• Why the Swedish Model for Fighting COVID-19 Is a Disaster | Time
    https://time.com/5899432/sweden-coronovirus-disaster

    Le fameux modèle suédois de lutte contre le #covid est une immense #imposture basée sur le précepte ultra-libéral du #laisser-faire, voire plus franchement de l’#eugénisme social.
    Non seulement ils ont imposé l’#immunité_de_troupeau à la population en lui mentant assez éfrontément, mais ils ont carrément donné un coup de pouce à la #contamination_de_masse en ouvrant massivement les #écoles pour en faire des #accélérateurs d’#épidémie.

    Et cette #forfaiture #criminelle est à présent à l’œuvre chez nous

    The Swedish COVID-19 experiment of not implementing early and strong measures to safeguard the population has been hotly debated around the world, but at this point we can predict it is almost certain to result in a net failure in terms of death and suffering. As of Oct. 13, Sweden’s per capita death rate is 58.4 per 100,000 people, according to Johns Hopkins University data, 12th highest in the world (not including tiny Andorra and San Marino). But perhaps more striking are the findings of a study published Oct. 12 in the Journal of the American Medical Association, which pointed out that, of the countries the researchers investigated, Sweden and the U.S. essentially make up a category of two: they are the only countries with high overall mortality rates that have failed to rapidly reduce those numbers as the pandemic has progressed.

    Yet the architects of the Swedish plan are selling it as a success to the rest of the world. And officials in other countries, including at the top level of the U.S. government, are discussing the strategy as one to emulate—despite the reality that doing so will almost certainly increase the rates of death and misery.

    Countries that locked down early and/or used extensive test and tracing—including Denmark, Finland, Norway, South Korea, Japan, Taiwan, Vietnam and New Zealand—saved lives and limited damage to their economies. Countries that locked down late, came out of lock down too early, did not effectively test and quarantine, or only used a partial lockdown—including Brazil, Mexico, Netherlands, Peru, Spain, Sweden, the U.S. and the U.K.—have almost uniformly done worse in rates of infection and death.

    Despite this, Sweden’s Public Health Agency director Johan Carlson has claimed that “the Swedish situation remains favorable,” and that the country’s response has been “consistent and sustainable.” The data, however, show that the case rate in Sweden, as elsewhere in Europe, is currently increasing.

    Average daily cases rose 173% nationwide from Sept. 2-8 to Sept. 30-Oct. 6 and in Stockholm that number increased 405% for the same period. Though some have argued that rising case numbers can be attributed to increased testing, a recent study of Stockholm’s wastewater published Oct. 5 by the Swedish Royal Institute of Technology (KTH) argues otherwise. An increased concentration of the virus in wastewater, the KTH researchers write, shows a rise of the virus in the population of the greater Stockholm area (where a large proportion of the country’s population live) in a way that is entirely independent of testing. Yet even with this rise in cases, the government is easing the few restrictions it had in place.

    From early on, the Swedish government seemed to treat it as a foregone conclusion that many people would die. The country’s Prime Minister Stefan Löfven told the Swedish newspaper Dagens Nyheter on April 3, “We will have to count the dead in thousands. It is just as well that we prepare for it.” In July, as the death count reached 5,500, Löfven said that the “strategy is right, I am completely convinced of that.” In September, Dr. Anders Tegnell, the Public Health Agency epidemiologist in charge of the country’s COVID-19 response reiterated the party line that a growing death count did “not mean that the strategy itself has gone wrong.” There has been a lack of written communication between the Prime Minister and the Public Health Authority: when the authors requested all emails and documents between the Prime Minister’s office and the Public Health Authority for the period Jan. 1—Sept. 14, the Prime Minister’s Registrar replied on Sept. 17 that none existed.

    Despite the Public Health Agency’s insistence to the contrary, the core of this strategy is widely understood to have been about building natural “herd immunity”—essentially, letting enough members of a population (the herd) get infected, recover, and then develop an immune system response to the virus that it would ultimately stop spreading. Both the agency and Prime Minister Löfven have characterized the approach as “common sense“ trust-based recommendations rather than strict measures, such as lockdowns, which they say are unsustainable over an extended period of time—and that herd immunity was just a desirable side effect. However, internal government communications suggest otherwise.

    Emails obtained by one of the authors through Freedom of Information laws (called offentlighetsprincipen, or “Openness Principle,” in Swedish) between national and regional government agencies, including the Swedish Public Health Authority, as well as those obtained by other journalists, suggest that the goal was all along in fact to develop herd immunity. We have also received information through sources who made similar requests or who corresponded directly with government agencies that back up this conclusion. For the sake of transparency, we created a website where we’ve posted some of these documents.

    One example showing clearly that government officials had been thinking about herd immunity from early on is a March 15 email sent from a retired doctor to Tegnell, the epidemiologist and architect of the Swedish plan, which he forwarded to his Finnish counterpart, Mika Salminen. In it, the retired doctor recommended allowing healthy people to be infected in controlled settings as a way to fight the epidemic. “ One point would be to keep schools open to reach herd immunity faster ,” Tegnell noted at the top of the forwarded email.

    Salminen responded that the Finnish Health Agency had considered this but decided against it, because “over time, the children are still going to spread the infection to other age groups.” Furthermore, the Finnish model showed that closing schools would reduce “the attack rate of the disease on the elderly” by 10%. Tegnell responded: “10 percent might be worth it?”

    The majority of the rest of Sweden’s policymakers seemed to have agreed: the country never closed daycare or schools for children under the age of 16, and school attendance is mandatory under Swedish law, with no option for distance learning or home schooling, even for family members in high risk groups. Policymakers essentially decided to use children and schools as participants in an experiment to see if herd immunity to a deadly disease could be reached. Multiple outbreaks at schools occurred in both the spring and autumn.

    At this point, whether herd immunity was the “goal” or a “byproduct” of the Swedish plan is semantics, because it simply hasn’t worked. In April, the Public Health Agency predicted that 40% of the Stockholm population would have the disease and acquire protective antibodies by May. According to the agency’s own antibody studies published Sept. 3 for samples collected up until late June, the actual figure for random testing of antibodies is only 11.4% for Stockholm, 6.3% for Gothenburg and 7.1% across Sweden. As of mid-August, herd immunity was still “nowhere in sight,” according to a Journal of the Royal Society of Medicine study. That shouldn’t have been a surprise. After all, herd immunity to an infectious disease has never been achieved without a vaccine.

    Löfven, his government, and the Public Health Agency all say that the high COVID-19 death rate in Sweden can be attributed to the fact that a large portion of these deaths occurred in nursing homes, due to shortcomings in elderly care.

    However, the high infection rate across the country was the underlying factor that led to a high number of those becoming infected in care homes. Many sick elderly were not seen by a doctor because the country’s hospitals were implementing a triage system that, according to a study published July 1 in the journal Clinical Infectious Diseases, appeared to have factored in age and predicted prognosis. “This likely reduced [intensive care unit] load at the cost of more high-risk patients”—like elderly people with confirmed infection—dying outside the ICU.” Only 13% of the elderly residents who died with COVID-19 during the spring received hospital care, according to preliminary statistics from the National Board of Health and Welfare released Aug.

    In one case which seems representative of how seniors were treated, patient Reza Sedghi was not seen by a doctor the day he died from COVID-19 at a care home in Stockholm. A nurse told Sedghi’s daughter Lili Perspolisi that her father was given a shot of morphine before he passed away, that no oxygen was administered and staff did not call an ambulance. “No one was there and he died alone,” Perspolisi says.

    In order to be admitted for hospital care, patients needed to have breathing problems and even then, many were reportedly denied care. Regional healthcare managers in each of Sweden’s 21 regions, who are responsible for care at hospitals as well as implementing Public Health Agency guidelines, have claimed that no patients were denied care during the pandemic. But internal local government documents from April from some of Sweden’s regions—including those covering the biggest cities of Stockholm, Gothenburg and Malmö—also show directives for how some patients including those receiving home care, those living at nursing homes and assisted living facilities, and those with special needs could not receive oxygen or hospitalization in some situations. Dagens Nyheter published an investigation on Oct. 13 showing that patients in Stockholm were denied care as a result of these guidelines. Further, a September investigation by Sveriges Radio, Sweden’s national public broadcaster, found that more than 100 people reported to the Swedish Health and Care Inspectorate that their relatives with COVID-19 either did not receive oxygen or nutrient drops or that they were not allowed to come to hospital.

    These issues do not only affect the elderly or those who had COVID-19. The National Board of Health and Welfare’s guidelines for intensive care in extraordinary circumstances throughout Sweden state that priority should be given to patients based on biological, not chronological, age. Sörmlands Media, in an investigation published May 13, cited a number of sources saying that, in many parts of the country, the health care system was already operating in a way such that people were being denied the type of inpatient care they would have received in normal times. Regional health agencies were using a Clinical Frailty Scale, an assessment tool designed to predict the need for care in a nursing home or hospital, and the life expectancy of older people by estimating their fragility, to determine whether someone should receive hospital care and was applied to decisions regarding all sorts of treatment, not only for COVID-19. These guidelines led to many people with health care needs unrelated to COVID-19 not getting the care they need, with some even dying as a result—collateral damage of Sweden’s COVID-19 strategy.

    Dr. Michael Broomé, the chief physician at Stockholm’s Karolinska Hospital’s Intensive Care Unit, says his department’s patient load tripled during the spring. His staff, he says, “have often felt powerless and inadequate. We have lost several young, previously healthy, patients with particularly serious disease courses. We have also repeatedly been forced to say no to patients we would normally have accepted due to a lack of experienced staff, suitable facilities and equipment.”

    In June, Dagens Nyheter reported a story of one case showing how disastrous such a scenario can be. Yanina Lucero had been ill for several weeks in March with severe breathing problems, fever and diarrhea, yet COVID-19 tests were not available at the time except for those returning from high risk areas who displayed symptoms, those admitted to the hospital, and those working in health care. Yanina was only 39 years old and had no underlying illnesses. Her husband Cristian brought her to an unnamed hospital in Stockholm, but were told it was full and sent home, where Lucero’s health deteriorated. After several days when she could barely walk, an ambulance arrived and Lucero was taken to Huddinge hospital, where she was sedated and put on a ventilator. She died on April 15 without receiving a COVID-19 test in hospital.

    Sweden did try some things to protect citizens from the pandemic. On March 12 the government restricted public gatherings to 500 people and the next day the Public Health Agency issued a press release telling people with possible COVID-19 symptoms to stay home. On March 17, the Public Health Agency asked employers in the Stockholm area to let employees work from home if they could. The government further limited public gatherings to 50 people on March 29. Yet there were no recommendations on private events and the 50-person limit doesn’t apply to schools, libraries, corporate events, swimming pools, shopping malls or many other situations. Starting April 1, the government restricted visits to retirement homes (which reopened to visitors on Oct. 1 without masks recommended for visitors or staff). But all these recommendations came later than in the other Nordic countries. In the interim, institutions were forced to make their own decisions; some high schools and universities changed to on-line teaching and restaurants and bars went to table seating with distance, and some companies instituted rules about wearing masks on site and encouraging employees to work from home.

    Meanwhile Sweden built neither the testing nor the contact-tracing capacity that other wealthy European countries did. Until the end of May (and again in August), Sweden tested 20% the number of people per capita compared with Denmark, and less than both Norway and Finland; Sweden has often had among the lowest test rates in Europe. Even with increased testing in the fall, Sweden still only tests only about one-fourth that of Denmark.

    Sweden never quarantined those arriving from high-risk areas abroad nor did it close most businesses, including restaurants and bars. Family members of those who test positive for COVID-19 must attend school in person, unlike in many other countries where if one person in a household tests positive the entire family quarantines, usually for 14 days. Employees must also report to work as usual unless they also have symptoms of COVID-19, an agreement with their employer for a leave of absence or a doctor recommends that they isolate at home.

    On Oct. 1, the Public Health Authority issued non-binding “rules of conduct” that open the possibility for doctors to be able to recommend that certain individuals stay home for seven days if a household member tests positive for COVID-19. But there are major holes in these rules: they do not apply to children (of all ages, from birth to age 16, the year one starts high school), people in the household who previously have a positive PCR or antibody test or, people with socially important professions, such as health care staff (under certain circumstances).

    There is also no date for when the rule would go into effect. “It may not happen right away, Stockholm will start quickly but some regions may need more time to get it all in place,” Tegnell said at a Oct. 1 press conference. Meanwhile, according to current Public Health Agency guidelines issued May 15 and still in place, those who test positive for COVID-19 are expected to attend work and school with mild symptoms so long as they are seven days post-onset of symptoms and fever free for 48 hours.

    Sweden actually recommends against masks everywhere except in places where health care workers are treating COVID-19 patients (some regions expand that to health care workers treating suspected patients as well). Autumn corona outbreaks in Dalarna, Jönköping, Luleå, Malmö, Stockholm and Uppsala hospitals are affecting both hospital staff and patients. In an email on April 5, Tegnell wrote to Mike Catchpole, the chief scientist at the European Center for Disease Control and Prevention (ECDC): “We are quite worried about the statement ECDC has been preparing about masks.” Tegnell attached a document in which he expresses concern that ECDC recommending facemasks would “imply that the spread is airborne which would seriously harm further communication and trust among the population and health care workers” and concludes “we would like to warn against the publication of this advice.” Despite this, on April 8 ECDC recommended masks and on June 8 the World Health Organization updated its stance to recommend masks.

    Sweden’s government officials stuck to their party line. Karin Tegmark Wisell of the Public Health Agency said at a press conference on July 14 that “we see around the world that masks are used in a way so that you rather increase the spread of infection.” Two weeks later, Lena Hallengren, the Minister of Health and Social Affairs, spoke about masks at a press conference on July 29 and said, “We don’t have that tradition or culture” and that the government “would not review the Public Health Agency’s decision not to recommend masks.”

    All of this creates a situation which leaves teachers, bus drivers, medical workers and care home staff more exposed, without face masks at a time when the rest of the world is clearly endorsing widespread mask wearing.

    On Aug. 13, Tegnell said that to recommend masks to the public “quite a lot of resources are required. There is quite a lot of money that would be spent if you are going to have masks.” Indeed, emails between Tegnell and colleagues at the Public Health Agency and Andreas Johansson of the Ministry of Health and Social Affairs show that the policy concerns of the health authority were influenced by financial interests, including the commercial concerns of Sweden’s airports.

    Swedavia, the owner of the country’s largest airport, Stockholm Arlanda, told employees during the spring and early summer they could not wear masks or gloves to work. One employee told Upsala Nya Tidning newspaper on Aug. 24 “Many of us were sick during the beginning of the pandemic and two colleagues have died due to the virus. I would estimate that 60%-80% of the staff at the security checks have had the infection.”

    “Our union representatives fought for us to have masks at work,” the employee said, “but the airport’s response was that we were an authority that would not spread fear, but we would show that the virus was not so dangerous.” Swedavia’s reply was that they had introduced the infection control measures recommended by the authorities. On July 1, the company changed its policy, recommending masks for everyone who comes to Arlanda—that, according to a Swedavia spokesperson, was not as a result of “an infection control measure advocated by Swedish authorities,” but rather, due to a joint European Union Aviation Safety Agency and ECDC recommendation for all of Europe.

    As early as January, the Public Health Agency was warning the government about costs. In a Jan. 31 communique, Public Health Agency Director Johan Carlsson (appointed by Löfven) and General Counsel Bitte Bråstad wrote to the Ministry of Health and Social Affairs, cautioning the government about costs associated with classifying COVID-19 as a socially dangerous disease: “After a decision on quarantine, costs for it [include] compensation which according to the Act, must be paid to those who, due to the quarantine decision, must refrain from gainful employment. The uncertainty factors are many even when calculating these costs. Society can also suffer a loss of production due to being quarantined [and] prevented from performing gainful employment which they would otherwise have performed.” Sweden never implemented quarantine in society, not even for those returning from travel abroad or family members of those who test positive for COVID-19.

    Not only did these lack of measures likely result in more infections and deaths, but it didn’t even help the economy: Sweden has fared worse economically than other Nordic countries throughout the pandemic.

    The Swedish way has yielded little but death and misery. And, this situation has not been honestly portrayed to the Swedish people or to the rest of the world.

    A Public Health Agency report published July 7 included data for teachers in primary schools working on-site as well as for secondary school teachers who switched to distance instruction online. In the report, they combined the two data sources and compared the result to the general population, stating that teachers were not at greater risk and implying that schools were safe. But in fact, the infection rate of those teaching in classrooms was 60% higher than those teaching online—completely undermining the conclusion of the report.

    The report also compares Sweden to Finland for March through the end of May and wrongly concludes that the ”closing of schools had no measurable effect on the number of cases of COVID-19 among children.” As testing among children in Sweden was almost non-existent at that time compared to Finland, these data were misrepresented; a better way to look at it would be to consider the fact that Sweden had seven times as many children per capita treated in the ICU during that time period.

    When pressed about discrepancies in the report, Public Health Agency epidemiologist Jerker Jonsson replied on Aug. 21 via email: “The title is a bit misleading. It is not a direct comparison of the situation in Finland to the situation in Sweden. This is just a report and not a peer-reviewed scientific study. This was just a quick situation report and nothing more.” However the Public Health Agency and Minister of Education continue to reference this report as justification to keep schools open, and other countries cite it as an example.

    This is not the only case where Swedish officials have misrepresented data in an effort to make the situation seem more under control than it really is. In April, a group of 22 scientists and physicians criticized Sweden’s government for the 105 deaths per day the country was seeing at the time, and Tegnell and the Public Health Agency responded by saying the true number was just 60 deaths per day. Revised government figures now show Tegnell was incorrect and the critics were right. The Public Health Agency says the discrepancy was due to a backlog in accounting for deaths, but they have backlogged deaths throughout the pandemic, making it difficult to track and gauge the actual death toll in real time.

    Sweden never went into an official lockdown but an estimated 1.5 million have self-isolated, largely the elderly and those in risk groups. This was probably the largest factor in slowing the spread of the virus in the country in the summer. However, recent data suggest that cases are yet again spiking in the country, and there’s no indication that government policies will adapt.

    Health care workers, scientists and private citizens have all voiced concerns about the Swedish approach. But Sweden is a small country, proud of its humanitarian image—so much so that we cannot seem to understand when we have violated it. There is simply no way to justify the magnitude of lost lives, poorer health and putting risk groups into long-term isolation, especially not in an effort to reach an unachievable herd immunity. Countries need to take care before adopting the “Swedish way.” It could have tragic consequences for this pandemic or the next.

    • Ça rappelle la formule « on n’additionne pas des choux et des carottes » (sauf pour confectionner un plat), toute distinctivité abolie en moins marrant :

      ... l’immunité collective contre une maladie infectieuse n’a jamais été obtenue sans vaccin.

      Sinon, on retrouve là bas ce que Epicov a mis en lumière, les plus âgés (plus de 50 ans), à la vie sociale moins foisonnante, en moyenne (?), et plus prudents, prennent des mesures de distanciation qui les préserve pour partie des contaminations.
      La non généralisation des #masques (découragée par le gvt) facilité le maintien et l’expansion de l’épidémie (à l’inverse de ce qui se passe ici, où la seconde vague se distingue pour l’instant nettement de la première avec cette modification du comportement).

      #Suède

  • La déclaration de Great Barrington : la politique capitaliste mondiale de l’#immunité collective - World Socialist Web Site
    https://www.wsws.org/fr/articles/2020/10/15/bari-o15.html
    https://www.wsws.org/asset/de181613-158c-48f8-afec-48ef75cdf12f?rendition=image1280

    « L’immunité collective est un concept utilisé pour la #vaccination, dans lequel une population peut être protégée contre un certain virus lorsqu’un seuil de vaccination est atteint. On atteint l’immunité collective en protégeant les personnes contre un #virus et non en les exposant à celui-ci. Jamais dans l’histoire de la santé publique, on n’a utilisé l’immunité collective comme stratégie pour répondre à une épidémie, et encore moins à une #pandémie. Laisser libre cours à un virus dangereux dont nous ne comprenons pas tout est tout simplement contraire à l’éthique. Ce n’est pas une option ». – Le Directeur général Tedros Adhanom Ghebreyesus, communiqué de presse de l’Organisation mondiale de la santé, 12 octobre 2020.

    Les remarques préliminaires du directeur général font suite à l’annonce la semaine dernière de la Déclaration de « Great Barrington », une proposition internationale rédigée et signée le 4 octobre à l’Institut américain de recherche économique (American Institute for Economic Research – AIER) à Great Barrington, dans le Massachusetts.

    La déclaration préconise une approche de l’immunité collective [en anglais : l’immunité de troupeau] appelée « protection ciblée », où on donne prétendument refuge aux plus vulnérables. Dans le même temps, les plus jeunes sont encouragés à s’infecter afin d’établir une immunité à grande échelle dans la population.

    L’AIER, un groupe de réflexion libertaire qui se fixe comme objectif « une société fondée sur les droits de propriété et l’ouverture des marchés », est engagé dans une entreprise hautement réactionnaire, anti-classe ouvrière et anti-socialiste. Le milliardaire de droite Charles Koch a financé la déclaration en partie. Il a organisé une soirée privée de scientifiques, d’économistes et de journalistes pour conférer à la déclaration homicide un minimum de respectabilité et a formulé l’immunité collective comme une #politique mondiale nécessaire en réponse à la pandémie.

    #covid #coronavirus

  • Témoignage d’une jeune qui a mené une #grève de #lycéens à Montréal contre la réouverture dangereuse des écoles - World Socialist Web Site
    https://www.wsws.org/fr/articles/2020/10/07/mont-o07.html

    Le débrayage de Lasalle s’inscrit dans un mouvement international croissant. Aux États-Unis et en Europe, des enseignants et des élèves ont organisé des manifestations pour protester contre la réouverture irresponsable des écoles par leur propre gouvernement. En Grèce, des milliers d’élèves ont occupé quelque 700 #écoles dans tout le pays ces dernières semaines pour exiger de meilleures mesures afin de protéger leur vie et leur communauté. (Voir : Les occupations d’écoles se poursuivent en Grèce alors que les étudiants résistent au chantage et à la violence du gouvernement)

    S’il revient aux jeunes d’organiser la première grève contre la réouverture inconsidérée des écoles et la campagne de retour au travail du gouvernement caquiste, c’est parce que les syndicats, y compris les syndicats d’enseignants, travaillent à étouffer systématiquement toute opposition des travailleurs aux politiques homicides de l’élite au pouvoir. Appelant à « l’unité nationale » pour faire face à la pandémie, les syndicats se sont ralliés au gouvernement de la CAQ et à l’ancien PDG de la grande entreprise Legault en pleine crise sanitaire et sociale qui est avant tout le résultat de l’indifférence et de la négligence criminelle de ce même gouvernement, de son homologue libéral fédéral et de leurs prédécesseurs, qui ont tous réduit le financement des soins de santé et des autres services publics essentiels.

    #coronavirus #covid #pandémie #immunité_de_troupeau

  • Covid-19 : Paris passe en « zone d’alerte maximale »
    https://www.lefigaro.fr/actualite-france/covid-19-paris-passe-en-zone-d-alerte-maximale-20201004

    Matignon a annoncé dimanche de nouvelles mesures restrictives pour deux semaines, à compter de mardi, pour Paris et sa petite couronne. Les restaurants sont autorisés à ouvrir en respectant un protocole sanitaire renforcé.

    Paris et sa petite couronne passent bien en « zone d’alerte maximale » ce lundi. « Cela faisait peu de doutes… », glissait-on dimanche matin à Matignon. Voilà plusieurs jours que les trois seuils correspondant à la zone d’alerte maximale (taux d’incidence de la maladie ; taux d’incidence pour les personnes âgées ; taux d’occupation des lits de réanimation par des patients Covid) étaient franchis, et « cette tendance s’est confirmée pendant le week-end », a indiqué Matignon.

    Des mesures plus contraignantes vont donc être mises en œuvre à partir de mardi, à Paris et dans les trois départements de la petite couronne pour une durée de 15 jours, au terme desquels elles seront réévaluées. Un protocole sanitaire sera mis en place pour permettre aux restaurants de rester ouverts. Les bars, en revanche, jusqu’ici autorisés à ouvrir jusqu’à 22 heures, devraient fermer totalement à partir de mardi. Les universités devront aussi adapter leurs capacités d’accueil, tous les établissements d’enseignement supérieur (universités, écoles, instituts de formation) situés en zone d’alerte renforcée et en zone d’alerte maximale devront réduire de moitié le nombre d’étudiants accueillis en présentiel. Les ministres concernés devraient préciser les choses lundi, et la maire de Paris Anne Hidalgo tenir une conférence de presse à la préfecture de Paris.

    Une saturation en réanimation attendue mi-novembre

    Mais l’inquiétude première continue à porter sur l’#hôpital et ses capacités à faire face à un nouvel afflux de patients. Des modélisations réalisées par l’Institut Pasteur, à partir de données en date du 25 septembre, estiment que le taux d’occupation par des patients Covid des lits de réanimation actuellement disponibles devrait à la mi-novembre excéder, parfois très largement, les 60 % (seuil de l’urgence sanitaire) dans toutes les régions exceptées le Centre-Val-de-Loire (46 %, en alerte maximale) et le Grand Est (seule région restant « verte » avec 20 % des lits de réanimation occupés par des patients Covid). Le nombre maximal de lits de réanimation mobilisables devrait être franchi dans la première moitié de novembre en Auvergne-Rhône-Alpes, Bourgogne Franche-Comté, Guadeloupe, Ile-de-France, Hauts-de-France et Nouvelle-Aquitaine (ainsi qu’en Normandie, mais selon des données trop fragiles). Ces simulations ont été réalisées en supposant une poursuite de la dynamique épidémique actuelle : taux de reproduction à 1,35, 29 hospitalisations pour 1 000 cas, 14 % de passages en réanimation, séjour moyen de 14 jours.

    #crise_sanitaire

    • Covid-19 : confronté à « une vraie grande deuxième vague », l’exécutif cherche sa boussole
      https://www.lemonde.fr/politique/article/2020/10/05/face-a-la-resurgence-du-covid-19-l-executif-cherche-sa-boussole_6054746_8234

      Le gouvernement veut maintenant agir par périodes de quinze jours. Le temps de voir quel est l’impact des décisions imposées sur le terrain. Mais il ne s’interdit pas « de prendre des mesures additionnelles ».

      [...]

      Agir par périodes de quinze jours

      En théorie, le gouvernement veut maintenant agir par périodes de quinze jours. Le temps, pour lui, de voir quel est l’impact des décisions imposées sur le terrain. Mais il ne s’interdit pas, « si ça flambe dans ces périodes, de prendre des mesures additionnelles », souligne-t-on à Matignon.

      Devant différents maires, dont ceux de Paris, Lyon ou Lille, qu’il a reçus dans son bureau, jeudi, Jean Castex a prévenu : il n’hésitera pas à pallier d’autorité les éventuelles carences des politiques locales. Une adaptation quasiment au jour le jour que déplore l’édile socialiste de la capitale, Anne Hidalgo. « La situation est très grave. Si on veut être efficaces, il faut se projeter, avec douze à dix-huit mois d’une situation dans laquelle il va y avoir des hauts et des bas, a-t-elle estimé, dimanche, lors de l’émission « Le Grand Jury » de RTL, LCi et Le Figaro. Se protéger dans ces douze à dix-huit mois, ça veut dire avoir une méthode. On ne peut pas être dans un “stop and go” permanent de nos activités. » Une critique qui agace en haut lieu. « Le virus est imprévisible, l’objectif est de s’adapter en temps réel. Préférerait-elle qu’on confine ? Cela réglerait le problème purement sanitaire », grince un conseiller de l’exécutif.

      Il n’empêche, l’opinion publique, elle aussi, exprime de la défiance. Selon un sondage Elabe pour BFM-TV, publié dimanche 4 octobre, 64 % des Français ne font pas confiance à Emmanuel Macron et au gouvernement pour lutter efficacement contre l’épidémie ; 54 % des personnes interrogées jugent par ailleurs qu’il faudrait mettre en place dès maintenant de nouvelles mesures de restrictions pour freiner le Covid-19. L’exécutif peut au moins être rassuré sur un point : face à la menace, une majorité importante de Français plébiscite l’instauration d’une politique coercitive. Cela tombe bien, la perspective d’un reconfinement n’est pas écartée en cas d’aggravation de la situation.

  • Immunité croisée entre les coronavirus des rhumes et SARS-CoV-2 : la fin de la pandémie ? - VIDAL - Actualités
    https://www.vidal.fr/actualites/25004/immunite_croisee_entre_les_coronavirus_des_rhumes_et_sars_cov_2_la_fin_de_la_p

    Récemment, deux articles ont été publiés en préprint, portant sur la réaction immunitaire cellulaire chez des patients souffrant de COVID-19. Ces deux études ont également exploré une éventuelle réaction immunitaire de ce type chez des personnes n’ayant pas été exposées à SARS-CoV-2.

    Chez 34 à 60 % de ces sujets, les immunologistes ont pu mettre en évidence une réaction des lymphocytes CD4 et CD8 envers des épitopes issus de SARS-CoV-2. Les auteurs émettent l’hypothèse d’une réaction immunitaire croisée entre un ou plusieurs coronavirus responsables des rhumes et SARS-CoV-2. En effet, l’ensemble des personnes non exposées étudiées présentaient également des anticorps dirigés contre ces coronavirus.

    Néanmoins, les personnes non exposées qui ne réagissaient pas aux épitopes de SARS-CoV-2 présentaient, elles aussi, des anticorps contre les coronavirus des rhumes. Ainsi, une immunité humorale contre ces coronavirus ne garantit pas une immunité cellulaire croisée contre SARS-CoV-2.

    Cette immunité croisée protège-t-elle contre les formes symptomatiques de la COVID-19 ? Rien ne permet de l’affirmer aujourd’hui et la découverte de cette immunité croisée ne suffit pas à justifier les prédictions que font certains sur la fin imminente de la pandémie.

    De plus, parce qu’il existe divers éléments pointant vers une moins bonne immunité envers les coronavirus des rhumes chez les personnes âgées, la question se pose, à la fois du lien entre cette moindre immunité et la plus grande vulnérabilité des personnes âgées vis-à-vis de la COVID-19, et aussi du risque d’une deuxième vague dans cette population particulière.

    #immunité #immunité_croisée

    • Serions-nous mieux immunisés à la Covid que prévu ?
      https://www.franceculture.fr/emissions/radiographies-du-coronavirus-la-chronique/radiographies-du-coronavirus-du-mercredi-27-mai-2020

      Comme le soulignait l’enquête de l’Institut Pasteur, seuls 5,7% des Français auraient produit des anticorps. Une nouvelle étude américaine souligne que cette immunité pourrait en réalité passer par une immunité croisée, laquelle pourrait équivaloir actuellement à 40-60% de la population.

      [..] C’est par exemple ce qui se passe pour la grippe : le virus de la grippe mute rapidement, c’est pour cela qu’il est nécessaire de se faire vacciner chaque année, pour être protégé contre la nouvelle souche en circulation. Néanmoins, lorsque vous avez attrapé la grippe une année et que vous avez déclaré les symptômes, il est possible que vous soyez immunisé l’année suivante grâce à cette immunité croisée. En bref, vos anticorps vont reconnaître l’une des deux protéines de la grippe, le H ou le N de (H5N1, ou H1N1, ou H7N9) même si le virus n’est plus tout à fait le même.

      Cette immunité croisée, ce n’est pas une nouveauté, elle est tout à fait connue en immunologie. Ce qui est vrai pour les anticorps est aussi vrai pour la réponse adaptative cellulaire, et notamment les lymphocytes T spécifiques, CD4 et CD8, qui ont été ciblés par l’étude publiée dans la revue Cell.

      Et cette étude, justement : que dit-elle ? Cell déjà, c’est une revue de microbiologie très sérieuse. L’étude a été publiée le 14 mai dernier, et a pour ambition de tester la production de lymphocytes T en réaction à certains antigènes du SARS-CoV2.

      Quel est le protocole ? Les chercheurs essayent initialement de quantifier la réponse immunitaire en lymphocytes T chez des patients convalescents Covid mais guéris et ils trouvent bien des lymphocytes T CD4 et CD8 spécifiques au SARS-CoV2 chez 70 et 100% des patients Covid de l’étude. Mais la surprise vient du fait que dans le groupe contrôle, entre 40 et 60% des donneurs jamais exposés au virus présentaient également des CD4 et CD8 spécifiques.

      Conclusion : entre 40 et 60% des patients non infectés par le SARS-CoV2 pourraient être naturellement protégés du fait de ces mécaniques d’immunité croisée. Résultat qui sont corrélés à l’étude dont je vous parlais lundi sur les macaques rhésus, étude dans laquelle les chercheurs ont trouvé une sérologie anticorps positive au CoV2 sur des individus qui n’y avaient pourtant jamais été confrontés.

      [...] même s’il est séduisant d’imaginer que nous soyons déjà tous immunisés et proche de l’immunité de groupe, cela reste pour le moment une hypothèse, et une hypothèse plutôt fragile. Pourquoi ?

      Eh bien parce que, comme je vous le disais, cette constatation sur le groupe contrôle ne permet en fait que d’émettre une hypothèse, et n’est en aucun cas une preuve de cette immunité croisée. Pour que cela puisse être une preuve, il aurait fallu « inoculer » le groupe témoin avec le SARS-CoV2 pour faire preuve d’une différence de réaction à l’infection, et d’une efficacité réelle de cette détection de lymphocytes T spécifiques sur la prévention de la propagation du virus dans l’organisme des personnes jusqu’alors non infectées.

      Il semble possible que des cibles virales autre que la protéine Spike, puissent rappeler une immunité antérieure, une cross-réactivité de l’immunité cellulaire, sur d’autres protéines, les protéines M et N qui sont respectivement des protéines de la matrice et du nucléocapside (qui protège le génome viral). En gros, le système immunitaire ne réagirait pas qu’à l’antigène S mais également à d’autres protéines, moins spécifiques.

      Donc une fois de plus, si cette option de l’immunité croisée via une sensibilisation précédente à des protéines homologues du SARS-CoV2 via d’autres betacoronavirus, comme les rhinovirus qui sont responsables du rhume hivernal, est très séduisante. Il faut encore être très prudent sur ces conclusions, qui ne sont à l’heure actuelle qu’une hypothèse sans aucun élément de preuve.

      #Immunité_de_troupeau #Immunité_de_groupe #Immunité_collective