COVID-19 Epidemiological Update for November 12: Slight Decline in Viral Circulation, Indicators Still at Very High Levels

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Published on 13 November 2020

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Stéphanie Champion: 01 41 79 67 48
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Camille Le Hyaric: 01 41 79 68 64

Published weekly, the epidemiological update on COVID-19 surveillance provides a detailed analysis of the various indicators established by Santé publique France and its network of partners to track the progression of the epidemic and guide public policy decisions. Analysis of the indicators for week 45 highlights a slight slowdown in SARS-CoV-2 transmission, with a decrease in the number of new cases (-14%) but a sharp increase in the number of deaths (+29%). The highest level of vigilance must be maintained for those most at risk of COVID-19 complications. Results from the CoviPrev study show a significant deterioration in the mental health of the French population between late September and early November, with a substantial increase in depressive symptoms across the entire adult population (+10 points).

Declining viral circulation

In mainland France, week 45 appears to be marked by a slowdown in SARS-CoV-2 transmission. Several indicators show a slight decline in week 45 (November 2–8). The number of new confirmed cases decreased by 14%, with 286,972 new cases in week 45 compared to 333,371 in week 44. The positivity rate fell from 21.0% to 19.5%, a decrease of 1.5 percentage points. The number of SOS Médecins calls for suspected COVID-19 decreased by 18% (from 7,655 to 6,269), and the number of emergency room visits for suspected COVID-19 decreased by 3% (14,584 in week 45 versus 14,959 in week 44).

An epidemic still at a very high level

Despite this slowdown, national indicators remain at a high level. New hospitalizations (+14%, 19,940 in week 45 versus 17,450 in week 44) and new ICU admissions of COVID-19 patients (+17%, 3,037 in week 45 versus 2,605 in week 44) continue to rise, with levels close to those seen in March and April 2020. The number of COVID-19-related deaths also continues to rise, up 29% (3,355 deaths in week 45; 2,605 in week 44).

An increase in depressive symptoms among French adults

The results of wave 17 (November 4–6) of the CoviPrev study show a significant increase in depressive symptoms compared to the survey conducted in late September (+10 points). Situations vary depending on how the health crisis has been experienced (fear, anxiety, anger, and frustration, or feelings of loneliness and isolation) and on the burdens it places on each individual (particularly in terms of financial difficulties). Thus, the largest increases were observed among young people (+16 points among 18-24-year-olds and +15 points among 25-34-year-olds), the economically inactive (+15 points), and those reporting a very difficult financial situation (+14 points).

General practitioners, mental health professionals (psychiatrists, psychologists), community organizations, and the full range of social assistance programs are essential resources for supporting these individuals in distress and reducing the anxiety caused by this pandemic.

To facilitate access to these professionals when needed, a section dedicated to mental health has been created on the Santé publique France website, listing all remote support services, categorized by topic (violence, grief, psychological distress, addictions, parenting, etc.).

Better Understanding and Interpreting the Effective Reproduction Number

The effective reproduction number (or Reff) is useful for analyzing the dynamics of virus transmission during an epidemic. It can be calculated using various data points: the number of cases (Reff SI-DEP), the number of emergency room visits (Reff OSCOUR®), and the number of hospitalizations (Reff SI-VIC).

In theory, Reff SI-DEP is the most responsive measure for tracking the dynamics of the epidemic; it depends on testing capacity. The Reff OSCOUR® and Reff SI-VIC describe trends with a greater time lag. The Reff OSCOUR® is based on emergency department visits by suspected COVID-19 cases and is therefore based on unconfirmed cases. The Reff SI-VIC is the most delayed but theoretically the most stable.

Effective reproduction numbers (Reff) help describe the dynamics of the epidemic: when the Reff is significantly greater than 1, this means the epidemic is growing; when it is equal to 1, the epidemic is stabilizing; when it is significantly less than 1, the epidemic is declining.
Effective R values should not be interpreted in isolation; their interpretation must be considered in light of all other available indicators and an analysis of the local situation.

For more information: What is R, or the virus reproduction rate?