The 2019 coronavirus (also known as Covid-19 or SARS-CoV-2) is an infectious disease caused by the SARS-CoV-2 coronavirus belonging to the very large family of Coronaviridae. These viruses are constantly changing and evolving. It was during one of these mutations that it became able to infect humans.

The essentials to know about the coronavirus

Unlike its predecessors, this virus appears to be particularly contagious. It has also been found in many fluids and biological excretions (secretions from the mouth and nose, blood, stools, urine), which suggests the risk of multiple transmission, especially since all patients infected do not necessarily show symptoms, especially in younger people. In 80% of cases, Covid-19 hardly poses a problem and the patient heals quickly, without needing to be hospitalized.

But in people who are already weakened – by chronic disease, immunosuppression, old age, etc. – Covid-19 can become complicated and require hospitalization, or even resuscitation. 

Coronavirus and covid-19, what are they?

Coronaviruses belong to a family of viruses, which can be responsible in humans for various infections ranging from the common cold to severe pulmonary infection, with acute respiratory distress.

In the case of the COVID-19 infection, due to a coronavirus called Sars-CoV-2, it is a coronavirus close to SARS which had caused a global epidemic in 2002-2003. But it is contagious at a higher level.

At the end of December 2019, the World Health Organization (WHO) was informed of several cases of pneumonia in China and since then the infection has spread rapidly around the planet. The WHO now qualifies it as a pandemic: 188 countries are affected.

What are the causes of Covid-19?

Coronaviruses are constantly mutating and from time to time one of them is shown to be able to infect humans, which is the case with Sars-CoV-2. The infected person can then infect others and so on. Human movements all over the world greatly facilitate the spread of the virus to other countries.

Two strains of Sars-CoV-2 are in circulation:

• An S strain which is the oldest. It is less frequent (30% of cases) and less aggressive.
• An L strain, more recent, more frequent (70% of cases) and more severe.

Likewise, no case of contamination by water or food has been reported, even for raw food.

Although it appears that the starting point is animal-to-human transmission (from the Wuhan market in China), there is no evidence to date that pets or breeding, play the least role in the spread of the virus.

Coronavirus variants

As of May 21, among the diagnosed cases, 77,9 % are suspected of infection with the English variant et 5,9% to the two other new strains (South African and Brazilian), according to Public Health France. The English variant, called 20I / 501Y.V1, is now present in 80 countries.

According to the French Public Health report of January 28, 299 cases of infection with the VOC 202012/01 variant (United Kingdom) and 40 cases of infection with the 501Y.V2 variant (South Africa) have been identified in France. Since then, the prevalence of variants has increased. 

The English variant

The British variant would, a priori, not have been imported from abroad. The coronavirus has probably evolved in the UK. According to British scientists, the new VOC 202012/01 variant contains 17 mutations compared to the coronavirus discovered at the end of 2019, two of which affect the protein that the virus uses to penetrate and infect human cells. In addition, it would be 70% more transmissible, without being more dangerous. This British version would have no impact on the effectiveness of anti-Covid vaccines, the body being prepared to produce many antibodies, directed against different targets.

In addition, VOC 20201/01 or B.1.1.7 quickly spread to the Netherlands, Denmark and Italy. Today, it is present on all continents. The first case was detected in France on December 25, 2020 in Tours. It was about a man of French nationality and residing in England. The results of his test, positive, evoked the variant which circulated in Great Britain. After performing sequencing, the National Virus Center confirmed infection with the 2020/01 VOC variant. The person has been isolated and is doing well.

The South African variant

The South African variant, named 501Y.V2, appeared in South Africa after the first wave of the epidemic. The country’s ministry has confirmed that it is spreading faster. On the other hand, it does not seem that this new version creates a greater risk of developing severe forms of the disease. According to the WHO, the South African variant of 501Y.V2 has been detected in 20 countries or territories. 

French authorities confirmed the first case on December 31, 2020. It was a man residing in the Haut-Rhin department, after having stayed in South Africa. He exhibited symptoms of Covid-19 a few days after his return. The test was positive for the 501Y.V2 variant. The person is now healed and is doing well, after immediate isolation at home.

The Indian variant

French health authorities have identified the first cases of infection with the B.1.617 variant, also called ” variant if ”, Because it is very present in India. He carries a double mutation, which would make him more transmissible and more resistant to vaccines against Covid-19. In France, a case was detected in the lot and Garonne. Two other cases were detected in the Bouches du Rhône. All of these people have travel histories in India. Other suspicions of the Indian variant have been reported in France. 

How to diagnose the coronavirus? 

Update December 1 – The French National Authority for Health has issued a favorable opinion for the EasyCov® saliva tests, with a satisfactory sensitivity of 84%. They are intended for symptomatic patients, for whom the nasopharyngeal test is impossible or difficult to perform, such as for young children, people with mental disorders or people of very advanced age.

As of November 5, the deployment of antigenic tests is accelerating in France to screen for Covid-19. These rapid tests are available in pharmacies or other medical offices and provide a result in 15 to 30 minutes. The list of pharmacies and volunteer caregivers should soon be available on the Tous Anti-Covid application. The antigen test complements the RT-PCR reference test, but does not replace it. As of November 13, according to the Minister of Solidarity and Health, Olivier Véran, 2,2 million PCR tests are carried out per week. In addition, 160 antigenic tests have been performed over the past two weeks.  

However, certain conditions must be met to perform this new virus detection test, according to the recommendations of the Haute Autorité de Santé: asymptomatic people who are not contact persons (large-scale screening to identify clusters in collective places, such as nursing homes or universities) and sick people, within 4 days of the onset of the first symptoms. 

Antigenic tests can be carried out in voluntary pharmacies, in general practitioners and in laboratories. Other health professionals are also authorized to perform the nasopharyngeal sample, such as dentists, midwives, physiotherapists or nurses. 

If the result is positive, the patient should self-isolate and contact their attending physician. On the other hand, if the antigen test is negative, it is unnecessary to confirm the result by an RT-PCR test, except for people at risk of developing a severe form of Covid-19.

Today, several types of professionals are authorized to practice the reference test, the RT-PCR test, in particular state-certified nurses, students in dentistry, maieutics and pharmacy, nursing assistants, sappers. firefighters, marine firefighters and first aiders from approved civil security associations.

Since October 19, anyone who wishes can be tested for Covid-19. The RT-PCR test is free and no longer requires a prescription. To reduce waiting times for obtaining results, people have priority to take the Covid-19 test: symptomatic people, contact cases, nursing staff and the like. 

It is fully covered by Medicare. In addition, new, innovative tests will soon be available, according to the government. Antigenic tests can be carried out in pharmacies by trained personnel. 

The result is given within 15 or even 30 minutes. They will not be reimbursed in full. Mass screening is already underway in some nursing homes, thanks to antigenic tests.The diagnostic tests for COVID-19 can be carried out in all the reference health establishments (ESR) which are the reference hospitals at the regional level. Samples for screening tests for Sars-CoV-2 can also be carried out by laboratories in town.

These diagnostic tests are only carried out in the event of suspicion of the infection after questioning by a doctor from the SAMU or a referring infectious disease specialist. In departments where the coronavirus is very active, tests are reserved for people with severe symptoms. The sample is taken using a swab (a kind of cotton swab) used to collect phlegm in the nose or throat. The result is known within 3 to 5 hours.

• If the diagnosis of SARS-CoV-2 is negative. There is nothing to do.
• If the diagnosis of SARS-CoV-2 is positive: in the absence of symptoms (or in the event of mild symptoms), the person tested positive goes home where they must remain confined for 14 days. He is asked to avoid as much as possible contact with other members of the family (or roommates) and, as far as possible, to have a specific bathroom and WC or, failing that, not to touch any common objects, frequently washing affected surfaces such as doorknobs. If it is delivered at home, it must ask the deliveryman to leave the package on the landing to avoid any contact. Since September 11, people who test positive, contact cases or people awaiting their results must remain in isolation for 7 days. 
• If the diagnosis of SARS-CoV-2 is positive and there are respiratory problems, hospitalization is decided.

The people concerned

Anyone can be infected with Sars-CoV-2 because this virus is new, our immune system does not recognize it and cannot protect us from it. However, it is especially some people who are at greater risk of serious complications. We may be concerned in the following cases:

• An age of over eighty,
• High blood pressure,
• Diabetes,
• A pre-existing lung disease,
• Heart disease,
• Cancer under treatment
• Immunosuppression,
• A pregnancy in progress (according to known infections by other coronaviruses, for a pregnant woman, there will no doubt be a risk of miscarriages and premature deliveries).
• More generally, any fragile person.

Coronavirus risk factors

• Having stayed in a place where the coronavirus is circulating in the previous 14 days, or having been in contact with a person infected with Sars-CoV-2, exposes the risk of developing the Covid-19 infection.
• In case of close contact with a coronavirus patient – same place of life and / or face to face within a meter at the time of a cough or sneeze or a conversation and / or presence in one place confined for at least 15 minutes – it is recommended to stay at home for 7 days – against 14 days previously – (strict quarantine) with self-monitoring of the temperature twice a day.
• If the contact was neither close nor prolonged, a simple reduction in social activities – such as not going to places where there are fragile people such as nursing homes, maternities, hospitals, clinics – and a car. temperature monitoring suffices.
• If a fever appears and / or if suggestive symptoms occur (cough, difficulty breathing, etc.) it is advisable to contact your doctor by phone. In the event of breathing difficulties, you should immediately call the Samu on 15 to quickly benefit from a diagnostic test.

In the meantime, do not go to a doctor’s waiting room or emergency room under penalty of contaminating all the people there. On the contrary, you must stay at home, avoiding any contact with a fragile person (elderly people, people with a chronic illness, pregnant women, etc.).

Transmission of the coronavirus

As a reminder, Covid-19 is transmitted mainly by droplets emitted during a discussion, a sneeze or even a cough. Therefore, barrier gestures must be applied, such as keeping a good distance from each other, wearing a mask or washing your hands regularly with soapy water. Covid-19 can also be transmitted through contaminated surfaces. It is therefore advisable to clean them with bleach as well as other objects liable to be soiled, such as switches or door handles. 

Recommendations to avoid transmission

Recommendations have been put in place to avoid getting infected. The new coronavirus spreads very quickly and will cause symptoms, although some people have little or no symptoms. 

Since July 20, 2020, wearing a mask is mandatory in enclosed public places, for people aged 11 and over. Since September 1, this obligation extends to companies, in particular for people who do not have an individual office. For pupils from 6 years old, the mask is compulsory inside and outside schools.

As of November 10, 2020, wearing a mask is mandatory in enclosed areas of French territory, but also outdoors in certain cities, such as Paris, Marseille or Nice. It is also found in the Alpes-Maritimes, Bas-Rhin, Bouches-du-Rhône, Charente-Maritime, Côtes d’Armor, Oise and other departments. The obligation to wear a mask can therefore extend over an entire municipality, since there are several areas at risk of contamination. To fight against the coronavirus epidemic in France, other cities make the wearing of a mask partially compulsory, in certain neighborhoods or certain public places, such as children’s parks. This is the case for Lille, Montpellier, Nantes and even Nancy. The cities are allowed to make the decision or not. A sanction is put in place if the rule is not respected, i.e. a fine of 135 €. 

Tightened restrictions and curfews

• travel between home and the place of exercise of the professional activity or an educational or training establishment; business trips that cannot be postponed; travel for a competition or exam. (to be used by self-employed workers, when they cannot have proof of travel established by their employer);
• travel to an authorized cultural establishment or place of worship; travel to make purchases of goods, for services the provision of which is authorized, for order withdrawals and home deliveries;
• consultations, examinations and care that cannot be provided remotely and the purchase of medicines;
• travel for compelling family reasons, for assistance to vulnerable and precarious people or childcare;
• travel for people with disabilities and their companions;
• travel in the open air or to an outdoor location, without changing the place of residence, within the limit of three hours per day and within a maximum radius of twenty kilometers around the home, linked either to physical activity or to individual leisure activities, to the exclusion of any collective sporting activity and any proximity to other people, either for a walk with only people grouped together in the same home, or for the needs of pets;
• judicial or administrative summons and travel to go to a public service;
• participation in missions of general interest at the request of the administrative authority;
• trips to pick up children from school and during their extracurricular activities.

• the exceptional travel certificate remains in force, but it will be authorized to travel within a radius of 20 km around your home, for a period of 3 hours; 
• businesses, booksellers and record stores can reopen on this date, in accordance with a strict protocol;
• extra-curricular outdoor activities may resume. 

As of December 15, if the health objectives are reached, i.e. 5 new infections per day and between 000 and 2 intensive care admissions: 

• containment will be lifted;
• unnecessary travel should be avoided;
• cinemas, theaters and museums will be able to reopen, with a strict sanitary protocol;
• a curfew will be implemented throughout the territory, from 21 p.m. to 7 a.m., except for the evenings of December 24 and 31.

January 20 is the third key date. On this date, if the conditions are met, restaurants, cafes and sports halls will be able to resume their activities. Classes in high schools will resume face-to-face, then 15 days later for universities. 

The President of the Republic announced a second confinement for France, from Friday October 30, for a minimum period of four weeks. This measure is taken to try to curb the Covid-19 epidemic in France. Indeed, the health situation in this second wave is more “brutal»Than the first, last March. In 24 hours, more than 35 cases were declared. The virus reproduction number (or effective R) is 000. The incidence rate (number of people positive for a screening test) is 1,4 per 392,4 inhabitants. In addition, the occupancy rate of resuscitation beds by Covid-100 patients is 000%. The first confinement was effective. This is why Emmanuel Macron decided to impose it a second time on the French. Some rules are similar to those of last spring: 

• each citizen must obtain the compulsory travel certificate during authorized outings (professional, pressing, medical reasons, to make essential purchases or to walk his pet);
• private meetings are excluded and public gatherings prohibited;
• establishments open to the public are closed (theaters, cinemas, swimming pools, etc.) as well as “non-essential” businesses (restaurants, bars, cafes, shops, etc.);
• partial unemployment is renewed for employees and employers.

On the other hand, changes take place compared to the first confinement:

• nurseries, schools, colleges and high schools remain open;
• the students follow the courses remotely; 
• teleworking is generalized, but not compulsory;
• activity in factories, farms, the construction sector and public services continues;
• it will be possible to visit an elderly person in nursing homes, provided that the health protocol is respected.

The mask made compulsory in France: which cities and places are concerned? 

Since May 11, 2020, wearing a mask is mandatory in public transport (bus, tram, trains, etc.). On July 20, 2020, it becomes so in closed places (shops, restaurants, cinema, etc.). Regarding the start of the school year in September 2020, children over 11 years old must wear a mask at school. Employers are required to issue masks to their employees. Since the end of July 2020, cities can decide to impose the mask, even in the streets. Regional prefects take restrictive decisions when towns or departments are on alert. This is the case of Paris, which joins Marseille, Toulouse and Nice. To fight against the epidemic linked to the coronavirus in France, other cities are content to make the wearing a mask partially compulsory, that is to say only in certain neighborhoods, such as Lille, Nantes, Nancy, Montpellier or even Toulon. It is possible to remove it to eat or drink, by staying away. Otherwise, the person is liable to a fine of up to € 135. The wearing of the obligatory mask extends in several cities of the region of the Rhône and in 7 cities of the Alpes-Maritimes, until October 15. This measure may be extended, if necessary. Local restrictions change regularly depending on the circulation of the virus.

Protecting yourself against the coronavirus

Prevention against coronavirus is the same as for influenza and gastroenteritis. It is thus recommended:

• To wash your hands regularly with soap and water, rubbing well between the fingers for at least twenty seconds and rinsing thoroughly.
• Only if there is no water point, wash your hands with a hydro-alcoholic solution. It is not recommended to use this solution exclusively, because there is a risk of skin dryness.
• Favor teleworking when possible.
• Avoid all unnecessary outings and gatherings.
• Any travel abroad should be postponed as far as possible. In fact, many flights have been canceled. In the event of travel, despite everything, to a country where the virus is circulating, refer to the specific recommendations given by the Ministry for Europe and Foreign Affairs (www.diplomatie.gouv.fr/fr/conseils-aux- travelers / advice-by-country-destination /)

To protect others

Sars-CoV-2 is transmitted among other things by droplets of saliva, it is requested:

• To wash your hands regularly with soap and water, rubbing well between the fingers and rinsing thoroughly.
• Only if there is no water point, wash your hands with a hydro-alcoholic solution.
• Coughing or sneezing into his elbow or a disposable tissue, to throw in a trash can.
• Avoid kissing or shaking hands to say hello.
• Provisional measures such as the closure of nurseries, schools, colleges, high schools and universities are taken to limit the spread of Sars-CoV-2.
• New restrictions are taken regularly, depending on the circulation of the virus and exceeding the alert thresholds. Among them, the reduction in the capacity of students to 50% in amphitheatres and classrooms, already in force.

How to clean a contaminated surface and inactivate the virus?

Cleaning a surface contaminated with 62-71% alcohol or 0,5% hydrogen peroxide or 0,1% bleach for one minute is an effective measure. This is important when we know that the survival of SARS-CoV-2 on an inert surface would be of the order of 1 to 9 days, in particular in a humid atmosphere and at low temperature.

To get informed

• During the epidemic, a toll-free number was set up to answer all questions about Covid-19, 24 hours a day, 24 days a week: 7 7 0800.

• The Ministry of Solidarity and Health answers many questions on its site: www.gouvernement.fr/info-coronavirus and the data is updated according to the evolution of Covid-19 in the country.

• The WHO website: www.who.int/fr/emergencies/diseases/novel-coronavirus-2019