COVID-19 Epidemiological Update, October 14, 2021 - Less pronounced decline in epidemiological indicators: the virus is still circulating, and a combination of preventive measures remains essential

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Published on 15 October 2021

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Santé publique France
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In week 40 (October 4–10, 2021), the situation continued to improve, although the decline in epidemiological indicators was less pronounced and they showed a tendency to stabilize in some regions. The decline in the incidence rate was confirmed in French Guiana, but pressure on hospitals remained high, and all-cause mortality still showed an excess in week 39.

Given that vaccination coverage and virological parameters (variants) remain stable, this increase is most likely attributable to more frequent and/or less well-protected contacts. The latest CoviPrev survey (September 28–October 5) indicates that the rate of vaccination adherence (being vaccinated or intending to be vaccinated) remains stable at 87%. Systematic adherence to preventive measures remains at levels lower than those reached during previous waves. With winter viruses circulating again, adherence to preventive measures—along with vaccination and compliance with other preventive measures—remains essential for sustainably controlling the epidemic and preserving the healthcare system.

Incidence rates declining except in certain regions

Nationally, in Week 40, the incidence rate continued to decline, with 44 new cases per 100,000 inhabitants (-10%), or an average of 4,172 cases diagnosed per day. It was decreasing across all age groups, with the exception of those aged 70–89, where it stabilized. It remained above 50 among those aged 30–39 and 20–29. The testing rate, including antigen and PCR tests (excluding self-tests), remained very high (4,265 per 100,000 inhabitants, -7%) and decreased across all age groups this week. The positivity rate was stable (1.0%, -0.1 percentage points).

In mainland France, the incidence rate was rising in Corsica (+18%) and stable in Île-de-France, Hauts-de-France (+4%), and Brittany (+4%). It was decreasing in the other regions. In the overseas territories, the incidence rate decreased in French Guiana, falling from 495 per 100,000 inhabitants to 369, a decrease of 25%. In Guadeloupe, it continued to decline in week 40 (-12%) but increased in Martinique (+12%).

The decline in virological indicators was, however, less pronounced than in previous weeks. Nationally, the effective R-value remained below 1, but its increase over three consecutive weeks (from 0.72 to 0.89) indicates a rise in viral circulation within the population.

Fewer than 7,000 hospitalized patients; the decline continues in hospitals

In hospitals, the decline in indicators continued, with 1,083 new hospitalizations (-17%) and 276 new admissions to intensive care (-16%). As of October 12, 6,690 COVID-19 patients were hospitalized, including 1,124 in intensive care.

In mainland France, rates of new hospitalizations and critical care admissions were decreasing or stable in all regions, except for a slight increase in hospitalizations in Brittany and the Pays de la Loire, and in critical care admissions in the Grand Est.

In the overseas territories, hospital pressure remained high in French Guiana, with high and stable rates of hospitalizations and critical care admissions. The moderate excess mortality observed between weeks 29 and 37 increased in weeks 38 and 39. The number of new hospital admissions continued to decline in Martinique and Guadeloupe.

Over 85% of those aged 12 and older are fully vaccinated

On October 12, the estimated vaccination coverage in France based on Vaccin Covid was 75.6% (50,706,321) for at least one dose and 73.5% (49,311,847) for full vaccination. 50,685,731 people aged 12 and older had received at least one dose (87.7%) and 49,297,130 (85.3%) were fully vaccinated.

As of October 12, 93.6% of residents in nursing homes (residential care facilities for dependent elderly individuals) or long-term care units had received at least one dose of the vaccine (91.7% for full vaccination). Among private healthcare professionals, vaccination coverage continues to rise slightly: 96.2% had received at least one dose and 95.2% were fully vaccinated.

How is the French public’s adherence to COVID-19 prevention measures evolving?

The results of Wave 28 of the CoviPrev survey (September 28–October 5) indicate that the systematic adoption of preventive measures has stabilized compared to the previous wave (early September). 87% of respondents support vaccination against COVID-19: they have either already received at least a first dose of the vaccine or intend to do so.

The most commonly cited reasons for not getting vaccinated among those who stated they did not intend to get vaccinated were:

“The new vaccines are not safe” for 64%.
“The information reported in the media about the safety and efficacy of vaccines is contradictory” for 48%.
A preference for other means of prevention over vaccination, cited by 43%.

Regarding adherence to preventive measures, a stabilization in the adoption of all preventive measures is observed compared to Wave 27. In Wave 28, systematic handwashing stabilized at around 60%, and 66% of respondents reported consistently wearing a mask in public. In September 2021, 45% of respondents reported ventilating their homes every hour for a few minutes, an increase of 6 percentage points compared to May and a stabilization compared to August.

Learn more - Le Point Sur: How is the French public’s adherence to COVID-19 prevention measures evolving? Results from Wave 28 of the CoviPrev survey

Impact of the health pass and the non-reimbursement of COVID-19 tests on vaccination rates

Among the 87% of people who are already vaccinated or intend to get vaccinated, 30% said they were influenced by the introduction of the health pass. Among the 13% of unvaccinated people, 68% stated that they would not go—or would no longer go—to places where the health pass is mandatory, 22% said they would pay for tests whenever they needed them (including 11% who would not limit their outings), and 8% stated that they would get vaccinated against COVID-19; among unvaccinated people aged 18 to 24, this proportion reaches 18%.

If tests are no longer reimbursed, 15% of people would refuse to pay for a test if they had symptoms (69% would make an appointment with their doctor to have the test reimbursed), and 26% would refuse if they were a close contact of someone who tested positive for COVID-19 (58% would make an appointment with their doctor to have the test reimbursed). Among those who are unvaccinated or do not have a health pass, 36% would be willing to pay for it if they needed the health pass.

Among the 733 people who have taken at least one screening test since July, 35% took it to obtain a health pass, 25% due to close contact with a confirmed case, and 16% due to symptoms suggestive of COVID-19. 56% of these people stated that they would have taken the test even if it were not reimbursed, including 63% in the event of symptoms, 59% in the event of a high-risk exposure, and 46% to obtain a health pass.

Starting October 15, certain tests will no longer be covered by Medicare. A decline in testing is expected, which is likely to have only a moderate impact on the incidence rate. As a reminder, the incidence rate is the product of the positivity rate (number of cases divided by the number of people tested) and the testing rate (number of people tested relative to the population). The positivity rates for so-called “convenience” tests are generally very low.

Santé publique France will publish data on the potential impact of the end of test reimbursement on the monitoring of epidemiological indicators in the epidemiological update on October 21.

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