Key Points

• COVID-19 Surveillance

  • Multi-source, consisting of systems designed to be comprehensive and/or descriptive;

  • Enabling the tracking and description of the epidemic;

  • First-time implementation of a system to centrally and responsively aggregate all diagnostic tests for a disease (SI-DEP available starting in May 2020) and vaccination data (VAC-SI).

• Study periods for the preparation of this BSP

  • From March 2020 to mid-October 2021

  • That is, 4 periods covering the 4 epidemic waves, the last of which had not yet ended in Martinique at the time of analyzing the data included in this BSP

• Epidemic dynamics in Martinique

  • Influenced by regional characteristics (frequent travel to mainland France and the Caribbean islands, insufficient vaccination coverage, failure to adhere to preventive measures during certain periods such as Carnival, etc.);

  • Epidemic dynamics reflected in all data sources;

  • Epidemic resurgences during or after each school vacation period amid the lifting of containment measures and non-compliance with preventive measures, followed by insufficient vaccination coverage;

  • Period 1: March to May 2020: featuring a first wave from March 9 to April 5, 2020, characterized by limited viral circulation and no impact on the healthcare system thanks to the implementation of the first lockdown, though it required a significant reorganization of hospital services;

  • Period 2: August to late December 2020: featuring a ^second wave, from August 3 to November 22, 2020, of moderate intensity and without major health impact. Its onset was linked to festive gatherings involving people who had traveled during the summer vacation period in July/August 2020;

  • Period 3 from January to the end of May 2021: featuring a third wave, from February 22 to May 16, 2021, of greater intensity than the previous one, triggered by the introduction of the Alpha variant (20I/501Y.V1, UK) and by the failure to observe preventive measures, particularly during the Carnival period;

  • Period 4: June to mid-October 2021: with a fourth wave beginning on June 28, of high intensity and with a severe health impact on the hospital system (numerous deaths and medical evacuations to mainland France), characterized by the predominance of the Alpha variant at the start of the wave followed by the introduction of the Delta variant, against a backdrop of insufficient vaccination coverage.

• Key data for Martinique from March 2020 to mid-October 2021 (percentage of the 4th period)

  • 502,238 people tested (55%), of whom 42,648 tested positive (72%);

  • 3,672 new hospitalizations (73%), including 977 in intensive care (68%); 667 deaths in the hospital and, since the fourth wave, in home hospitalization (84%);

  • 623 cases reported by intensive care units; median age of 57 years; presence of comorbidities in over 65% of them; median length of stay of 6 days, resulting in death in 27% of cases. Overweight/obesity, high blood pressure, and diabetes were the main risk factors among patients admitted to an intensive care unit;

  • 5,010 visits to the adult emergency department at the Pierre Zobda Quitman (PZQ) site for suspected COVID-19 (57%), 140 visits to the pediatric emergency department at the Maison de la femme, de la mère et de l’enfant (MFME) site for suspected COVID-19 (86%);

  • 4,054 coronavirus-related visits conducted by SOS Médecins out of 70,122 visits for all reasons (56%);

  • Approximately 25,000 extrapolated consultations for acute respiratory infections (ARI) in private practice, conducted by sentinel physicians (62% during period 4);

  • Mid-October (S41): 35.5% of the general population had received one dose of the vaccine and 32.2% had completed the full vaccination series; 40.3% of the population aged 12 and older had received one dose and 36.5% had completed the full vaccination series;

  • Among healthcare professionals, by mid-October, 48.0% had received one dose and 43.1% had completed the full vaccination series.