Paris hospitals brace for COVID-19 third wave peak

PARIS (Reuters): France is expected to hit the peak of its third COVID-19 wave around April 20, according to forecasts by the Paris hospitals group AP-HP seen on Friday by Reuters.

They also estimated there would be just under 2,000 COVID-19 patients in hospital intensive care units in the Paris region around that peak, versus 1,723 as of Thursday. “The enforcement of additional restrictive measures (…) allow us, for the first time, to project a turning point, with assumptions that remain fragile”, AP-HP boss Martin Hirsch said in an email sent to staff.

“The central assumption is for the second wave to peak around April 20, when, in the greater Paris region, we would have slightly less than 2,000 patients in intensive care”, he said. At the start of the month, just after President Emmanuel Macron ordered France into its third national lockdown, Health Minister Olivier Veran said the ICU peak, on a national level, should be reached at the end of April.

Daily new COVID-19 infections in France have doubled since February to average between 35,000 and 40,000. The number of COVID-19 patients in intensive care is at an almost year high of 5,705. But that figure did decrease on Thursday, by 24, for the first time in eight days.

France’s top health advisory body in charge of COVID-19 vaccines recommended on Friday that recipients of a first dose of the AstraZeneca shot who are under 55 should receive a second dose with a so-called messenger RNA vaccine. Reuters reported on Thursday that the Haute Autorite de la Sante (HAS) had opted for the dose-mixing recommendation, which has not yet been evaluated in trials. The French decision came after European drug regulators said on Wednesday there was a possible link between AstraZeneca’s COVID-19 shot and a very small number of cases of rare blood clots.

Some countries had already suspended use of the AstraZeneca vaccine as a precaution, but most have resumed using the shot, although some have done so with age restrictions. “This is a logical choice and one of security,” Dominique Le Guludec, the head of the HAS, told reporters. “Our approach is absolutely not to engage in a gigantic experimentation on the French population…We actually want to be cautious and not expose people to thromboembolic accidents, even though they are very rare,” she said.

Two mRNA vaccines, one from Pfizer and BioNTech and one from Moderna, are approved for use in France. mRNA vaccines prompt the human body to make a protein that mimics part of the virus, triggering an immune response, while AstraZeneca’s shot uses a harmless, weakened version of a chimpanzee common-cold virus to deliver instructions to generate an immune response and prevent infection.

The HAS also called for real-world studies to assess the immune response triggered by the mixed vaccination scheme. It said its decision was based on an immunisation strategy known as heterologous prime-boost, in which separate doses of different effective vaccines are used to confer protection. The HAS said that while there is little data yet available on using different vaccines in a prime-boost strategy for COVID-19, animal studies and evidence from other disease areas is encouraging.

A member of the German vaccine commission, Marianne Roebl-Mathieu, said earlier this week she saw no immunological disadvantage for younger recipients of AstraZeneca’s vaccine in getting a second dose of another vaccine. In France, the HAS said on March 19 that only people aged 55 and over should get the AstraZeneca shot, which had already been given to more than 500,000 people as a first dose. Germany was the first European country to recommend that people under 60 who have had a first AstraZeneca shot should receive a different vaccine as a second dose.