Coronavirus file: Epidemic point on the Covid-19 in Guadeloupe, Saint-Martin and Saint-Barth

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The Public Health epidemiological bulletin is a complementary tool for assessing the circulation of the virus on the territory. It monitors, with the contribution of the network of sentinel doctors, consultations for acute respiratory infection
This week, there is a decrease in circulation in town medicine. In the past three weeks, the share attributable to Covid-19 in these consultations is estimated at 318 cases.
To prepare for the release of de-containment, theARS Guadeloupe, Saint-Martin, Saint-Barthélemy is setting up an analysis by PCR tests of cases of acute respiratory infection seen by sentinel doctors and in emergency rooms in order to confirm or not this circulation in town in a less symptomatic form.

What is already known about the situation in our territories?

The first cases of Covid-19 appeared in late February in Saint-Martin and Saint-Barthélemy and in early March in Guadeloupe. Few new cases have been confirmed during the past week (S 15 2020) in Guadeloupe and Saint-Martin. In Saint-Barthélemy, no confirmed case has been recorded since 26/03/2020. Eight deaths are to be deplored in Guadeloupe and two deaths in Saint-Martin, all occurred in a hospital environment.

What is new in this Point for the region?

Since the beginning of April 2020, a downward trend in all Covid-19 monitoring indicators in the city and in hospitals has been observed in the three territories. The number of estimated cases of acute respiratory infection (ARI), part of which is attributable to Covid-19 via the network of sentinel general practitioners, has decreased by more than two thirds in three weeks. During the past three weeks, the share attributable to Covid-19 in these consultations (cumulative number between 23/03 and 12/04) is estimated at 318 cases in Guadeloupe, 27 cases in Saint-Martin and 3 cases in Saint -Barthélemy. In addition, 33 confirmed cases of Covid-19 were admitted to intensive care. No new deaths have been recorded in hospitals since the last epidemiological point. Key indicators

Individual monitoring:

► 145 biologically confirmed cases in Guadeloupe, 34 in Saint-Martin and 6 in Saint-Barthélemy City surveillance

► Sentinel network: 107 (tele-) consultations for IRA / 100 inhabitants (S, 000 in S-176) in Guadeloupe, 1 (tele-) consultations for IRA / 42 inhabitants (S, 100 in S-000) in Saint-Martin and 82 (tele-) consultations for IRA / 1 inhabitants (S, 50 in S-100) in Saint-Barthélemy

► Virology (samples taken in town medicine): three positive samples out of 15 analyzed (positivity rate of 20%) in Saint-Martin and one sample produced negative income in Saint-Barthélemy.

Surveillance in nursing homes including nursing homes ► 7 possible cases including 0 confirmation reported on 15/04/2020

Hospital surveillance

► Oscour® network: 50 passages for suspected COVID-19 between 06/04 and 12/04/2020 (S, 42 in S-1), one passage in Saint-Martin (S, 5 in S-1) and three passages in Saint-Barthélemy (S, 2 in S1)

► Hospital laboratories: 8,4% of positive tests (S, 16,5% in S-1)

► Resuscitation / intensive care services: 57% of cases aged 65 and over, and 36,4% of cases with at least one risk factor

* S / S-1: for week S (from 06/04 to 12/04/2020) and week S-1 (from 30/03 to 05/04/2020)

City surveillance

Acts / consultations for suspected COVID-19

Surveillance in city medicine is based on the network of sentinel doctors and 3Labos virological tests. A clear decrease in the number of (tele) consultations for acute respiratory infection (ARI) via the network of sentinel doctors has been observed in the three territories since the start of surveillance (week S 13 2020). Last week S 15 2020 (between 06/04 and 12/04/2020), no positive test was identified via 3labos. All the samples were taken in medical biological laboratories in France from people domiciled in Guadeloupe but sampled in mainland France during their stay.

Number of cases estimated and estimated rate of (tele-) consultations for an acute respiratory infection (ARI) in Saint-Martin

· Week 15 2020: 15 cases estimated or 42 consultations / 100 inhabitants [000% CI = 95 - 28]

share attributable to Covid -19 (23% positivity rate): 4

· W14 2020: 29 cases estimated, i.e. 82 consultations / 100 inhabitants [000% CI = 95 - 157]

share attributable to Covid -19 (27% positivity rate): 8

Number of cases and actual rates of (tele-) consultations for acute respiratory infection (ARI) in Saint-Barthélemy

S15 2020: 5 clinical cases or 50 consultations / 100 inhabitants

share attributable to Covid -19 (0% positivity rate): 0

S14 2020: 14 clinical cases or 141 consultations / 100 inhabitants

share attributable to Covid -19 (0% positivity rate): 0

Hospital surveillance

In Guadeloupe, the number of emergency visits for suspected Covid-19 is stable, with 50 emergency visits in week S15 (from 06/04 to 12/04/2020).

In Saint-Martin, the number of emergency visits for suspected Covid-19 has been low for two weeks, with only one emergency visit in week S15.

In Saint-Barthélemy, no emergency calls for suspected Covid-19 have been recorded since 11/03/2020.

Hospitalizations, resuscitation admissions, home returns

As of April 15, 2020, 102 people had been seized in the SIVIC system, distributed as follows: 35 in the course of hospitalization, including 8 in intensive care. Among these 102 people, 56 people returned to their homes, or 55% of those who were hospitalized. The number of hospitalizations has been decreasing since the beginning of April 2020. The hospitalized people most affected are aged between 60 and 89 years (71%). Among them, 50% of people admitted to intensive care are between 70 and 79 years old. Home returns concern 54% of 50-69 year olds.

In Saint-Barthélemy, no hospitalizations have been recorded in confirmed cases.

Characteristics of cases admitted to intensive care (sentinel services)

The resuscitating doctors of the Pointe-à-Pitre / Abymes teaching hospital and the Louis-Constant Fleming hospital center reported to Public Health France Antilles 33 patients meeting the case definition:

- confirmed case: patient hospitalized in an intensive care unit and presenting a biologically confirmed covid-19 diagnosis

- probable case: patient hospitalized in an intensive care unit and presenting a thoracic CT suggestive of a covid-19 diagnosis.

Among these 33 patients, 57% are over 65 years old and 36,4% have at least one risk factor. Six people died. The number of resuscitation cases decreased in week S 15 2020. (Source: Resuscitation / intensive care services, Public health France, at 15/04/2020 at 6 a.m., Guadeloupe and Saint-Martin)

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