New Covid-19 restrictions ‘only delaying the inevitable’, say French health experts

New Covid-19 restrictions ‘only delaying the inevitable’, say French health experts

January 31, 2021 0 By boss

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French Prime Minister Jean Castex announced Friday that France will bar travel to and from non-EU countries and close large shopping centres in a bid to avoid a third Covid-19 lockdown. For some French epidemiologists, the new restrictions won’t be enough to flatten the curve.

“Our duty is to do all we can to avoid another lockdown,” Castex said in a televised address that laid out new measures to stem the latest wave of French Covid-19 cases. But the government’s surprise decision to not put the country in lockdown has drawn criticism from some of the country’s health professionals. 

The new measures ban all but emergency travel to and from non-EU countries from midnight Sunday. People arriving from within the EU have to present a negative PCR Covid-19 test, taken within 72 hours of travelling. Shopping centres larger than 20,000 square metres that do not sell food are to close, and fewer customers will be allowed inside a supermarket at the same time.

France reported 24,393 new Covid-19 infections on Saturday, up from 22,858 the day before, while more than 27,000 patients were in hospital for a fifth straight day.

The rate of daily new infections is lower than when the government ordered the last lockdown in October, but hospitalisation rates are already comparable.

“Everything suggests that a new wave could occur because of the [more contagious British] variant, but perhaps we can avoid it thanks to the measures that we decided early and that the French people are respecting,” Health Minister Olivier Véran told French weekly Le Journal du Dimanche on Sunday.

He said that the number of new coronavirus cases had barely increased last week, while other indicators – such as traces of the virus detected in waste water – were also reassuring.

“Even when the path is narrow, you need to take it,” President Emmanuel Macron was reported as telling ministers at the meeting on Friday.

But some French health experts were unimpressed by the new restrictions.

“The health measures are almost meaningless,” Gilbert Deray, the head of nephrology at the Pitié-Salpêtrière hospital in Paris, told French TV network BFMTV on Saturday. 

Using a French idiom about making a successful jump, Deray said: “You’re not taking a step back to make a better jump forward. You’re taking a step back to make a worse jump forward. The more you step back, the more quickly the virus spreads – and it will spread. And it’s going to make it harder and longer.” 

When Dominique Costagliola, an epidemiologist who won France’s Inserm Public Health Institute’s 2020 Grand Prize for her work on Covid-19 research, was asked about the potential impact of the measures announced by Castex, she turned the question on her interviewer.

“You think there have been announcements?”

‘Nothing that can break the current dynamic’

“These [measures] cannot break the current dynamic,” French epidemiologist and biostatistician Catherine Hill told FRANCE 24. “The virus is already circulating in the country so it’s too late to close the borders.” 

The UK variant of Covid-19 now accounts for 10 percent of cases detected in France.

“I think the government wants to synchronise lockdown with the school holidays [starting February 6]. That was probably [Friday] night’s logic,” Hill said.

Bruno Megarbane, head of the medical and toxicological intensive care unit at Paris’s Lariboisière hospital, was of a similar opinion. “It’s clear there’s a willingness to wait, probably to dovetail additional restrictions with the February holidays. It’s going to be a lockdown of at least a month, so we need to weigh how necessary it is,” he told the TV station LCI.

Hill believes that France urgently needs to impose a new lockdown. Using a graph to explain the current dynamics of the epidemic, she compared January’s figures to the periods before the first two lockdowns.

The dynamics of France's Covid-19 epidemic.
The dynamics of France’s Covid-19 epidemic. © Catherine Hill

“The number of people admitted to hospital (in red) and ICU admissions (in blue) have been generally synchronous since the beginning of the pandemic,” she said. “Now they are rising again to worrying levels. By not putting people in lockdown, we’re only delaying the inevitable. Hospitals will be inundated.”

France reported 27,242 Covid-19 patients in hospital on Saturday, not far below the peak tallies during the outbreak’s first wave (32,000) and second (33,000). On Friday, 3,120 patients were in intensive care, though this is below the peaks of 7,000 last spring and 4,900 in autumn. 

“We lifted the second lockdown too soon. We haven’t come down to the June-July level, as the graph shows,” Hill said. 

“Lockdown is a palliative solution,” she added. “I like this quote from a World Health Organisation expert I read in The Guardian: “Lockdowns affecting entire populations is a price countries pay for failing to ensure people with coronavirus and their contacts self-isolate … The key to controlling epidemics … is to test people, trace their contacts and ensure all those who are positive or who have been close to those infected are quarantined.”

Hill also said that by focusing almost exclusively on symptomatic cases, France’s approach to testing was misguided. “More than half of cases come from people without symptoms. The virus circulates covertly through them. We don’t look for these people, and so we don’t find them,” she said, citing a recent study published on the Journal of the American Medical Association’s open network.

“Nasopharyngeal tests are the preferred tests at the moment, but they are very painful and limited. We could move on to saliva tests. Spitting in a tube won’t hurt anyone,” Hill said. “To improve the speed of tests, we could also “pool” them. Instead of testing samples one by one, samples are pooled in groups of 10 or 15. If the test result is negative, we can immediately rule out these people.” 

“We must take advantage of a new lockdown to test massively and to review our strategy,” Hill said. “Failing that, there may well be more lockdowns until enough people are vaccinated.”

This article has been translated from the original in French.

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