Hospital and Population-Based Evidence for COVID-19 Early Circulation in the East of France.

Laurent Gerbaud,Franck Breysse,Camille Dezfouli-Desfer,Jonathan Peterschmitt,Joséphine Odoul,Lemlih Ouchchane,Candy Guiguet-Auclair,Vincent Breton

doi:10.3390/ijerph17197175

Abstract

Background: Understanding SARS-CoV-2 dynamics and transmission is a serious issue. Its propagation needs to be modeled and controlled. The Alsace region in the East of France has been among the first French COVID-19 clusters in 2020. Methods: We confront evidence from three independent and retrospective sources: a population-based survey through internet, an analysis of the medical records from hospital emergency care services, and a review of medical biology laboratory data. We also check the role played in virus propagation by a large religious meeting that gathered over 2000 participants from all over France mid-February in Mulhouse. Results: Our results suggest that SARS-CoV-2 was circulating several weeks before the first officially recognized case in Alsace on 26 February 2020 and the sanitary alert on 3 March 2020. The religious gathering seems to have played a role for secondary dissemination of the epidemic in France, but not in creating the local outbreak. Conclusions: Our results illustrate how the integration of data coming from multiple sources could help trigger an early alarm in the context of an emerging disease. Good information data systems, able to produce earlier alerts, could have avoided a general lockdown in France.

Highlights

The coronavirus disease COVID-19 was labelled a pandemic by the World Health Organization (WHO) on 12 March 2020 [1]
In order to further discriminate COVID-19 cases from other respiratory syndromes circulating in the population, we focused on anosmia, identified as the symptom with the largest positive predictive value for SARS-CoV-2 infection [4,26,27,28]
A total number of 1516 individuals experienced symptoms commonly attributed to COVID-19 infection, corresponding to 1301 adults and children aged 15 years and older and 189 children less than 15 years old

Summary

Introduction

The coronavirus disease COVID-19 was labelled a pandemic by the World Health Organization (WHO) on 12 March 2020 [1]. France has been heavily affected by the SARS-CoV-2 epidemic [2]: the first three cases of COVID-19 in France were confirmed on 24 January 2020 [3]. The Oise department north of Paris was among the first COVID-19 clusters in France where SARS-CoV-2 was actively circulating weeks before the country lockdown on 17 March 2020 [4]. The Alsace region in the East of France has been among the first French COVID-19 clusters in 2020. We check the role played in virus propagation by a large religious meeting that gathered over 2000 participants from all over France mid-February in Mulhouse. Results: Our results suggest that SARS-CoV-2 was circulating several weeks before the first officially recognized case in Alsace on 26 February 2020 and the sanitary alert on 3 March 2020. Able to produce earlier alerts, could have avoided a general lockdown in France

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