What do we know about the English variant cluster that affects an Ehpad?

An Ehpad in Saint-Maur-des-Fossés, in June 2020. – Anne-Christine POUJOULAT / AFP

  • Since the beginning of January, out of the 67 residents of the Saint-Exupéry nursing home in Toulouse, 42 have been infected with the coronavirus, as well as 19 members of staff.
  • Eleven of the residents tested positive for the English variant, including the two 93-year-olds who died.
  • Among the residents affected by the English variant, one of them had already tested positive for SARS-Cov2 during a first epidemic wave last September.

It is a rapid and abnormal spread which put the chip in the ears of the persons in charge of the nursing home Saint-Exupéry and at the geriatrics pole of the CHU of Toulouse a few days ago. After being affected by a first wave in September, this establishment managed by the CCAS recorded an outbreak of coronavirus cases at the beginning of the month among its residents and staff.

Of the 67 elderly people, 42 were affected and 19 of the 80 staff members. Two of the residents, a man and a woman of 93, have since died. The other affected elderly were isolated in a dedicated wing.

Eleven confirmed variant cases

Among them, “eleven cases tested positive for the English variant, there are also eleven other probable cases for which we are awaiting the results of the analyzes”, indicated the departmental director of the Regional Health Agency of Haute-Garonne. That is to say 22 probable positive cases with the English variant among which the two deceased persons.

“This Ehpad had already experienced a first wave of coronavirus during the month of September with several cases and three deaths. We saw a new major epidemic wave, which prompted us to carry out the sequencing, the results of which we had on Friday evening. There is no greater severity in the clinical signs, nor less, than in establishments not affected by the English strain, ”says Dr. Hélène Vilars, geriatrician at the Toulouse University Hospital and who coordinates the Covid platform for the 135 Ehpad of the department.

A case of a patient reinfected with the variant

Among the positive cases for the English variant, there is an elderly person already affected by the coronavirus during the first epidemic wave in September. “It’s a person who had it a first and then a second time. This notion of reinfection has already been observed ”, indicates Professor Jacques Izopet, head of the virology department at Toulouse University Hospital and whose laboratory has carried out the sequencing.

According to the latter, for the moment the results of the survey launched at the national level show that “this variant represents between 1 and 2% of positive cases, in our region this figure is 1.5%”.

The unidentified zero patient

The health authorities as well as the management of the nursing home are still looking for the zero patient who could have introduced the English variant within the establishment. At first, they thought it might be one of the residents who went out during the end-of-year festivities. “She was put in solitary confinement and tested under protocol on January 4. The test results we had on the 7th showed that she was positive. But after the sequencing it turned out that it was not the variant ”, indicates Céline Cazaux, the head of the elderly sector, within the CCAS of Toulouse.

Between the screening of the first positive case on January 7 and the discovery of the presence of the English variant last Friday, two generalized screenings were organized within the structure. And sequencing to verify the intuition of medical officials of a possible presence of the variant, at the origin of this outbreak.

“We are looking for contact cases and those who have been in contact with English visitors or people returning from England. The zero variant positive patient is still looking for identification, ”said the departmental director of the Haute-Garonne regional health agency, Laurent Poquet. It may have been brought in by visitors, staff or the rare cases of residents having gone out.

Other clusters to come?

This is the first case of an English variant cluster in a nursing home in Occitania. But it might not be the last. Indeed, among the twelve clusters still active in retirement homes last week, some are showing signs of the English variant given the number of cases.

“There are three or four places that worry us and for which we have done screening and sequencing,” notes Dr. Hélène Vilars. But beyond nursing homes, the authorities are also closely monitoring the youngest. They are waiting in particular for the results for a Toulouse college affected by many cases of Covid to know if it is the English variant.

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