Covid-19: why the fourth wave is so violent in overseas territories

DECRYPTION – The overseas territories are hit by an unprecedented explosion of contaminations, favored by particularly low vaccination coverage.

In less than three weeks, the number of Covid-19 cases overseas has exploded. The incidence rates are breaking all records in Martinique, which records 995 cases per 100.00 inhabitants, and in Guadeloupe at 828. A “dramatic”, “catastrophic” situation, declared Jean Castex while the two territories, as well as Reunion Island , are re-defined for at least three weeks from this Wednesday evening. Faced with hospital tension, three transfers of Martinican patients took place to the metropolis on Saturday. Why this sudden surge in cases in territories that had hitherto been relatively untouched?

“We are surprised by the violence of this fourth wave”, concedes André Cabié, infectious disease specialist at the Martinique CHU. “All the more so since the majority variant remains the Alpha variant; the situation is likely to deteriorate further with the spread of the Delta variant. ” According to the professor, the inhabitants of the overseas territories tend to underestimate the epidemic threat. “In Martinique, there was a movement of total abandonment of barrier gestures, and many festivities which coincided with the end of wearing a mask”, he explains. “As we had not been very badly affected by the previous waves, the Martinicans often took things lightly.”

The epidemic has struck a fragile population because it is less immune than that of regions where covid-19 has actively circulated. It affects a population that is often at risk, presenting co-morbid factors. Severe obesity affects 18 to 30% of the population in overseas territories, against 17% on the continent. In the Antilles, 10% of the inhabitants present some form of diabetes.

SEE ALSO – Covid-19: the state of health emergency declared in Guadeloupe, Saint-Martin and Saint-Barthélémy

The population is all the more vulnerable as vaccination coverage in the Overseas Territories is low, very low. Only 15.9% of Martinicans had received the two doses of vaccine on July 28, like 15.8% of Guadeloupe and 16.2% of Guyanese. In Reunion, the rate of people vaccinated is significantly better, around 30%, which remains however well below the national average. “We have a population which is more wait-and-see” than in metropolitan France, with “one inhabitant in four in the Antilles-Guyana zone (…) favorable to vaccination but who would prefer to wait”, underlines the Ministry of Health.

A reluctance which can be explained by “A complex mixture of various sociological phenomena”, according to Stéphane Artano, senator from Saint-Pierre and president of the overseas delegation, cited by West France . “The history of colonization, the weight of the decisions of a State far from local realities and young people little affected by the virus provide avenues of response. Without forgetting, in certain territories, the importance of religious practices and the belief in traditional medicine. ”

Distrust of the metropolis

“We often observe a systematic mistrust vis-à-vis what represents Paris, whether it is the ARS or the prefecture”, continues infectious disease specialist André Cabié. “Mistrust is very important in the health field, after the chlordecone scandal. “ The pesticide, used to protect banana crops, has poisoned West Indian soils. According to Public Health France, more than 90% of Martinicans and Guadeloupeans have been contaminated with chlordecone, while it was banned since 1990 in metropolitan France. “We feel a very great anxiety vis-à-vis the vaccine and what is imported from the continent.”

“The Martinicans are reluctant to vaccination, normal, we are already poisoned with chlordecone!” writes a woman on Twitter. In Guyana, Senator Marie-Laure Phiner Horth had announced her choice not to be vaccinated, questioning the effectiveness of the injections. Traditional medicines continue to seduce: in the West Indies, peak grass has been acclaimed as the miracle cure against the coronavirus, although no scientific study has demonstrated the effectiveness of this endemic plant. Guadeloupe pharmacist Henry Joseph filed a patent for “Virapic” syrup, sales of which exploded at the start of the year.

SEE ALSO – Covid-19: in Martinique, the vaccination debate rages as the Delta variant spreads

The “big stake” for the weeks to come

Faced with the outbreak of Covid in the Overseas Territories, the Ministry of Health indicated that the vaccination of “Wait-and-see” and part of the “Refractory” constituted “The big stake for the next few weeks”. “This encourages us to be much more proactive in the way we offer the vaccine to people”, he adds, emphasizing systems such as mobile teams, “vaccibuses” and partnerships with local associations. “It is also for this reason that we particularly count in these territories on school vaccination”, who could “Have a ripple effect” on these people, wants to believe the ministry.


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