–27), a decline in epidemiological indicators was still observed nationwide, though to a lesser extent than in previous weeks. This decline was seen across all age groups and in all metropolitan regions. The proportion of the Delta variant detected among diagnosed cases was on the rise, with significant variation across departments.
As of June 29, 2021, 50% of the population had received one dose of the vaccine and 33% were fully vaccinated. The first vaccine efficacy results published today estimate that full vaccination is 84% effective in preventing symptomatic cases among all individuals aged 50 and older. The pace of vaccination has slowed in recent weeks, particularly among the oldest age groups, highlighting the need to continue public outreach efforts to keep the epidemic under control.
Against the backdrop of the growing spread of the Delta variant and the easing of public health restrictions, and given the less pronounced decline in the number of new cases, it is essential to maintain a high level of adherence to prevention measures, testing, contact tracing, and isolation in the event of infection or contact with a confirmed case.
A less pronounced decline in the incidence rate
Nationwide, 12,514 new cases were confirmed in week 25, averaging approximately 1,800 cases per day. The incidence rate of 19 per 100,000 inhabitants was decreasing (-23%) but less sharply compared to the steep declines of the previous two weeks (approximately -40%). This decrease was observed across all age groups. The testing rate continued to decline (2,460 per 100,000 inhabitants, or -6%). The positivity rate tended to stabilize at 0.8% (a decrease of 0.1 percentage points compared to Week 24) after nine weeks of decline.
A decline in indicators tracking transmission chains was also observed. This may be explained by reduced testing among at-risk contacts, or by less comprehensive identification of these contacts, and/or by the increase in the number of fully vaccinated individuals.
In the overseas territories, the decline in viral circulation has accelerated in French Guiana despite continued heavy pressure on the hospital system. Incidence rates, hospitalization rates, and intensive care admission rates remain the highest in France. In Réunion, the incidence rate and intensive care admission rates were once again on the rise.
Fewer than 9,000 hospitalized patients
The decline in the number of reported new hospitalizations and admissions to critical care units, observed since Week 15, continued in Week 25 (down 28% and 26%, respectively, compared to Week 24), but this decline was less pronounced than in the previous week. The number of hospitalized COVID-19 patients continued to decline as of June 29, with 8,686 patients hospitalized, including 1,263 in critical care units.
Deaths among hospitalized COVID-19 patients continued to decline in week 25 (-29%), and those occurring in social and medico-social institutions (ESMS) remained at a very low level.
The proportion of the Delta variant is rising sharply
The national strategy for systematic RT-PCR screening of SARS-CoV-2 positive tests has evolved since May 31, 2021, and now targets the three mutations of interest: E484K (carried notably by the Beta and Gamma variants), E484Q, and L452R (carried notably by the Delta variant). In week 25, the E484K, E484Q, and L452R mutations were detected in 24.0%, 0.8%, and 20.5% of the positive samples screened for these mutations, respectively.
The increased circulation of the Delta variant in mainland France is reflected in a rise in community transmission events and more sustained circulation of the virus in certain regions. The growing spread of this variant is being monitored with the utmost attention, given its increased transmissibility compared to reference viral strains and the Alpha VOC, a possible increase in the severity of infection, and preliminary data suggesting reduced vaccine efficacy following an incomplete vaccination regimen.
More than 12% of 12- to 17-year-olds have already received a first dose of the vaccine
As of June 29, 2021:
33,740,554 people had received at least one dose of the vaccine, representing 50.3% of the population
22,303,302 have been fully vaccinated, representing 33.2% of the population
Vaccination has been available to children aged 12 and older since June 15, 2021, and 12.4% of 12- to 17-year-olds have already received a first dose of the vaccine. The pace of vaccination has slowed in recent weeks, particularly among the oldest age groups, highlighting the need to continue public outreach efforts to keep the epidemic under control. Vaccination coverage among residents in nursing homes (Ehpad) or long-term care facilities (USLD) is high: 88.5% for at least one dose and 82.4% for full vaccination. Coverage among private healthcare professionals is also high: 79.7% for the first dose and 73.4% for full vaccination. Vaccination coverage among healthcare professionals working in nursing homes and long-term care facilities was estimated at 59% for the first dose and 46.9% for full vaccination.
Full vaccination is 84% effective in preventing symptomatic cases among people over 50
Vaccine efficacy is based on a comparison of the incidence of the disease among vaccinated and unvaccinated individuals.
Santé publique France has published the first estimates of real-world vaccine efficacy among people aged 50 and older. These estimates were obtained by cross-referencing the “Vaccin COVID” database for vaccination status (vaccinated or unvaccinated) and the SI-DEP database for infection status (infected or uninfected). The estimate of vaccine efficacy is based on a case-control study similar to those used for influenza: the assessment involves comparing the probability of having been vaccinated among biologically confirmed symptomatic COVID-19 cases (cases) and among symptomatic individuals who tested negative for SARS-CoV-2 (controls) between January 18 and May 23, 2021.
The results, consistent with those of studies conducted in other countries, show very high vaccine efficacy in preventing symptomatic COVID-19 following the full vaccination series, regardless of the vaccine:
45.7% for the first dose
84.1% for the full vaccination series
The analysis will be repeated in September with a longer follow-up period. Work is underway to study the possibility of generating new estimates of vaccine efficacy, particularly regarding the prevention of severe cases.
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1 July 2021
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