In week 26 (June 28–July 4, 2021), SARS-CoV-2 transmission began to rise again across the country. The increase in incidence was marked among people aged 15–64, and particularly among those aged 15–44, and affected all regions, with significant variation across departments. The proportion of the Delta variant detected among diagnosed cases was rising sharply, with regional variation. As of July 6, 2021, 52% of the population had received one dose of the vaccine and 38% were fully vaccinated. New data from the CoviPrev survey show a decline in adherence to preventive measures among the population.

Against the backdrop of the Delta variant’s increasing spread, it is important to continue encouraging vaccination for all eligible individuals, with specific measures to facilitate access for older adults who have not yet been vaccinated, with the goal of achieving a sufficient level of herd immunity and protecting the most vulnerable. It is also essential to maintain a high level of adherence to prevention and testing measures, contact tracing, and compliance with isolation at the first signs of infection or contact with a confirmed case.

After 11 consecutive weeks of decline, the incidence rate is rising

Nationally, 16,538 new cases were confirmed in week 26, or an average of approximately 2,360 cases per day. After 11 consecutive weeks of decline, the incidence rate was rising, reaching 25 per 100,000 inhabitants, a 31% increase compared to week 25. The testing rate was also up by 11% (2,736 per 100,000 inhabitants).

The incidence rate was rising sharply among those aged 15–64: the increase was very marked among those aged 15–44 (+53%) and more moderate among those aged 45–64 (+12%). The incidence rate was rising slightly among those aged 0–14 (+1%) and declining among those aged 65 and older. An increase in testing was observed among those aged 15–64 (+28% among those aged 15–44 and +7% among those aged 45–64).

In mainland France, the incidence rate increased in all regions, though the magnitude of the increases varied by region. The effective reproduction number estimated as of July 3 based on virological data (SI-DEP) was significantly greater than 1 in seven mainland regions: Brittany, Corsica, Île-de-France, Nouvelle-Aquitaine, Occitanie, Pays de la Loire, and Provence-Alpes-Côte d’Azur. In the overseas territories, the decline in viral circulation continues in French Guiana but is increasing very significantly in Martinique and, to a lesser extent, in Réunion.

Furthermore, contact tracing data indicate a sharp rise in the number of cases who have frequented settings conducive to transmission (private gatherings, restaurants, and bars, etc.) where mask-wearing cannot be systematic, as well as cases returning from travel abroad.

Heightened vigilance regarding the potential impact of rising indicators on the hospital system

The number of reported new hospitalizations and admissions to critical care units continued to decline in Week 26, though at a less pronounced rate than in previous weeks (down 16% and 23%, respectively, compared to Week 25). The number of COVID-19 patients currently hospitalized continued to decline as of July 6, with 7,696 patients hospitalized, including 1,045 in critical care units. However, the trend in hospitalization rates must be closely monitored in the coming weeks due to the increase in the incidence rate in Week 26.

Deaths among hospitalized COVID-19 patients continued to decline in week 26 (-24%), and those occurring in social and medico-social institutions (ESMS) remained at a very low level.

The Delta variant is now circulating across most of the country

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 mainly by the Delta variant). In week 26, the E484K and E484Q mutations were detected in 19.1% and 0.8% of screened positive samples, respectively, that were tested for these mutations. Detection of the L452R mutation increased sharply: it was found in 43% of screened positive samples (compared to 21% in week 25).

Preliminary results from Flash Survey #12 dated June 22, 2021, show that the proportion of the Alpha variant of concern was in sharp decline. In contrast, the increase in the proportion of the Delta variant was marked (rising from 8.5% to 30.5% in two weeks).

The Delta variant is circulating across most of the country, with community transmission reported in many departments. 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.

Vaccination coverage, although high, is struggling to increase, particularly among the elderly

As of July 6, 2021:

• 34,904,228 people had received at least one dose of the vaccine, representing 52% of the population;

• 25,402,481 had completed the full vaccination series, representing 38% of the population.

Vaccination has been available to children aged 12 and older since June 15, 2021, and 17.0% of 12- to 17-year-olds have already received a first dose of the vaccine. Vaccination coverage, although high among older adults, has struggled to increase in recent weeks.

Vaccination coverage among residents in nursing homes (Ehpad) or long-term care facilities (USLD) is high but is increasing only slightly: 89% for at least one dose and 83% for full vaccination. Coverage among private healthcare professionals is also high: 81% for the first dose and 75% for full vaccination. Vaccination coverage among healthcare professionals working in nursing homes and long-term care facilities is estimated at 61% for the first dose and 45% for full vaccination.

Systematic adoption of protective measures on the decline

The results of the latest CoviPrev survey conducted from June 21 to 28, 2021, showed that the consistent adoption of measures related to social interaction had decreased significantly compared to Wave 24 (May 17–19, 2021):

• 66% of respondents reported greeting others without shaking hands and avoiding hugs (72% in wave 24);

• 37% reported avoiding face-to-face gatherings with loved ones (43% in wave 24).

Following the easing of mask-wearing requirements outdoors in June, a significant decrease in consistent mask-wearing was observed (70% in Wave 25 vs. 82% in Wave 24).

Regarding mental health, a significant decrease in reported anxiety and depression was observed. The prevalence of anxiety and depression, sleep problems, and suicidal thoughts remained higher than levels observed outside the pandemic (2017 Health Barometer), and life satisfaction remained lower. In total, 26% of respondents reported experiencing anxiety or depression.