COVID-19 Epidemiological Update, March 11, 2021. High viral circulation, increased strain on intensive care units, and dominant variants: the situation remains a cause for concern

CP_pe_covid_110321.pdf

Published on 12 March 2021

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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 guide public policy decisions. In Week 09, infections stabilized at a very high level with 147,699 new confirmed cases, a decrease of 2% compared to Week 08. Pressure on hospitals is increasing further as admissions to intensive care units continue to rise (+9%). Since Week 04, the number of ICU admissions has decreased among those aged 75 and older, who benefit from the protective effect of vaccination, but is increasing among those aged 15–74. More transmissible variants have become the dominant strains, amid concerns that infections caused by these variants may be more severe. In the coming weeks, adherence to preventive measures and accelerating vaccination efforts remain key priorities to counter these trends.

The virus continues to circulate at very high levels across the country

After two weeks of increases, the number of new confirmed cases has stabilized, with 147,699 new cases in week 09 compared to 150,037 in week 08, a decrease of 2%.

The Île-de-France, Hauts-de-France, and Provence-Alpes-Côte d’Azur regions have incidence rates exceeding 300 per 100,000 inhabitants and the highest rates of hospitalizations and intensive care admissions. All indicators are on the rise in Île-de-France, unlike in the other two regions, where stability or a decline is observed. In the other regions, varying trends with disparities between departments are observed. In Mayotte, which has been under lockdown since February 5, 2021, the slowdown in the epidemic continues with a sharp decrease in the incidence rate: 229 per 100,000 inhabitants in week 9, compared to 496 in week 8 and 861 in week 7.

Severe strain on hospitals, particularly in intensive care

The number of hospitalized COVID-19 patients in France remains very high, with 25,246 people hospitalized as of March 9. The number of new ICU admissions for COVID-19 patients increased by 9% in Week 9 (2,034 versus 1,871 in Week 8). A slow but steady increase in ICU admissions has been observed for several weeks. As of March 9, 2021, 3,928 patients were hospitalized in intensive care (compared to 3,348 on February 16, a 17% increase over 4 weeks).

A shift in the age distribution of cases

While those most vulnerable to this epidemic remain people aged 65 and older, as well as those with comorbidities, a decrease in the age of new cases and newly hospitalized patients has been observed over the past few weeks. People aged 75 and older still accounted for the majority of hospitalized patients in Week 09 (53% of those hospitalized on March 9), but a significant decrease in the incidence rate has been observed in this age group since Week 04, consistent with the increase in vaccination coverage. At the same time, intensive care admission rates have risen among those aged 15–74 since Week 04. These trends are occurring against a backdrop of rising incidence in these age groups over this period but may also reflect an increase in the severity of infections caused by variants of interest. This latter hypothesis is the subject of further analysis.

The 20I/501Y.V1 (UK) variant, predominant in 79 metropolitan departments

According to indicators generated from SI-DEP, the following was observed in week 09:

65.8% of positive screening tests correspond to a suspected 20I/501Y.V1 (UK) variant, compared to 59.5% in week 08,
4.9% corresponded to suspected cases of the 20H/501Y.V2 (ZA) or 20J/501Y.V3 (BR) variants, compared to 6.3% in week 08.

These variants were detected in all metropolitan regions, with disparities across departments: 79 departments had a proportion of suspected 20I/501Y.V1 (UK) variants exceeding 50% among screened positive tests (57 in week 08), and 10 departments had a proportion of suspected 20H/501Y.V2 (ZA) or 20J/501Y.V3 (BR) variant above 10%.

Sequencing: the 20I/501Y.V1 (UK) variant is predominant

The final results of Flash Survey #2 conducted on January 27, 2021 confirm that the 20I/501Y.V1 variant was predominant among the screened samples from this survey.

Flash Survey #3, conducted on February 16 (Week 07) on 699 positive samples regardless of screening results, shows that among SARS-CoV-2-positive cases as of the survey date:

39% were due to the 20I/501Y.V1 variant,
5% were due to the 20H/501Y.V2 variant
1% were due to the 20J/501Y.V3 variant.

Other lineages are also circulating in the country and are being monitored.

Furthermore, the results of Flash #3 highlight that clade 20A.EU2 (historical strain) is predominantly found in children aged 0–9, and clade 20I/501Y.V1 (variant of interest) is mainly found in people aged 10–69, with a higher prevalence (>50%) among those aged 10–29.

Flash surveys are conducted every two weeks to track the spread of each known variant of interest and enable the detection of any new variants. Flash Survey #4 took place on March 2, 2021 (week 09) and included over 1,600 positive samples; its results will be reported in an upcoming epidemiological update.

Vaccination Drive Gains Momentum: Over 1 Million People Vaccinated in One Week

Since March 2, the vaccination rollout has accelerated; in one week, more than 1 million people have received a first dose of the vaccine.
As of March 9, 2021, 4,164,418 people in France had received at least one dose of the COVID-19 vaccine, and 2,032,791 people had received two doses (data by date of injection). It is thus estimated that, as of that date, 6.2% of the population in France had received at least one dose of the COVID-19 vaccine (vs. 4.7% on March 3, 2021) and 3.0% had received two doses.

Vaccination coverage has increased particularly among the oldest age groups in parallel with the improvement in epidemiological indicators; 80 years and older: 35.3% (vs. 29.1% on March 2, 2021), 75–79 years: 32.8% (vs. 25.6%), and 70–74 years: 7.8% (vs. 4.5%).

Vaccination monitoring indicators are updated daily and now include information on the type of vaccine administered; they are available on Géodes.

Given the high level of viral circulation and significant strain on the healthcare system, the strict enforcement of all individual and collective measures is more essential than ever. It remains crucial that anyone experiencing symptoms suggestive of COVID-19 immediately self-isolate and get tested as soon as possible. The use of digital tools (TousAntiCovid) is recommended to strengthen contact tracing and rapid isolation measures.

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