Key Points

COVID-19

• In the Pays de la Loire region, a stabilization in SARS-CoV-2 transmission was observed in weeks 39 and 40, but this masks varying trends across different areas and age groups. In week 40, the regional incidence rate was down very slightly, remaining between 30 and 50 per 100,000 inhabitants, as was the positivity rate, which was close to 1%. However, while indicators continued to decline or stabilize among those under 65, they were rising among those aged 65–75 and even more so among those aged 75 and older. These age groups, which are at the highest risk of severe disease, now had the highest indicators in the region, with incidence rates of nearly 50 and 75 per 100,000 inhabitants, respectively. As in mainland France, the L452R mutation (primarily carried by the Delta variant) remained the overwhelming majority among regionally screened results.

• The number of reported clusters in communities has remained generally stable in recent weeks and relatively low. Schools accounted for nearly half of the clusters that occurred in S39 (S40 not yet consolidated). The number of cases in long-term care facilities also remained low in recent weeks.

• In urban areas, the rate of SOS Médecins calls for suspected Covid-19 decreased in weeks 39–40 compared to week 38, while the rate of emergency department visits across all age groups for suspected Covid-19 remained stable at a low level.

• In hospitals, a renewed increase in the number of new hospitalizations of Covid-19 patients reported at the regional level was recorded in week 40, for the first time in six weeks, though the number remained low. The same was true for the number of new admissions to critical care units, which rose again in week 39 and remained stable in week 40, also at a low level. The number of deaths, meanwhile, remained stable and at a low level.

• At the departmental level, incidence rates remained stable or even decreased slightly in Loire-Atlantique, Maine-et-Loire, and Sarthe in weeks 39 and 40, while an increase was observed in Mayenne and Vendée. Mayenne was the only department with an incidence rate exceeding 50 per 100,000 inhabitants in week 40. It was also the department with the sharpest resurgence in conventional hospitalizations and admissions to critical care units for patients confirmed to have COVID-19 in week 40 in the region, although these indicators remained moderate. Loire-Atlantique also saw a moderate increase in hospitalizations in week 40.

• In terms of vaccination, vaccination coverage continued to increase, most notably among 12- to 17-year-olds (82% of whom now have a complete vaccination regimen). It remains highest among those aged 65 to 74 (97%).

• The latest regional results from the CoviPrev survey (survey wave 27, August 31–September 7, 2021) on the adoption of reported protective measures are presented in this bulletin on page 12. These data show a relaxation of preventive measures and physical distancing practices at the start of the winter season.

Bronchiolitis

• The region has entered the pre-epidemic phase for bronchiolitis, like much of metropolitan France, while the Grand Est and Île-de-France regions have entered the epidemic phase (see map opposite). Visits to emergency departments and SOS Médecins by children under 2 years of age for bronchiolitis have increased significantly over the past 2–3 weeks, though they remain moderate. These visits are partly linked to the moderate increase in RSV isolations over the same period.

• Some of the current healthcare visits for “bronchiolitis” are also likely attributable to the circulation of rhinovirus, which is typically observed at this time of year and reported by the laboratories at the Angers and Nantes University Hospitals. This circulation was evident in the increase in SOS Médecins calls for nasopharyngitis over the past 4–5 weeks. The gradual increase in RSV circulation in the coming weeks is therefore expected to be accompanied by an increase in healthcare visits and hospitalizations of young children for bronchiolitis.

Asthma

Following the sharp increase observed after the start of the school year, healthcare utilization for asthma remains at high levels, likely linked to the circulation of the respiratory viruses mentioned above (rhinovirus and RSV).