COVID-19 – Update as of August 11, 2023: Remain Vigilant

Since July 1, the information systems used for COVID-19 surveillance have evolved. Santé publique France continues to monitor the epidemic, based on existing systems, through its multi-source system, which allows for an assessment of its progression. This system relies on indicators related to genomic surveillance, calls to SOS Médecins, hospital emergency room visits, and deaths. In Week 31 (July 31–August 6, 2023), a slight increase in these indicators was observed, but they remain at low levels. The current situation requires continued vigilance, and Santé publique France, along with health authorities, remain fully mobilized.

The SurSaUD® syndromic surveillance system

Santé publique France has developed a health surveillance system known as syndromic surveillance, which is based on the collection of non-specific data. The system enables the daily...

A very low incidence rate

In week 31 (July 31–August 6, 2023), an increase in the number of emergency room visits for COVID-19 across all age groups was observed in France (928 in W31 vs. 712 in W30), though numbers remain low. The proportion of hospitalizations following visits remains stable. SOS Médecins
medical procedures for suspected COVID-19 also increased, with 1,512 procedures in week 31 vs. 822 in week 30.
It is important to note that case numbers remain low regarding syndromic data.

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The incidence* of COVID-19 in France shows a 24.6% increase compared to Week 30, rising from 6.2 to 7.7 per 100,000 inhabitants, remaining at very low levels. The incidence rate is rising across all age groups, but is most pronounced among those aged 40–49 (+38.8% compared to week 30).

The current situation requires continued vigilance, and the surveillance systems in place allow us to assess its evolution. Given the low incidence levels currently observed, it is not unusual to see fluctuations or localized outbreaks of active transmission, which will not necessarily result in major waves. It remains important, however, to continue monitoring SARS-CoV-2 using existing systems, particularly syndromic surveillance (SOS Médecins and OSCOUR networks), surveillance in acute care hospitals, and genomic surveillance.

*Please note that incidence rates should be interpreted with caution, as this indicator reflects only laboratory-confirmed cases and not the actual situation (fewer tests overall and testing rates that may vary over time; results from self-tests are not included). These data do, however, allow us to assess trends.

A limited increase confined to the southwest

Most of the positive cases reported during week 31 came from five regions: Nouvelle-Aquitaine (n=789), Occitanie (n=730), Île-de-France (n=689), Provence-Alpes-Côte d’Azur (n=638), and Auvergne-Rhône-Alpes (n=541).

Nevertheless, available data suggest that the national increase is primarily driven by the Nouvelle Aquitaine region, particularly departments 40 (Landes) and 64 (Pyrénées-Atlantiques): laboratory data and data from the SOS Médecins and OSCOUR networks are consistent in this regard. This localized increase across the country can be explained primarily by the large gathering that took place in Bayonne (Fêtes de Bayonne, July 26–30), and other similar local summer festivals where conditions in terms of population density may have facilitated transmission.

While a more limited increase in the number of cases is observed across all regions, most cases have been reported in heavily visited vacation areas, highlighting the additional role of other types of gatherings during the vacation period. This increase could therefore continue or fluctuate as the school year begins.

Santé publique France continues to monitor the epidemic through existing systems that allow for an assessment of its progression.

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Adherence to preventive measures remains necessary

Adherence to preventive measures is still required. Isolation in the event of a positive COVID-19 test and/or symptoms, and continued adherence to preventive measures: wearing a mask, particularly in the presence of older adults or in crowded indoor spaces (including public transportation) or during large gatherings, as well as handwashing and ventilating enclosed spaces.

COVID-19 vaccination, particularly for at-risk individuals, remains important, and the flu and COVID-19 vaccination campaign launched this fall will be the subject of an upcoming announcement.

What is known about the EG.5.1 sublineage of the EG.5 variant?

EG.5 is a sublineage of XBB.1.9, with the first sequence detected dating back to mid-February 2023. Nearly 90% of global EG.5 sequences correspond to its EG.5.1 sublineage. Genetically, EG.5 remains closely related to other XBB.1.9 variants, and data published in preprints (not peer-reviewed) suggest cross-protection against other XBB sublineages.

In early May, global detection of EG.5 began to rise, driven by circulation in Asia (China, Japan, and South Korea). Since then, an increase in EG.5 has been observed in North America and Europe.

EG.5 accounted for 12% of global sequences in week 28 (compared to 11% in week 27 and 10% in week 26). Compared to previous variants, the rise of EG.5 is therefore proceeding at a relatively slow pace. Furthermore, EG.5 appears to be stabilizing at around 45% in China and between 15% and 20% in Japan and South Korea. These findings suggest that EG.5 has a relatively weak growth advantage compared to other currently circulating variants.

In mainland France, an increase in the detection of EG.5.1 has been observed: it accounted for 26% of interpretable sequences in the Flash survey of July 17, 2023, compared to 15% in the Flash survey of July 10, which is consistent with the global situation.

EG.5 was classified as a VUM (Variant Under Monitoring) by the WHO on July 19, 2023, and then as a VOI (Variant Of Interest) on August 9, 2023, following an increase in its detection in several regions of the world since Week 21 (May 22–28, 2023). At this stage, the WHO indicates that there is no evidence to suggest a change in the severity of EG.5.

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