Jean-Daniel Lelièvre Head of the infectious diseases department at Henri-Mondor hospital (Créteil)
Do we have the means to follow the distribution of variants in France?
Jean-Daniel Lelièvre It depends which ones. The English variant is easier to follow, as it can be flushed out through certain PCR tests. For others, it is more complicated, because we have to sequence the virus. This takes time, results are not available within hours, and not all laboratories are equipped with the necessary machines.
Are we sure that the English variant will become dominant in France?
Jean-Daniel Lelièvre With this epidemic, we are not sure of anything! But according to all epidemiologists, we are in the situation that was in the United Kingdom a few weeks ago. Across the Channel, this variant took precedence over the classic strain, due to its greater transmissibility. Everything suggests that it will be the same with us. About 50% more contagious, its progression is exponential.
Shouldn’t we reconfine as soon as possible, then?
Jean-Daniel Lelièvre It is a very delicate question, which is the responsibility of the public authorities. Is containment the most effective tool? It seems so. But it must be put in place neither too late, to prevent the wave from growing too large, nor too early, because its social, economic and psychological consequences are extremely serious, especially among young people. Sanitary too, with pathologies outside Covid less well diagnosed and treated.
Could shorter regional confinements be a good compromise?
Jean-Daniel Lelièvre It is under discussion. The problem is to ensure that the seal is respected between a confined region and another which is not. But it may be relevant not to confine the entire country.
Are we doomed to see new variants appear almost every week?
Jean-Daniel Lelièvre Every week no, but regularly yes. The more the virus continues to diffuse in the population, the more variants will appear, selected naturally because they are more transmissible. One hypothesis is that these variants arise in immunocompromised subjects. The only possibilities to prevent this are confinement and a very broad vaccination. But unfortunately, we don’t have enough vaccines yet to do this.
Precisely, should we be worried about the delivery delays announced by Pfizer?
Jean-Daniel Lelièvre Yes and no. We knew that this process would take time. To reduce the threat of the virus, 80 to 90% of the population should be vaccinated. The delays of the last few days will therefore only play on the margins. The objective remains to vaccinate as many people as possible, starting with populations at risk, and then expanding. This vaccination must also be global, because the borders are not impermeable to the virus. However, there are concerns on this level which have led the WHO to bang their fists on the table, calling on the rich countries not to monopolize the doses. It would also be a bad calculation to do so, both economically and in terms of health.
Adverse effects of vaccines are also closely watched: in France, there were 139 in the first weeks and 5 suspicious deaths are being investigated … What do you say about these figures?
Jean-Daniel Lelièvre There are people who die every day in nursing homes. And it’s not necessarily related to vaccines. We must therefore look closely at each case, to understand what really happened. The ANSM has promised a weekly report on this subject. We should know more this weekend.
To ramp up this campaign, the authorities are awaiting the green light given to the AstraZeneca vaccine. Have doubts been raised about this serum?
Jean-Daniel Lelièvre Yes, it should soon be validated by the European Agency. The problem will be his positioning in the vaccination campaign, because the strategy that gives him the best results is a little original: the injection of a half-dose, then a dose. However, it has not been tested in people over 55 years old. It is a lack. But its approval will still feed the vaccination campaign.
