2023-09-03 16:03:00
Years pass and it still does not disappear. Even if it means remembering with more vigor to our good memories. After a relatively calm summer on the Covid-19 front, contamination is indeed on the rise this back to school.
Behind this summer wave, a manager: EG.5.1. Sometimes nicknamed Eris, this variant is a descendant of XBB (from the large Omicron family), and does not contain a high number of mutations.
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“We do not see any sign of particular gravity with EG.5.1, reassures Antoine Flahault, epidemiologist, doctor and director of the Institute of Global Health in Geneva. And as with each new wave of Covid and each new variant, it is very difficult to predict the extent and severity. However, we can observe the experiences of other countries, especially those that have kept a minimum of health monitoring tools. This is the case for the British and North Americans among whom a plateau seems to be emerging at the end of August which could resemble the epidemic peak of a summer wave of moderate magnitude and without any sign of particular gravity”.
There is a non-zero probability that this variant will cause a strong wave in the coming months.”
What remains to be confirmed in the coming weeks and then Belgium, which has seen its indicators continue to rise for three weeks, could follow the same trend and soon see its peak occur. It is also complicated to quantify the evolution of the disease, given that there are very few tests and that there is no longer an official monitoring barometer. Currently, we know that the concentration is increasing in the wastewater from Leuven and the first sequencing results show the presence of the XBB variants (see graph opposite).
The wastewater report in Leuven shows an increase in the circulation of Covid-19. ©Sciensano
A new highly mutated and closely watched variant
If we do not see signs of particular gravity with EG.5.1, a sub-variant can often hide another in the large Omicron family.
“BA.2.286”: What is this new variant of Covid detected in four countries and which the WHO and the United States are monitoring closely?
Indeed, BA.2.86 has been identified in a few patients from Denmark, Israel, the United States and the United Kingdom as well as in wastewater from several countries including Switzerland, but not yet in Belgium. The WHO and the American health authorities have announced that they are monitoring it closely.
“We assume that it is already there even if we have not yet observed it, indicates virologist Steven Van Gucht. With us, the increase in cases continues according to the analysis of wastewater and there is a soup of variants with several strains in which it is difficult to see clearly. Even if a stabilization seems to be coming, we can imagine that it will be temporary because the return to school will surely cause a new dynamic”.
This BA.2.86 variant was quickly classified by the WHO as a “variant of interest” due to its very high number of mutations (more than thirty) on its genome, coding for the Spike protein, a strategic region of the virus. which allows it to contaminate our cells. “The fact that it is highly mutated does not mean that it is more transmissible, but we must follow how the immune system reacts, and in particular current vaccines. For the moment, it remains sporadic, however, we must monitor it”, he continues.
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We will have to reconsider wearing the mask in the waiting room while having strict respiratory hygiene.
This BA.2.86 variant was quickly classified by the WHO as a “variant of interest” due to its very high number of mutations (more than thirty) on its genome, coding for the Spike protein, a strategic region of the virus. which allows it to contaminate our cells.
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For the moment, we do not yet know either its transmissibility or its virulence. It is not even known if it will spread like its BA.2 ascendant did or like other sub-variants in recent months.
“It is therefore a strain under close surveillance but at a very early stage of its emergence. The first case of BA.2.86 infection was reported in Israel on August 13 only. However, there is a non-zero probability that this variant will cause a strong wave in the world in the coming months, explains Antoine Flahault. The world wanted to quickly turn the page on this pandemic which has strongly mobilized energies and public policies for nearly three years. Capitalizing on high vaccination coverage and good immunity of the population protecting it against serious forms, hospitalizations and deaths, Europe has indeed lowered its guard in terms of health monitoring, testing much less and in certain countries such as Belgium”.
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A vaccination campaign from the end of September
With us, wastewater monitoring remains the last weapon for monitoring and tracking the circulation of covid-19.
Letting your guard down has many consequences. First of all, the difficulty in assessing the current health situation, the impossibility of comparing the waves and finally, the resulting impossibility for the public authorities to steer health policy, for example vis-à-vis the introduction of mandatory masks or vaccination reminders.
Without reliable and precise information, it is indeed difficult to introduce such measures and to justify them to the public. It should be remembered, however, that in Belgium, the pressure on health care remains stable, both for hospitalizations and for intensive care and only a small number of hospitalizations are currently recorded in geriatrics and paediatrics. Most outpatients are young adults with symptoms of the virus.
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Going forward, the Risk Management Group (RMG) expects further waves of Covid-19 infections. To cope, new vaccination campaigns are planned by the Regions from the beginning of autumn. The vaccine adapted to the Omicron XBB.1.5 variant should be available from mid-September, after approval by the European Medicines Agency.
A triple epidemic to come?
“According to the latest predictions of the models provided by the universities of Hasselt and Antwerp, we can expect a larger wave in November, an increase which should however remain manageable, underlines Van Gucht. It is for this reason that we plan to launch the vaccination campaign from the end of September, in particular with regard to the elderly, the immunocompromised and the most fragile. On the other hand, the risk of seeing a concomitant triple epidemic exert strong pressure on our healthcare system is a reality that must be taken into account. We will therefore have to reconsider wearing the mask in the waiting room while having strict respiratory hygiene on the side because we risk having a winter that resembles that of last year”.
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Indeed, like last year, the flu, colds, bronchiolitis are likely to occur at the same time. The Covid occurs all year round as this summer epidemic shows, but the Covid epidemics prove to be more serious and of greater magnitude during the cold season when we are more in closed places while the windows are less often open.
“Thus, the probability of seeing the conjunction of different winter epidemics occurring at the same time is of course high, causing risks of temporary saturation of the health system and in particular of hospitals as we experienced last December and January in Western Europe. west”, concludes the director of the Institute of Global Health in Geneva.
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