In week 45 (November 8–14, 2021), SARS-CoV-2 transmission intensified in mainland France, and the rise in new hospitalizations was confirmed. The increase in the adjusted incidence rate (to account for the effect of the public holiday) was observed across all age groups. The use of screening tests also increased, particularly among children under 10, in connection with the resumption of testing in schools. Rising across all metropolitan regions, the adjusted incidence rate exceeded 100 cases per 100,000 inhabitants in 61 departments. In the overseas territories, the situation remained concerning in Réunion, where the adjusted incidence rate had been rising for three weeks, reaching 195 cases per 100,000 inhabitants. As of November 16, 75.2% of the population was fully vaccinated. Among people aged 65 and older, 29.1% had received a booster dose. In the current epidemic context, it is essential to encourage vaccination as well as the administration of booster doses among eligible individuals. Maintaining the strategy of testing and isolating at the first sign of symptoms, contact tracing in the event of a positive test, and ensuring high adherence to preventive measures remain essential, given the importance of these measures in limiting the spread of SARS-CoV-2 and other winter viruses and preserving the healthcare system.

More than 10,000 cases diagnosed per day on average; hospital indicators on the rise

Nationally, the incidence rate adjusted for the effect of the public holiday (November 11) was 125 per 100,000 inhabitants in Week 45 (vs. 90 in Week 44), representing a 38% increase. On average, more than 10,000 cases were diagnosed per day. The adjusted incidence rate was rising across all age groups and exceeded 100 per 100,000 among those under 70. The adjusted testing rate was 3,335 per 100,000 inhabitants (+14%), and increased by 228% among those under 10 years of age due to the resumption of testing campaigns after the start of the school year. The positivity rate rose across all age groups, with the exception of those under 10, reaching 3.7% in S45 (+0.6 percentage points).

The numbers of new hospitalizations and admissions to intensive care increased by 15% and 11%, respectively, despite the fact that the data has not yet been consolidated. As of November 16, 7,596 COVID-19 patients were hospitalized, including 1,290 in intensive care.

In mainland France, the adjusted incidence rate was rising in all regions. It exceeded 100 per 100,000 inhabitants in nearly all regions. It exceeded 50 per 100,000 in all departments and 100 per 100,000 in 61 departments. Rates of new hospitalizations were stable or rising across all regions, with the highest rates again observed in Pays de la Loire and Provence-Alpes-Côte d’Azur.

In the overseas territories, the worsening situation was confirmed in Réunion, where the adjusted incidence rate reached 195 per 100,000 inhabitants (+63%) with an increase in hospital indicators. In French Guiana, the incidence rate and new hospitalizations continued to decline, allowing for a gradual lifting of collective containment measures.

Surveillance of infections among healthcare workers

Since September 22, 2021, 557 additional cases have been reported, bringing the total number of healthcare workers (HCWs) infected to 88,204 for the period from March 1, 2020, to November 2, 2021. No additional COVID-19-related deaths have been reported since the last update. In total, 19 deaths related to SARS-CoV-2 infection have been recorded since March 1, 2020. Among the reported deaths, none have occurred since mid-December 2020. Furthermore, among the 88,204 cases, 69% were healthcare professionals and 11% were non-healthcare professionals. The two most frequently reported professions are nurses (23% of cases) and nursing assistants (20% of cases).

• For more information: National survey of COVID-19 cases among healthcare workers in healthcare facilities

Constant vigilance regarding variants, even minor ones

The L452R mutation (carried mainly by the Delta variant) was detected in 96.7% of positive samples screened in S45 (vs. 96.3% in S44). Sequencing data confirm the very clear predominance of the Delta variant, which was identified in over 99.9% of interpretable sequences in mainland France during the Flash survey of October 19–22 and 99.8% during the survey of October 25–29 (unconsolidated data). In the overseas territories, Delta also accounted for 100% of interpretable sequences during previous Flash surveys.

Sequencing activities within the EMERGEN consortium also allow for continued vigilance regarding any new variant, even minor ones. Thus, a non-Delta variant, named B.1.640, was detected during the investigation of a cluster in Brittany in October 2021. This B.1.640 variant has been classified as a VUM (Variant Under Monitoring) but remains very rarely detected in France and internationally. Its evaluation is currently underway, and it is being closely monitored. For more information, see the preliminary risk analysis dated November 12, 2021.

Nearly 30% of those aged 65 and older have received a booster dose

On November 16, 2021, the estimated vaccination coverage based on Vaccin Covid was 76.9% for at least one dose, 75.2% for full vaccination, and 7.2% for the booster dose. Among those aged 12 and older, 89.2% had received at least one dose and 87.4% were fully vaccinated. Among those aged 65 and older, vaccination coverage for the booster dose stood at 29.1% (+4.9 percentage points compared to Week 44). This indicator represents the ratio of the number of doses administered to the total population in this age group; it reflects the level of protection for this population. It is also estimated that 68.1% of people aged 65 and older who were eligible for the booster dose as of November 16, 2021, had actually received it. This additional indicator tracks the progress of the booster campaign for eligible individuals (taking into account the required waiting period before receiving the booster dose).

As of November 16, 93.9% of residents in nursing homes (residential care facilities for dependent elderly individuals) or long-term care units (USLD) had received at least one dose of the vaccine, 92.3% were fully vaccinated, and 54.4% had received a booster dose.

Vaccination coverage for at least one dose was 92.2% for healthcare professionals working in nursing homes or long-term care units (91.3% fully vaccinated, 4.6% with a booster dose), 96.8% for private practice healthcare professionals (fully vaccinated: 96.4%, booster dose: 22.2%), and 92.2% for healthcare professionals working in healthcare facilities (fully vaccinated: 91.4%, booster dose: 5.6%).

The estimated vaccination coverage among people aged 15 and older identified as living in precarious circumstances was 76.1% for at least one vaccine dose, 74.3% for full vaccination, and 7.8% for the booster dose.