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COVID-19

Coronavirus: The data from France, Italy and Spain that provides a glimmer of hope

While the epidemic situation across Europe remains extremely serious, there are numbers coming out of Italy, Spain and France - the three worst affected countries so far - that give cause for cautious optimism.

Coronavirus: The data from France, Italy and Spain that provides a glimmer of hope
France, Spain and Italy are the hardest hit countries in Europe so far. Photo: AFP

The latest statistics on recovery rates, intensive care admissions and death rates from these countries is providing a small gleam of hope in what remains a very serious situation.

All three countries are still reporting hundreds of deaths every day, and each have imposed strict lockdown measures on their populations, which are likely to continue for weeks if not months.

France, Italy and Spain have all imposed strict lockdown measures in an attempt to contain the spread of the virus. Photo: AFP

Health systems in all three countries are struggling with the sheer number of cases of coronavirus and medics have reported extremely difficult situations in which they are forced to make heartbreaking decisions.

But while no-one is suggesting we get complacent about the sheer scale of the challenge facing all three governments, scientists say there is some emerging data that gives them cause for cautious optimism.

Daily death tolls

The question everyone is asking is 'when will this peak and then start to get better' but the one thing that virtually all medical and scientific experts agree on is that this is impossible to predict with any kind of accuracy.

Italian epidemiologist Pierluigi Lopalco has been widely quoted as saying that predicting any further than three days ahead “would involve relying on a crystal ball”.

Italy reported more than 800 deaths on Monday, and while this figure is shockingly high, it is still down from the 969 deaths recorded on Friday.

Italian health authorities have urged caution and said it is too early to declare a trend, but there is some hope that the numbers will continue to slow.

In France and Spain numbers are still rising every day, and these countries are generally estimated to be between one week and 10 days behind Italy in the progress of the epidemic.

Emergency departments in Spain are under severe pressure. Photo: AFP 

Hospital/intensive care admissions

Experts say this is the crucial number to watch with France's Director General of Health Jérôme Salomon saying this is “the most important number to give an indicator of coming days”.

Coronavirus patients display a wide range in the severity of their symptoms – for around 80 percent of people the symptoms are relatively mild and do not require hospital treatment. However around 15 percent develop pneumonia type symptoms and breathing difficulties, while five percent develop very severe symptoms – often but not always patients who are elderly and have underlying health conditions.

The number of people who need intensive care treatment and ventilators is putting a severe strain on health services in all three countries.

Of the people who need intensive care treatment, the average patient is there for 14 to 21 days before they either recover or die – therefore the number of intensive care patients provides a crucial indicator of the likely death rate for the coming days.

It is also the number that public health bosses are looking at anxiously to see if they have the facilities they need for such critically ill patients.

And in all three countries, the number of new patients being admitted to hospital per day is slowing, with the trend particularly marked in Italy.

This graph shows from Spain show the number of hospitalisations (blue) recoveries (green), admission to intensive care (yellow) and deaths (red) through March. Graphic: Ministerio de Sanidad

“We can be cautiously optimistic for Italy,” Marie-Paule Kierny, former deputy director of the World Health Organisation, told French newspaper Le Parisien.

Despite the overall trend there are still concerns for medical facilities where a lot of cases are concentrated, especially as more cases are reported in southern Italy which in general has fewer facilities than in the north.

In France patients have been airlifted or shipped by special trains out of the worst affected regions in the east of the country.

An exhausted medic takes a break in a Paris hospital. Photo:AFP

Recovery rates

While deaths naturally grab the headlines, it remains the case that the majority of people admitted to hospital with coronavirus will recover and go home.

Calculating recovery rates is tricky because, as with the death rate, there is a time lag. So the people leaving hospital now will have been infected two to three weeks ago – before lockdown measures began in France and Spain.

Calculating them as a percentage of the total number of cases is even more problematic because countries have very different testing policies and pretty much the only constant is that the officially confirmed cases are just a fraction of the number of people who actually have the virus.

Nevertheless, the numbers of patients recovering from coronavirus are encouraging.

On Monday the French public health body listed 792 patients who has recovered and been sent home, set against 424 who had need ventilating that day.

In Italy on Monday 1,590 people recovered – the largest number of recoveries in a single day since the outbreak began.

Of Italy's 101,793 confirmed cases since the outbreak began, 11,591 people have died and 14,620 are listed as having recovered.

Italy has also seen a marked slowdown of new cases reported in recent days, with Monday's new cases around 1,000 lower than the new cases over the weekend.

 

* Data cited in this article comes from Santé Publique France, Johns Hopkins University, Spain's Ministerio de Sanidad and Italy's Protetzione Civile

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HEALTH

Experts warn of high levels of flu in France this winter

Experts have warned of a particularly bad flu epidemic this winter in France due to a combination of lowered immune systems and 'vaccine apathy' - urging high-risk groups to get their shot as soon as the flu vaccination campaign begins in October.

Experts warn of high levels of flu in France this winter

France’s annual flu vaccine campaign will officially get under way on October 18th this year – and medical experts have warned that this year’s season may be a bad one amid fears of “vaccine apathy”.

When, where and how to get flu shots and Covid boosters in France this autumn

Immunologist Alain Fischer, who chaired France’s Conseil d’orientation de la stratégie vaccinale throughout the Covid-19 pandemic said that the high number of flu cases in Australia and the southern hemisphere in its winter were “a warning sign” that this winter’s flu, coupled with rising cases of Covid-19, could lead to a sharp rise in hospitalisations again in the winter.

“For two years, influenza has been kept at bay, thanks to the barrier measures we have put in place against Covid,” he told Le Parisien. 

“This year, it will be difficult to maintain the same level of protection: masks, distancing, intensive hand washing … Faced with this relaxation, there is a serious risk of flu epidemic.”

Between two million and six million people contract flu every winter in France. The infection is responsible for between 4,000 and 6,000 deaths every year, usually among people aged 65 and over. But in ‘bad’ flu years, that mortality figure can rise rapidly.

READ ALSO When, where and how to get flu shots and Covid boosters this autumn in France

The country, meanwhile, is at the start of what is being described as an “eighth wave” of Covid, and the Haute Autorité de santé recommends the eligible, vulnerable people ensure they are vaccinated against both viruses as early as possible. “A Covid-flu cohabitation is not a good thing,”  Fischer said. “It is synonymous with a very high number of hospitalisations. 

“Hence the objective of two strong vaccination campaigns – Covid and flu – especially for the most vulnerable.”

“The double injection is very good, and practical for patients. But I think that we should not wait, especially vulnerable people. It is a mistake to think that you will get your Covid booster when the flu vaccine is here – the Covid jab should not be delayed.”

Currently less than 40 percent of people eligible for a fourth Covid vaccine have received their latest dose.

Dual-strain Covid-19 vaccines designed to combat both delta and omicron variants will be available in France from October 3rd.

READ ALSO France approves new vaccines for Covid Omicron sub-variants

“It is quite possible to get your Covid injection in early October and flu vaccine in late October – you will need both anyway,” Fischer said.

The Haute Autorité de Santé recommends influenza vaccination for the following groups:

  • people aged 65 and over; 
  • people with chronic diseases; 
  • pregnant women;
  • people suffering from obesity (BMI equal to or greater than 40 kg/m 2 );
  • Infants under 6 months at risk of serious influenza;
  • Families and others close to immunocompromised people; 
  • home help workers caring for vulnerable individuals.

For anyone in these groups, the flu vaccine is 100 percent covered by health insurance and delivered free of charge to the pharmacy, on presentation of a voucher.

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