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“We will be forced to reconfigure the country”

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Despite the national curfew at 6 p.m. in force throughout the country, new hospitalizations and resuscitation are increasing in France. “The health situation is bad,” said epidemiologist Catherine Hill, for whom “we will be forced to refine”. Interview.

Never two without three ? A new confinement in France is no longer to be ruled out, and it “would probably become an absolute necessity” if the circulation of the British variant of Covid-19 increased “significantly”, the Minister of Health warned Thursday, January 21, Olivier Véran, during a hearing before the Senate Law Commission.

In the evening, invited on TF1, the minister again raised this possibility: “If the situation were to change (…) and if despite the curfew at 6 p.m., the health pressure should increase, then we could consider a confinement”.

In several European countries, restrictions have multiplied in recent weeks: confinement has been extended and reinforced in Germany until mid-February, strict confinement has been applied in England from the beginning of January at least until the beginning of March, lockdowns are also underway in Portugal and Austria …

France, “rather good student” in health matters in Europe, as the President of the Scientific Council Jean-François Delfraissy said on January 12, sees its epidemic curves deteriorate despite the establishment of a national curfew at 18 h. The incidence rate – new cases per 100,000 inhabitants over a week – has stabilized nationally for several days, around 190. While it is still too early to see an effect of curfews, the Ministry of Health considers that this solution is “effective” in the 15 departments where it came into force since January 2. Two weeks later, the incidence rate is down in ten departments.

But in the eyes of health authorities and many doctors, the context is still made very fragile by the threat of Covid-19 variants, including the more contagious VOC 202012/01, which has overwhelmed the hospital system in the United Kingdom, where 1 820 additional deaths were recorded on Wednesday (93,290 deaths in total), a new daily record.

France recorded 25,735 patients hospitalized for a Covid-19 infection on Thursday, or 49 more in 24 hours, and 2,876 patients in intensive care, or 24 more people than Wednesday.

Catherine Hill, epidemiologist, explains to France 24 why “we will be forced to re-limit” even if “this is not the solution” to control the epidemic.

France 24: what is your current state of health in France? ?

Catherine Hill: We see that the arrivals at the hospital and in intensive care are more or less synchronous [les lignes rouge et bleue sur le graphique ci-dessous, NDLR]. From 1er December, there was a kind of plateau, then a drop in hospitalizations during the “truce for confectioners”. And after the Christmas holidays, hospital and intensive care arrivals have increased, as have mortality in recent days.

The health situation is bad: we deconfined much too early in December, which is why we remained on a high plateau with more than 350 deaths per day. And the health situation is deteriorating.

To this are added the variants in circulation: if we have more contagious (like the British variant, Editor’s note), the growth of the epidemic will be faster. And if in addition it is more serious, as could be the variant which kills the inhabitants of Manaus at high speed, it would be even more catastrophic.

Evolution of epidemic curves in France since October 1, 2020 (source: DataGouv data). © Catherine Hill, data

Should we reconfine the country ? If so, why and for how long ?

As French hospitals are going to be saturated again, we will be forced to reconfigure the country. But confining the country without mass testing is of little use. The first containment did not solve the problem, the second either, the third will not solve anything because the epidemic will continue. You have to confine to massively test the population: by testing 95% of the population at the same time with saliva tests, you can find people who are positive and then isolate them quickly instead of waiting for them to show symptoms. But we obviously did not decide to do this in France.

Regarding the duration, the later we confine, the more the epidemic progresses, so this is not a good strategy. If we had confined a little earlier the first time [en mars-avril, NDLR] we would have had a lot less deaths. The earlier we confine, the more we reduce the risks, but anyway confinement is not the solution, because when we deconfine, the epidemic starts again.

What form should this third confinement take? ?

We should stay at home, a real confinement where we do not move as we did last spring. The more places we close, the less the virus circulates.

The next few weeks in France are not going to be good from a health point of view. The situation is very complicated, it is not improving and the authorities do not want to confine. They think it’s counterproductive and it’s not good politically, but they’re going to have to do it. As the authorities procrastinate, the virus is circulating more and more.

And the epidemic will still last for months: we are not yet vaccinating quickly enough [près de 824 000 personnes vaccinées jeudi depuis le début de la campagne, NDLR] to be able to control it. There are roughly 5.8 million people aged 75 and over in France, as well as caregivers. We are very far from having vaccinated all of this priority population.

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