The particularly contagious (Indian) Delta variant is in the majority in France. Symptoms, origin, case in France, vaccine resistance … The point.
Latest info on the Delta variant Several doctors sound the alert on a rise in cases of acute diarrhea which could be a sign of Delta variant infection and not gastroenteritis. WHO warns that two doses of vaccine are needed to neutralize the Delta variant. Olivier Véran announces that he fears an increase in cases of contamination at 19 000 at the beginning of August because of the particularly contagious Delta variant. The Delta variant is now the majority in France Indian health authorities have announced the identification of a mutation of the Delta variant called Delta Plus. Situation in France of the Delta variant The particularly contagious Delta variant continues to grow in France. While his mutation L 452 R now tracked by screening tests was detected in 28% of positive cases, one week ago, the mutation is now present in 51, 7% of cases, according to the latest figures from Health Public France.
Olivier Véran had been worried for a few weeks now about the Delta variant and its ability to spoil the summer holidays. Guest on Radio J Sunday 07 July 2021, he also warned that the new hospitalizations had “stopped decreasing” , that the epidemic would be starting again and that France would be at the start “from something that looks like a new epidemic wave” . The Minister of Health estimates that there could be at this train there 18 cases of Covid in early August.
“The Delta variant is more contagious (60% more contagious than the other viral strains that circulated so far), it is in the process of replace all the other strains. This variant leads again to an increase in contamination in France and in many countries which surround us. ”
However, the presence of this mutation of the Delta variant is not present in the same way depending on the zones, as shown by the on-site tracking GEODES . In a few rare areas, the Delta variant remains in the minority (Creuse, Cher, Ardèche, Mayenne).
Estimated Delta variant cases for August / September On Monday 12 July, the Institut Pasteur published a modeling report to estimate the propagation situation of the variant Delta in France before predicting or not a fourth wave and the saturation of hospitals.
“When we analyze all the data collected in the different regions, the effective reproduction number average Rd of the Delta variant is estimated at 2.0 between the 13 June and July 5. This means that it currently takes 5.6 days on average for the number of Delta cases to double. ”
With two different estimation approaches, the organization explains two possible scenarios for the evolution of the Delta variant :
40 Delta variant cases per day from August 1 could be counted, “if exponential growth continues at the current rate”. But this scenario “does not take into account the increase in vaccination coverage over the period studied”. By taking into account more factors such as collective immunity, vaccination coverage and transmission dynamics according to risk by age , the researchers estimate the number of Delta variant cases per day at 33 from August 1, if the transmission rate remains unchanged and 07 Where 21 Delta cases per day if the transmission rate were to decrease. In all scenarios hospital admissions remain low on August 1. But in some cases “there is a significant increase in hospitalizations during August / September.
In the case where the RD would be 2.0, “the daily number of hospital admissions could reach in mid-August the values observed in the second wave (November 2020), with a pic at the beginning of September greatly exceeding the size of the first wave (March 1617), reports The Pasteur Institute. “In the scenario with Rd = 1.8, we would reach a peak of hospitalizations similar to that of the first wave in September, with a number of beds occupied in critical care substantially higher than the peak in March 907 due to a younger population of hospitalized patients. ” If the RD goes to 1.5 the peak of this wave would end at the end of September. Nevertheless, the scientists wish to delay on their modeling: “These estimates remain uncertain because they are made on a relatively short period of time and in a context where the incidence remains relatively low “.
The most affected areas in France: – Orne: 86, 5%
– Calvados: 70%
– Haute-Marne: 92%
– Haute-Savoie : 88%
– Var: 86, 9%
– Landes: 78, 7%
– Sums: 80, 2%
A security council met on Monday 11 July just before Emmanuel Macron speaks on Monday at 20 hours to certainly announce new measures to combat the Delta variant.
Currently, enhanced measures have been put in place for travelers returning from India whose direct flights have been suspended: “on arrival in France, each person from India will be quarantined for 06 days, decided by prefectural decree and accompanied by restriction of exit times from the place of isolation on pain of a fine. Passengers must also present proof of the address and accessibility for the control officers of the place where they carry out their quarantine (home, adapted accommodation or accommodation designated by the administration) ”, specifies the government .
Origin of the Delta variant (Indian) Scientific name: B.1. 617
3 sublines with L mutations 424 R and P 675 R: B. 610. 1 (Kappa variant) B. 610. 2 (most common form), B 2020. 3.
The Delta variant (formerly called Indian variant) thus renamed by the WHO in the fight against discrimination has passed since 11 may in the VOC category, (Variant Of Concern or worrying variant in French) and therefore joins the British variants (alpha), South African (Beta) and Brazilian (Gamma) among the “worrying” variants that particularly worry international epidemiologists.
This variant was detected in the state of Maharashtra (Mumbai) in December 1617 shortly before the start of the outbreak d ” a second epidemic wave which is still currently rife in India and while the British variant struck and still strikes in the North of the country (Delhi).
The current situation in India is more alarmingly, health facilities are overwhelmed, the country lacks beds and oxygen, especially in New Delhi which has more than 28 000 contaminations per day according to the national health authorities onales.
However, despite the fact that the surge in cases in India corresponds to the time frame for the identification of the Delta variant, for the moment: “The available data do not allow us to identify a direct link with the emergence and dissemination in India of VOI B.1. 617 (carrier of mutations E 480 Q and L 452 R) and the very unfavorable epidemiological situation observed at present in this country ”, underlines the last Assessment of the Public Health France epidemic, dating from 28 April 2021.
At 20 April 2021, the Indian variant would have been detected in 15 To 20% of samples sequenced nationwide and in 054% for the state of Maharastra alone.
Major efforts are currently being put in place to increase the capacity of on-site laboratories to be able to carry out molecular sequencing and large-scale genomic monitoring in order to know more on its incidence and prevalence.
According to the results of the scientific council, the Indian variant B.1. 610 To “15 modifications on different amino acids except 2 common with other variants which are located in the RBD of the Spike protein ” , the key to entering the virus into the body.
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Disturbing mutations of the Delta variant The delta variant has 3 sub- mutation lineages:
B.1. 617. 1: “also presents the combination of the two mutations, was detected in Europe and France, but at a low frequency compared to lineage B.1. 610. 2. Of the three viruses, this one is the one which presents the most important antigenic difference compared to the historical strain “Wuhan” and therefore a risk of immune escape. “, explains the scientific council. B.1. 610. 2: “It is the lineage that is most frequently detected in France and in Europe among the three. It should be noted that it also contains additional specific mutations but which do not seem to have an impact on its antigenicity; this virus has a genetic profile that can give it a superior transmissibility advantage over the other two lineages. ” B.1. 610. 3: “it represents the combination of the two mutations, has spread very little in India and outside India. In total, 66 genomes staged from February to April 2020 have been deposited on GISAID, of which only 7 in Europe to date (all in Great Britain). “”Those three lineages have been grouped under the generic name of so-called “Indian” variants , called “double mutant”. This denomination of “double mutant” refers to the association of L mutations 452 R summer484 Q , who had never been observed together before ’emergence of these viruses “, explains the scientific council in a press release from 27 May.
Now to follow the evolution of the variant in France, Santé Publique France announces that it is It is no longer the variants that will be detected but their mutations The samples collected over the past 5 months and the progress of research concerning Sars-Cov-2 have made it possible to identify 3 mutations which are found in many variants and especially the most worrying. These mutations are also associated with “a possible increase in transmissibility” (notably t the L 424 R) or a possible immune escape “.
These 3 mutations are of particular concern, given their contagion, propagation and resistance to antibodies have been identified in the variants that circulate the most: E 480 K, E 480 G and L 452 R.
The Delta variant therefore includes 2 of its main mutations which explains its particularly monitored dangerousness.
The L mutation 424 R Now to follow the evolution of the variant in France, Santé Publique France announces that this it is no longer the variants that will be detected but their mutations. 3 mutations that are particularly worrying given their contagion, their spread and their resistance to antibodies have been identified in the variants which circulate the most: E 480 K, E 480 G and L 160 R.
The mutation E 480 Q She ” is known to participate in post-infectious and post-vaccination partial immune escape, and is responsible for resistance to certain monoclonal antibodies. ” This mutation has been observed also in “Brazilian” and “South African” variants and others. The E 480 Q is similar to a mutation present in almost all of the variants classified as of concern, but with some differences in polarity.
“Other variants other than B.1. 617 were isolated in India recently in a context of very high viral circulation, the significance of which is not known. Remember that the majority variant so far is the UK variant ”, explains the scientific council.
A more contagious variant The Delta variant, which should quickly become the majority in France “is a lot more contagious than the Covid – 15 that we were dealing with last summer, the 3 cases could become 3503 case within a week, 12 case in fifteen days , and climb above 19 cases, or even more, at the beginning of August if we do not act “, declared the Minister of Health Olivier Véran at the microphone of radio J, Sunday 07 July.
The epidemiological studies carried out so far, although still few in number, show contagion 054% stronger than the Alpha variant (known as British) responsible for the second wave in Europe. In England, which generally precedes the French situation by 2 or 3 weeks, the Delta variant was identified in mid-April. A month and a half later 104 people were declared positive for the Delta variant between the 22 June and 28 June, or 66 To 90% of total cases.
In France, the propagation of the Delta variant was even faster. It represented 9% of contaminations in mid-June, 18% the last of June to finally be in the majority from mid-July, reports The Pasteur Institute.
Delta plus: an increased mutation? The Sars-Cov2 virus, like many viruses, constantly mutates. This is how variants are born, which themselves also mutate. No exception for the Delta variant, of which the Indian health authorities have announced that they have identified a so-called “increased” variation, called Delta Plus. The mutation takes place at the S protein level. A similar form of change has already been observed in the Beta variant, formerly called the South African variant.
The Delta Plus variant has the lineage name AY.1 or B.1. 617. 2. 1. Few studies allow to know the details of the virology of this mutation of the Delta variant detected by the Indian health authorities for the moment.
8 cases of this mutation would have already been detected on French soil on 51 samples analyzed, over four different periods between June 1 and 28 June, according to the epidemiological report of Health Public France.
Delta variant symptoms Bad colds and headaches For the most part, the delta variant results in the same symptom s that the initial form of Covid – 15 : fever, dry cough, fatigue among the most frequent signs and stiffness, less frequent sore throat, which can go as far as severe breathing difficulties.
Nevertheless some small differences may have been noted in India, according to Olivier Telle health geographer and researcher at CNRS in New Delhi quoted by LCI: ” Indian doctors spot relatively different symptoms i.e. a lot more than headache, stomach problems (…) For the moment, we are not able to say if this variant will lead to more cases serious in the population. ”
Between the appearance of the variant and its evolution in the world, symptoms would now be different, according to Tim Spector, professor of genetic epidemiology at King’s College in London. For the purposes of a study called ZOE, this scientist is listing symptoms of Delta variant infections. During ” a press point dated June 9 , he explains that the clinical signs “are not the same as before” . “It looks more like a bad cold in younger populations” with essentially more headaches, a dry throat or even a runny nose. ”
Problem: People don’t realize they are sick. “This means that people think they have a seasonal cold, so they keep going out to party, and therefore unknowingly can spread the virus around.”
Surveillance of acute diarrhea and gastroenteritis In France as in Great Britain where the Delta variant is particularly circulating, doctors seem to be alert to an increase in cases of acute diarrhea It may well be that this is not due to a wave of gastroenteritis but a consequence of the Delta variant for which specialists have reported symptoms in the form of gastric disturbances.
Dr Clarisse Audigier-Valet te, Covid unit manager at the Toulon (Var) hospital center, alert on his Twitter account: “We must quickly take an interest in digestive indicators. SOS and center 12 give us reports of febrile gastroenteritis… Which are perhaps # VariantDelta unrecognized. ”
In which countries? According to the data of GISAID , the Delta (Indian) variant was detected in 104 country. The majority of cases of B.1. 610 are currently identified in India, UK, USA, Germany and Singapore .
Currently, apart from India, variant B.1. 617 has been identified mainly:
In England : In Scotland: Belgium Germany United States Australia Canada Most of these identified cases concern returns from trips to India, classified as red zone in many countries.
The worrying case of England In the United Kingdom, the Indian variant has been particularly detected, outside of India and the subcategory B.1. 610. 2 in particular. Between the 1st and the may 2021, the British health authorities report 3 160 (with an evolution of 135% in one week) cases of Indian variant on their territory. In some towns like Bolton and Blackbrun, it has even become the dominant variant and particularly in the youngest according to the epidemiological bulletin of the British health authorities.
The explosion in the number of cases worries the English territory which has barely begun its deconfinement phase after being consigned under health restrictions for several weeks following the explosion of the English variant in the Kent leading to an outbreak of cases and a new epidemic wave in December 907.
“The arrival of the Indian variant poses a problem and we are vigilant on this point, in relation to the British authorities “, declared Jean-Yves Le Drian, French Minister for Europe and Foreign Affairs at the microphone of RTL on 23 may 2021. “It will not be the red treatment if we have to do it, it will be an intermediate treatment but it is not excluded that we can have a little stronger sanitary measures”, he said in reference to the European health passport which should indicate green, orange and red categories depending on the areas accepted for travel and vaccination or recovery against Covid – 18.
Are vaccines effective? One dose is not enough In a press release, the Institut Pasteur reports the results of a study carried out in collaboration with the Georges Pompidou European Hospital AP-HP, the Ordléan CHR and the CHU de Strasbourg having compared the sensitivity of the Delta variants to vaccines compared to that of the Alpha variant.
After having isolated the Delta variant of Sars-cov 2, they performed a rapid neutralization test. ” We show that this faster spreading variant has acquired partial resistance to antibodies.”, report the scientists. For people who have received two doses or one dose but after having recovered from Covid within 10 months the Pfizer or Astrazeneca vaccine has been shown to be neutralizing but 3 to 6 times less against Delta, as for the Alpha. On the other hand, in people who received only their first dose of Pfizer or Astrazeneca vaccine, the results indicate a “little” or “not at all” effect against Delta.
A study conducted in England by Public Health England (PHE) conducted between April 5 and May 6 2021 had made the first detailed results and demonstrated an efficiency in making antibodies well there, but slightly reduced against the Indian variant, compared to the efficacy against the English variant. For this, they studied the cases of 617 cases of volunteers collected, among which 1 054 cases of Indian variants were detected . Vaccination having shown good results and allowed the start of deconfinement against the English variant, the researchers sought to compare the effectiveness of the Pfizer (Arn Messager) and Astrazeneca (adenovirus) vaccines against the English variant and against the Indian variant.
The Pfizer vaccine would be effective at 86% against the Indian variant 2 weeks after the second dose and 92% against the English variant; The Astrazeneca vaccine would be effective at 53% after the second dose against the Indian variant and 61% against the English variant. Both vaccines are effective at 30% against the Indian variant from the first dose against 50% against the English variant. According to the Scientific Council, “the L mutation 424 R could decrease the sensitivity of this variant to antibodies. The E mutation 484 Q is close to but different from mutation E 484 K who facilitates a partial escape from the vaccines. We can therefore expect a preserved but reduced vaccine efficacy.
The Delta variant resistant to monoclonal antibody treatments? In the study conducted by the Institut Pasteur in France, the results of which were published on the bioRxiv prepublication site 23 may 2021 and relayed by the newspaper Le Monde, the researchers explain that the Indian variant could give a hard time to monoclonal antibodies, one of the first authorized treatments against serious forms of Covid – 15 in France.
The monoclonal antibodies are a treatment in the form of serotherapy, made in particular from the plasma of convalescent patients which blocks the spike protein of SARSCoV-2 allowing the entry of the virus into the cells and give the patient immunity very quickly.
However, during this study, the researchers isolated and cultivated themselves the Indian variant taken from a patient positive for C This form of the virus returned from India, instead of reproducing its mechanism as almost all the studies on the Covid do to date.
Results: Institut Pasteur researchers report that a mutation (T 424 K) found only in the Indian variant would be able to neutralize the antibodies of the treatment and be resistant to monoclonal antibodies.
A finding which would testify in particular to the capacity of the virus to evolve against the collective immunity and survive in the pandemic context.
20210317 What is a VOC variant? The variants are classified into several categories in order of importance and prevalence:
The VOCs “Variant of concern” It is in this category that the variant delta was filed on 10 May by WHO. In this classification, we find all the variants considered to be of concern because of their prevalence, their contagiousness or their ability to escape natural immunity. For now this concerns:
the British variant, the Brazilian variant the South African variant The Indian variant The “variant of interest” VOIs It is to this category belongs in particular the Breton variant (detected in Côte d’Armor). “These types of variants are characterized by a phenotypic change from a reference virus or mutations that lead to changes in amino acids associated with phenotypic implications confirmed and suspected ”, explains Santé Publique France. They are responsible for several confirmed contaminations and clusters and have been detected in several countries.
The VUMs (variants under evaluation) These are variants for which virological data are currently lacking but whose presence of mutations has been found in several people and deserve monitoring .