Aurélien Rousseau is still struggling to see “the end of the tunnel”. “This virus is changing, adapting, we are not there yet,” says the director of the Regional Health Agency (ARS) of Ile-de-France. If the vaccination campaign against the coronavirus has experienced a serious boost this week, the increase in the incidence or the appearance of the different variants, considered to be even more contagious than the original strain of Covid-19, or the delays vaccine delivery remains a concern. Interview.
Nearly 1% of the Ile-de-France population has received a first dose of vaccine to date. How long will it take to vaccinate all those over 75 and at risk who want it?
It is impossible to answer this question precisely since it depends on several factors that we do not control: the deliveries of the Pfizer vaccine that have been delayed, the marketing and the recommendations associated with other vaccines such as that of AstraZeneca. The last element to take into account is the battle for trust which is still far from being won. In some nursing homes, only 20% of residents want to be vaccinated, in others, on the contrary, this rate reaches 100%. What we are sure, however, is that Saturday 150,000 Ile-de-France residents will have received their first injection, next week they will be 250,000. And at the end of the month, the 700 nursing homes in the region will have carried out the first injection of patients who so wish, i.e. around 45,000 people.
Many elected officials regret that it does not go faster. How can we explain that certain European countries – which have nevertheless received the same number of doses in proportion to their population – go twice as fast as us?
Each country has set up its own vaccination strategy: we have chosen to start with the most vulnerable – in particular the residents of nursing homes who have paid the heaviest price for this pandemic – before accelerating the pace. Different choices have been made elsewhere, it will be necessary to compare the figures at the end of the month. But I understand this frustration of elected officials, we are able to vaccinate more but we are conditioned by the number of doses. Remember, when you do an injection, you have to make sure that we can inject the second dose four weeks later.
How are the doses distributed among the 109 centers in the region?
First of all, there is a breakdown by department, according to the percentage of the population over 75 years old but also social criteria: in younger departments but whose population experienced a very high excess mortality during the first wave – such as in Seine-Saint-Denis or in Val d’Oise – additional doses are allocated. Then, we work with elected officials and prefects to distribute the doses between the different centers according to the population basins but also vaccination capacities.
Some elected officials evoke an early shortage of syringes …
The week of January 11, some vaccination centers opened on an experimental basis and it may have happened that elected officials or support institutions were forced to buy syringes. Since the launch of the campaign over 75, Monday, this is no longer the case: all the centers receive at the same time as the vaccines, syringes and compresses. I’m not saying that out of the 109 centers, there has never been any quack or delay in delivery, but there is no shortage of syringes.
Since the Christmas holidays, the incidence has been increasing in Ile-de-France as in the rest of the territory. Can we make a link with the different variants, considered to be more contagious?
There is indeed a rise in the incidence which, if it is not massive, is worrying because it is accompanied by an increase in hospitalizations. Today, 52% of the region’s intensive care beds are occupied by patients with Covid. On the other hand, it is difficult to establish a link with the circulation of the different variants because we do not know precisely their circulation. So far, we have identified 44 people cases infected with the British variant in the region but other suspected cases are still being investigated.
How to limit the spread of these variants?
We have a very aggressive approach. As soon as we have any doubts, we act as if it were the variant: the duration of isolation is potentially greater than seven days, pools of specialized investigators look for contact cases. If it is detected in a class, it is immediately closed. Major screening campaigns are also organized. In Bagneux, for example, where a school officer was contaminated with the English variant, 2,100 PCRs were carried out, 13 were found to be positive and among them two are potentially variants. In Colombes, Maison-Alfort, Bonneuil sur Marne and Fleury-Mérogis, 2,900 PCRs were carried out in schools having been attended by a person in connection with a confirmed case of the South African variant. In the family circle, 8 cases of variants were brought to light. Outside, we had nine positive cases, but no variants. Other situations are being investigated: 609 tests were carried out in a school in Courdimanche, for example. As long as this is possible in terms of volume of intervention, we will do everything to break the chains of contamination as quickly as possible.