For weeks, France's Covid-19 case rate has risen rapidly with on average around 10,000 new positives confirmed each day.
When cases first began to rise hospital wards stayed relatively empty, leading some to hope that the virus had become weaker over the summer.
However in recent weeks that trend has reversed and hospitals and intensive care units are starting to see more patients.
There are however some differences to the situation in March and April.
Intensive care patients
ICU patients is the number that health authorities anxiously watch, as it gives the best indicator for deaths in the future.
If you compare the numbers gathered since March 1st to the newest numbers available (which were collected in the seven days before September 15th in Santé Publique France's weekly report), there seems to have been a lowering of the average age of those admitted into ICUs in France.
Of the total patients admitted to intensive care units since the beginning of pandemic, 71 percent were aged over 75.
But between September 8th and September 15th – the newest detailed data available – over 75s represented just 25 percent of the total ICU patients.
That week, 35 percent of patients were aged 45-64 and 31 percent were aged 65-74, a considerably younger profile than the early days of the epidemic.
Photo: Santé Publique France
'Younger than before'
“It's clear that we are seeing younger and younger patients being admitted into intensive care units,” Célestin-Alexis Agbessi, an emergency doctor at the Bichat Claude-Bernard Hospital in the 18th arrondissement in Paris, told The Local.
Agbessi and his colleagues increased their number of intensive care beds from 24 to 73 by transforming section after section of the hospital into intensive care areas. Most of their patients were very old and very vulnerable to serious complications from the virus.
However its last few weekly reports, Santé Publique France has warned about a worrying rise in the proportion of new cases among elderly, and the over-75s were the age group seeing the biggest increase in new cases over the seven days prior to September 15th.
In the greater Paris region Île-de-France, regional hospital group AP-HP saw numbers in ICUs double from 60 to 120 in two weeks.
“We're set for another doubling of these figures in the next fifteen days, we are preparing to host 250 intensive care patients at the end of the month,” François Crémieux, Deputy General Director of AP-HP told Le Monde on Tuesday.
The government this week announced a toughening on rules regulating bar opening hours and public gatherings in all areas with high levels of spread in a bid to reverse the trend.
As of September 15th, France had counted a total of 30,999 deaths caused by the pandemic. Of these, 20,471 were registered in France's hospitals and 10,528 in nursing homes for elderly (EHPAD) and other institutions.
Over the course of the epidemic, 92 percent of the total fatalities have been people aged over 62.
France on Tuesday reported 68 Covid-19 deaths in its hospitals, the highest number of daily fatalities recorded since the summer. On Wednesday the number was 43, lower but still above the average rate of a month ago.
These numbers are currently being analysed by Santé Public France, so as yet there is no detailed breakdown of the age profile of those dying from the virus in recent weeks.
However, Agbessi said the profile of those dying from the virus “is the same as before.” That is to say very old people, often with other pre-existing complications.
“The virus has not mutated and become more dangerous yet, so a 25-year-old without pre-existing illnesses will be better protected than someone with more risk factors,” he said.
An employee is having lunch in a room at the morgue of the Hospital (AP-HP) Bichat Claude Bernard in Paris. Photo: AFP
Hygiene protections for these institutions have improved, but the number of clusters – grouped outbreaks – across the country's EHPAD has grown, reaching a total of 180 on Tuesday, authorities worry that the death rate in these institutions will increase in the coming weeks.
“This winter could be very difficult, as we will see an increase in the number of other respiratory illnesses such as the flu. What are we going to do then?”