FOCUS – The dreaded change that is plunging Brazil into chaos is raising questions and mistrust in France.
Despite the entry restrictions on French soil, every day around fifty people continued to land on French soil from Brazil, where the epidemic situation turned into disaster under the explosion of local variants. “A right”, had specified the Minister of Transport Jean-Baptiste Djebbari in the face of calls to suspend air links. The Prime Minister, however, decided on Tuesday to suspend all air links with Brazil, “until further notice”, Taking into account the risks represented by the Brazilian variant.
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The subject of concern is called P1, or rather variant 20J501Y.V3, and was first observed in mid-December in the city of Manaus, in the Brazilian part of the Amazon rainforest. This is characterized by mutations in the protein Spyke N501Y and E484K, like the British and South African strains, as well as K417T. This impacts the contagion and resistance to immunity of this new variant.
A fear verified by the first studies. According to the medical journal MedRxiv , the Brazilian variant can be up to 2.5 times more contagious than the original strain. Its potential for reinfection, i.e. its ability to infect people infected in the past, is estimated to be between 25% and 61%.
Several indications also suggest that P1 affects patients much younger than the other variants. The Brazilian Association of Intensive Care (AMIB) revealed on Sunday April 11 that more than half of the approximately 11,000 patients in intensive care in the country were under 50 years old. An observation linked to the fact that young people expose themselves more and are less likely to be vaccinated, of course, but also to the increased mortality of the virus in this age group. Mortality figures among those under 45 have increased by 193% since P1 has dominated the country, according to AMIB.
- Is it resistant to different vaccines?
Few data are currently available to reaffirm the efficacy of vaccines on the P1 variant. Only 10% of Brazilians have received a dose of the AstraZeneca vaccine, the only one currently administered in the country. A few studies are nevertheless reassuring. According to scientists at the University of Oxford, the vaccines produce a stronger immune response than has been feared. Its immune response is said to be similar to that of the British variant, and better than the South African. The AstraZeneca vaccine would be three times less effective on P1 than on the original strain, against nine times for the South African variant.
- What is happening in Brazil?
With 4,000 new deaths a day linked to the coronavirus, the epidemic outbreak is out of control in Brazil. Hospitals are overcrowded in most areas. In the economic capital of the country São Paulo, buses reserved for school transport are mobilized to transport corpses.
This situation is due to the preponderance of the P1 variant in the country, but also to the management of the health crisis. President Jair Bolsonaro still refuses to pronounce general confinement across the country, and strives to criticize the various measures taken locally, such as in Rio de Janeiro and São Paulo.
The situation is all the more critical as Brazil is not fighting against a mutant, but dozens. Faced with this intense circulation of the epidemic, the virus evolves very quickly, including the P1 variant itself. “We are at 17 mutations so far, it is a lot and this is what can explain that it is so transmissible”, details the neuroscientist Miguel Nicolelis on Europe 1. Added to these is his twin P2, a very similar variant detected in October in the region of Janeiro, and the formidable Belo Horizonte, a strain that contains no less than 18 combined mutations, from different Brazilian, South African and British variants.
In all, the Fiocruz Institute has currently identified 92 variants of the coronavirus in Brazil. “Brazil could thus become a laboratory of open-air variants that can compromise the fight against the pandemic around the world“, Miguel Nicolelis fears. The virus, by re-infecting people who have already had the disease, or who have received a single dose of vaccine, mutates to adapt to these new configurations: an uncontrolled variant can thus generate another. A worrying epidemic scenario called “exhaust“.
- Should we fear a similar situation in France?
To date, the Brazilian variant represents less than 1% of contaminations in France, according to the latest epidemiological bulletin of Public Health France which qualified, on April 8, of “stable” the situation of South African and Brazilian variants in France. Thus, for example, only a hundred cases have been identified in a week in the Occitanie region, according to Jacques Izopet, head of the biology center and head of the virology department of the Toulouse University Hospital, who told the Midi Dispatch : “For the moment, there is no particular concern, but we must watch”.
The Brazilian variant is not the majority in France, because in the absence of massive arrivals of patients, “he disappears in front of the British variant, explain to Parisian Bruno Lina, member of the Scientific Council. It has a transmissibility only 20 to 30% higher than the original virus, against 60% for the British.“
P1 has however created important clusters beyond the Brazilian borders. In the province of British Columbia, Canada, nearly 900 people have been infected with this variant after a cluster exploded in the Whistler ski resort. There, none of the patients, often young, nevertheless returned from Latin America. “If it arrives on European and French soil, it will be able to experience rapid growth”, says Professor Rémi Salomon, who calls for limiting the movement of travelers from Brazil and for the imposition of a strict quarantine.