how will the vaccination of over 75s go?

After controversial beginnings, vaccination against Covid is opening up to the general public. From Monday, January 18, people over 75 who do not reside in an nursing home who have booked appointments will be able to get vaccinated.

→ ANALYSIS. Vaccination against Covid: in nursing homes, the race for consent

Registration is done online on one of the three platforms chosen by the government, Doctolib, Maiia and Keldoc, or on the official sante.fr website. An appointment by telephone is also possible, but, for the moment, no number has been communicated at the national level. “From January 22, the people concerned should receive a letter with the contact details of the centers on which they depend”, adds a case specialist.

The role of the attending physician

A prior visit by his general practitioner is not compulsory. Vaccination centers (village halls, hospitals, gymnasiums, etc.) should provide consultations before the injection, in particular to check the patient’s medical history and treatments, as well as to inform him. “But this will greatly streamline the process if the people who come have already completed a pre-consultation with their attending physician”, wishes Luc Duquesnel, doctor and president of the generalist branch at the Confederation of medical unions. Before calling back: “We know our patients and their health the best, and they trust us. “

For Vincent Renard, from the College of General Teachers, “The risk is to have patients facing unknown caregivers, who will take more or less the time for explanations”. “People who are convinced will be vaccinated anyway, but for those who hesitate, these centers may not be the best approach., he believes. Everything will depend on the territory, sometimes these centers will be very relevant with concerted action with professionals, and in other cases, they will only serve as showcases for a speed race of local elected officials. “

Appointments to group injections

Doctors cannot make the injection in an office, given the cold chain required by the two vaccines currently authorized in France. “On the other hand, we are mobilized to intervene in the vaccination centers”, continues Luc Duquesnel. In Strasbourg, the municipality has launched a broad appeal to the Liberals to be able to offer as many time slots as possible in the room which is due to open on January 18. “Health insurance should indicate how many people are eligible for this phase of vaccination in each territory, alerts the practitioner. We’re not going to open the same number of windows if we have 150 or 15,000 patients. ” In Nancy, where 19,000 people over 75 are potentially concerned, the vaccination campaign must exceptionally start this Wednesday, January 13, and the appointment books for the first two days are already well filled.

→ ANALYSIS. Anti-Covid vaccines: France prepares for a jump in reports of adverse reactions

“Each vial of the Pfizer product allows 5 to 6 doses of vaccine, so injections must be grouped together to avoid waste”, recalls Philippe Besset, president of the Federation of Pharmaceutical Unions. He claims the possibility for pharmacists to carry out vaccinations, as is already the case for influenza. Beyond the centers in the agglomerations, what about the rural areas where the elderly and isolated live, and those who can no longer move?

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The secret of the centenarians who defeated the coronavirus

SEEN FROM ELSEWHERE – They are more resilient than young people to the virus, and many of them had to fight the Spanish flu first. Explanations from an immunologist.

By Elena Dusi (The Republic)

They have just crushed the coronavirus under the weight of their 107 years. A lady from Caorle was declared cured on New Year’s Eve. Around the same time as another lady of the same age from Loro Piceno. But these are not the oldest citizens to have survived the coronavirus: last September and June, respectively, a 108-year-old man from Genoa and a woman of the same age from Milan also managed to knock out the virus. record, however, goes to the Spaniard Maria Branyas, born in 1907 and resident of a Catalan retirement home. The latter was probably infected during the party organized for her 113th birthday, but only developed a few mild symptoms.

Many cured centenarians remember beating the Spanish flu a century ago. ” What if it was the result of residual immunity? Claudio Franceschi, a professor, wonders

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of caregivers divided between doubt and impatience to be vaccinated

Bare arm, slightly tense smile: the photo is often taken at the time of the injection, then published a few minutes later on social networks. For a little over a week, the vaccination against Covid-19 has been open to all caregivers who are over 50 years old and to those who suffer from other diseases. Freshly bitten, some take the stage.

“I just had a bit of pain at the site of the bite. I’m going to post a new tweet to say it’s okay, smiles Philippe Amouyel, 61, professor of public health. This vaccine is our only way out of the crisis and we, caregivers, must set an example. “ The government is counting on them to give new impetus to the vaccination campaign (138,000 people vaccinated on Tuesday 12 January) and to convince the general public.

Very rare side effects

How many will be vaccinated? It’s still too early to tell “But it is an essential question, recognizes Professor Amouyel. Our only point of reference are the figures for the flu vaccination campaigns ”. However, Public Health France considers the national vaccine coverage against influenza in health establishments to be low (35% in 2018-2019) and points to disparities between professions: 67% for doctors, 48% for midwives, 36 % for nurses and 21% for nursing assistants.

“For the Covid vaccine, I wouldn’t say I’m reluctant but I’m waiting to see, declares Annie (1), 59, nursing assistant in an nursing home in Brittany, hit hard by the Covid. For now it’s no, but in June, it might be different. ” Édouard, 33, a liberal nurse in Saint-Étienne, also believes “Lack of perspective on side effects. But I’m not anti-vaccination at all, and when my elderly patients ask me, I tell them that the benefits outweigh the risks. “

Out of a dozen still skeptical caregivers questioned, it is this same argument on the speed of research that comes first, in front of the ignorance of the messenger RNA technique. “We now have several months of hindsight, opposes Professor Amouyel. Pfizer’s vaccine is 95% effective and like all medicines there may be side effects which are very rare. ” The Minister of Health, Olivier Véran, heard in the Assembly, indicated Tuesday, January 12 “Only one adverse case of an allergic nature” since the start of the campaign in France.

“I want to be a caregiver, but a protected carer”

Bénédicte Mignot, 54, a nurse at the Lille University Hospital, was impatient to be vaccinated: it has been done since January 4. “I was vaccinated against the H1N1 flu at the time without hesitation, she remembers. I want to be a caregiver, but a protected caregiver. “

Overexposed to the disease, Sophie, 39, nurse anesthetist at Strasbourg University Hospital, awaits her turn. “I’m not afraid of dying, but I don’t want to work like this for years. This vaccine is our only hope to return to normal life. “

→ EXPLICATION. The benefit-risk balance, the challenge of vaccines against Covid-19

“It’s still the best of arguments! abounds Romain, 32, an emergency nurse. When it comes to going on vacation, people don’t hesitate to get vaccinated against yellow fever! I am the father of a little boy and I will also get vaccinated to protect my loved ones. “

The motivation of Maxime, 29, a liberal nurse in Bordeaux, is also altruistic. “Many of my patients say they are against it. Leading by example will probably carry more weight than anything we can say. “

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how many patients in intensive care?

The beds occupied in the hospital are crucial figures for reflecting the daily strain on the health system. During the first wave, the peak of Covid-19 patients in the hospital was reached in mid-April (the 14th), with more than 32,131 beds occupied in France. In intensive care, it was April 8, with 7,000 people, when the initial capacity was then 5,000 beds.

During the second wave, it was in mid-November (the 10th) that the number of occupied beds was highest (31,477). Resuscitation stays for Covid are, on the other hand, much less numerous at this stage than at the height of the crisis of the first semester, with a rate of intensive care admissions of 400 to 500 people per day.

The big difference between spring and today is better care for Covid patients, treated early with high flow oxygen. They are given anticoagulants to prevent embolism and stroke, and they are given corticosteroids to calm inflammatory conditions.

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WHO in China, a study on the variant in France, giant vaccination centers in the United Kingdom… The recap of January 11

► One year after the first death, the WHO finally expected in China

Ten investigators from the World Health Organization (WHO) will travel to China from Thursday, January 14, and in particular to the city of Wuhan, where the first victim of Covid-19 was identified just a year ago . This survey aims to determine the origin of the disease, which has since made more than 1.9 million in the world.

→ LARGE FORMAT. Covid-19: how investigators trace the virus

In recent months, the Chinese government has reacted very badly to requests for an independent investigation, which explains the long delay for its implementation and risks complicating the task of scientists on the first traces of the infection.

► France measures the effect of the holidays and the British variant on the spread of the virus

While the circulation of the virus started to rise again in December in France, the end-of-year celebrations raise fears of a sharper rebound in January. Public Health France recorded 96,743 positive cases the week of December 28, “In clear increase”, and 28,830 people tested on January 4, the day of the start of the school year, were positive, the highest since mid-November.

Another worry: how far has the variant that caused an outbreak in the UK settled in France? To answer this question, a national survey, the results of which are expected in the middle of the week, was conducted. At this stage, only three potential clusters have been identified, in Bagneux in the Paris region, in Marseille and in Brittany.

► 23 French departments now under cover from 6 p.m.

Since Sunday January 10, 23 departments are now subject to a curfew from 6 p.m. The eight new departments concerned are Cher, Allier, Côte-d’Or, Haut-Rhin, Bas-Rhin, as well as Vaucluse, Alpes-de-Haute-Provence and Bouches-du-Rhône .

→ DEBATE. Should the winners of the crisis contribute more to deleveraging?

The mayor LR of Cannes and three other neighboring municipalities attacked Monday before the administrative court the decree instituting the curfew by denouncing his “Perverse effects”. The Assembly must consider a further extension of the state of health emergency on Monday January 18.

► Seven giant vaccination centers opened in the United Kingdom

Prime Minister Boris Johnson has inaugurated in Bristol one of the seven mass vaccination centers open in the United Kingdom. In addition to these giant centers established in conference centers or stadiums, notably in London, Birmingham and Manchester, more than a thousand sites, such as hospitals and town medicine centers, have been set up since the start of the campaign on December 8.

→ MAINTENANCE. “Europe is not lagging behind when it comes to vaccines”

To stem the outbreak of contamination, the government hopes to immunize 15 million people by mid-February.

► The world’s largest vaccination campaign begins in India

In India, the world’s most ambitious vaccination campaign will begin on Saturday, January 16. The country hopes to vaccinate 300 million people by July. The 30 million healthcare workers and those most exposed to the disease will be the first, followed by around 270 million people over 50 or in a state of great vulnerability. India is the second most affected country – after the United States – by Covid-19, with more than 10 million reported cases, even though the death rate is one of the lowest in the world.

► Joe Biden will receive the second dose of the Covid-19 vaccine on Monday

US President-elect Joe Biden will receive the second dose of the Covid-19 vaccine on Monday, three weeks after the first injection. This second injection will be, like the first, administered in front of the media.

► Suspension of the European Rugby Cups

L’EPCR “Has no choice but to announce (…) a temporary suspension” of the group stage of the two continental competitions (Champions Cup and Challenge Cup), announced the organizer of the European Rugby Cups after the decision of the French government to ban Franco-British matches “At least until the beginning of February”.

The 3e and 4e days of these European Cups were to take place on the weekends of January 15 and 22. The next dates for these competitions are therefore now in the dark.

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how is the “RO” parameter calculated

The effective reproduction rate of the virus is a fundamental indicator of epidemic surveillance.

The R0 is the number which represents the average reproduction rate (or the average speed of contagion) of a disease, that is to say how many people on average a single infected individual risks infecting around him.

It is calculated by multiplying three factors: 1 / transmissibility, which depends on the mode of transmission of the disease (contact, droplets…) but also on hygiene and prevention measures in the population.

2/ Le contact social, that is to say the number of people crossed on average per day by each individual and the degree of contact between them (kiss, handshake, physical proximity, etc.)

3 / The duration of the contagious period, specific to each virus, and which varies between people and the degree of infection.

If it is greater than 1, the number of new cases increases every day: the dynamic is exponential, it is runaway. If it is equal to 1, the number of new cases is constant over time: the dynamics are linear, the epidemic under control. If it is less than 1, the number of new cases gradually decreases and the virus eventually disappears.

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Masks transformed into rules for schoolchildren, Meudon launches into recycling

25 collection points have been distributed in Meudon in order to recycle surgical, FFP2 and fabric masks.

With the Covid-19 epidemic, new polluting waste has appeared. When they are not on our face, the masks are sometimes thrown on the ground. To fight against this urban pollution, the city of Meudon, in Hauts-de-Seine, is launching a collection operation with the aim of recycling surgical, FFP2 and fabric masks.

This is not the first operation of this kind in Meudon. The City is working to fight against polluting waste in urban areas – starting in April 2019 with the collection of cigarette butts. With the Covid-19 epidemic, it is now the masks that litter the ground. According to the Zero Waste association, wearing two masks a day generates around 400 tonnes of plastic waste. To overcome this problem, 25 collection points have been set up near markets, schools and administrative buildings in Meudon. An unprecedented and experimental operation. The principle is simple: once the mask is used, the inhabitants simply have to drop it off in one of the terminals. After quarantine of 7 days, a second life awaits him.

From masks to rulers for schoolchildren

The recycled masks will be transformed into rulers, squares and protractors made for the students of Meudon. If this ecological resolution already appears attractive in terms of recycling, a second initiative is behind this process. After the waste has been quarantined, the masks are collected, disinfected and then sorted by the association for the professional and human integration and reintegration of the disabled (ANRH). Recognized as a public utility, it allows people with disabilities to “to contribute locally to global issues».

Once this step is completed, the masks are sent to the start-up Plaxtil, in Châtellerault, responsible for carrying out the transformation. The company has developed a new polymer composite material. Injected into a mold, it then becomes a new recycled object. The start-up plans to collect 10,000 to 15,000 masks in Meudon – a figure far from the 120,000 hoped by the town hall to extend the initiative. This approach is not only ecological. It is “raise students’ awareness of recycling and environmental issues“But also to promote”circular economy».

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AIDS and coronavirus, when research converges

If the entire planet is grappling with the coronavirus, there is an epidemic not to be forgotten: that of AIDS. The rapid progress in the fight against Covid impress and challenge us, unlike those against HIV, who are slipping after clear improvements in treatment. ” Faced with AIDS, we started from nothing, would like to remind Morgane Bomsel, virologist at the Cochin Institute. There, we already knew the coronaviruses well because of the two previous epidemics, SARS and Mers. »

Although both are RNA viruses, the mechanisms of infection – and of course the symptoms – of HIV and SARS-Cov-2 have nothing to do with it. The retrovirus responsible for AIDS integrates into the nucleus of cells, unlike the coronavirus. It is therefore much more difficult to fight it, stop it, or even target it.

As a result also, HIV induces chronic disease, where SARS-Cov-2 is only occasional. ” In an acute viral infection, it appears more important to get vaccines quickly, while for a chronic disease, treatment will be preferred. », Recalls Brigitte Autran, from the center of immunology and infectious diseases. In other words, it is quite normal to have vaccines against Covid-19, the outcome of which is decided in a few weeks, and treatments against AIDS, with which you have to live your whole life.

HIV is a much more complex virus

However, vaccines against the coronavirus have greatly benefited from research against AIDS. “Unable to develop a vaccine against HIV with traditional methods, we began to imagine vaccines with recombinant vectors”, says Brigitte Autran. A technique that can be found in certain products against Covid, such as the Russian Sputnik V or that of AstraZeneca. Since 1is In January, the Inserm Reacting consortium, very mobilized against Covid, and the national research agency on AIDS and viral hepatitis were merged into a single entity.

So why do coronavirus vaccines come before HIV vaccines? Quite simply because HIV is a much more complex virus to pin down, and which mutates far too quickly. ” HIV has extremely strong immune system escape mechanisms, confirms Brigitte Autran. An HIV-infected patient produces about a billion mutants per day, which is as many as the number of influenza mutants on the planet in a year. “ Knowing that we already change flu shots every year …

Good news, however, has come from research on the coronavirus: the technological flexibility and rapidity of development of RNA vaccines, such as Pfizer. ” It won’t work any miracles and the specific problems of an HIV vaccine will not change, but maybe we will go faster in the tests. “, Wants to believe the specialist. ” Developing vaccines for the respiratory tract to prevent the transmission of the coronavirus would also be a good step forward for possible vaccines against HIV, to block the transmission of the virus in the genital mucous membranes. », Adds Morgane Bomsel.

Barrier actions and protection against AIDS

Beyond medical discoveries, the AIDS epidemic has provided experiences on the logistics of deployment and access to drugs, especially in the poorest countries. Experiences that can be used to avoid, perhaps, “hiccups” with anti-Covid vaccines.

→ CHRONICLE. AIDS, this “plague of modern times” which no longer prevents people from living

Infectious disease specialists also hope that the discourse on barrier gestures, well anchored in practices with the coronavirus epidemic, will make it possible to relaunch communication around protective measures against AIDS.

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the only hospital in Saint-Pierre-et-Miquelon disrupted by a cluster

The French archipelago of Saint-Pierre-et-Miquelon, which had recorded only 16 cases of Covid-19 since the start of the pandemic, has been facing several contaminations since Friday, January 22, which restrict the activity of its only hospital and forced the state high school to close some classes.

Four positive cases of Covid-19 were identified on Friday by the Territorial Health Administration, announced the prefecture of Saint-Pierre-et-Miquelon. The first two concern two doctors on mission for a week at the François Dunan Hospital Center in Saint-Pierre. Another hospital practitioner, as well as his high school son, were infected.

This is the first time that the archipelago has recorded endogenous cases resulting from non-familial transmission. The two medical specialists and the emergency physician having been in contact with patients in the days preceding their test, the health authorities have already identified “at least 65 contact cases»At the hospital, and at the high school where the fourth identified case is attending. PCR tests began immediately to assess their positivity and will continue on Saturday January 23.

As a precaution, the Saint-Pierre-et-Miquelon hospital has invited its non-essential staff to stay at home and has restricted its activity to essential interventions. Health authorities have also ordered a comprehensive testing campaign among hospital staff, more than 300 people. In view of the limited local capacities, part of the samples will be sent and analyzed in neighboring Canada, in an approved laboratory in Halifax.

One of the four positive cases being a final year student at the Emile Letournel high school in Saint-Pierre, the national education services also decided to close the general terminal classes for two weeks, and re-established the obligation to wear mask for school children six years and older.

For security reasons, the authorities have also recommended the cancellation of all sporting and cultural events until further notice and invited the 6,000 residents to limit their social interactions and scrupulously respect barrier gestures. Bars and restaurants can ‘for the moment»Continue their activities, in this territory where restrictions have been lifted since the end of the first confinement.

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Vaccinations suspended for two days in the Bas-Rhin

Faced with delivery delays, the Grand Est Regional Health Agency has postponed the vaccinations scheduled for early next week.

A possible vaccine shortage could emerge in the Bas-Rhin. The Grand Est Regional Health Agency (ARS) announced this week that the opening of several vaccination centers would be postponed in the department. At issue: “Decreases in deliveries of Pfizer vaccines over the next two weeks”. Four centers, in the municipalities of Wasselone, Illkirch-Graffenstaden, Schiltigheim and Lingolsheim, will open their doors on January 28, with a “8 day lag”. The ARS also reports a “Postponement of vaccinations scheduled for Monday 25 and Tuesday 26 January” while waiting for the next vaccine delivery. Appointments will be integrated “In the schedules of the coming weeks”. In the rest of the Grand Est region, some centers will close “Temporarily Thursday and Friday” in the Marne, while in Haute-Marne, closures are also under consideration “for several days”.

In Strasbourg, 600 meetings had to be postponed, reports France Bleu Alsace. “There is tension on the number of vaccines, the Bas-Rhin has been very proactive, 5,500 appointments have been made in a few days”, explains Alexandre Feltz, doctor and Strasbourg elected official in charge of health, interviewed by the radio. According to him, vaccinations should resume Wednesday with “a lighter intensity». “The Haut-Rhin can continue to vaccinate but with a lower intensity”, he continues. The Latest News from Alsace explained Wednesday evening that no more appointments were available for a first injection in any of the Alsatian centers open on the Doctolib platform. Internet users are referred to making appointments by telephone, which is itself saturated.

We are in the dark. We open we close. We adapt according to the number of doses we receive.

Rémi Heym, communication director of Rouen University Hospital

Several other regions are unable to cope with the influx of demands. In Alençon, the ARS of Normandy asked the hospital on Tuesday to close its vaccination center which had been open for two weeks, reports West France . The number of vaccine doses available was again not sufficient to meet the appointments. Only second injections are possible. For lack of dose, the Rouen University Hospital was also forced to close a vaccination center. “Supplies are not stabilized”, explains Rémi Heym, communication director of the CHU, interviewed by France 3 Normandie. “We are in the dark. We open we close. We adapt according to the number of doses we receive. We can no longer vaccinate massively. ” In Nord and Pas-de-Calais, several appointments had to be canceled, vaccination centers having received fewer doses than initially planned, according to The voice of the North. The opening of a new center in Calais has even been postponed by a week.

Vaccination against Covid-19 has widened since Monday to all over 75s, amid fears of a shortage. Because the American group Pfizer, associated with the German laboratory BioNTech, warned last week that it was not going to be able, until early February, to provide EU countries with the weekly quantities to which it had obtained. engaged. The laboratory invokes modifications to be made in the production line of the Belgian factory in Puurs, which “Require additional regulatory approvals”, Pfizer explained. “The schedule calls for a drop in delivery of 140,000 doses this week and, starting next week, we will have 520,000 weekly deliveries”, as initially planned, detailed Monday the Minister for Industry, Agnès Pannier-Runacher, on CNews. According to her, the accumulated delay will be caught up “At the end of the first trimester”.


»SEE ALSO – “Chez Mauricette”: in Poissy, immersion in the heart of a vaccination center against Covid-19

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