Is it too early for France to ease Covid restrictions?
France is to begin emerging from its “lockdown lite” on Monday with the lifting of the 10km limit on travel. And if local health conditions allow, terraces, shops and cinemas will reopen on 19 May. President Emmanuel Macron is banking on a return to the “French-style way of life” but some health experts warn it’s an irresponsible gamble that could usher in a fourth wave.
Macron laid out his four-stage timetable for easing Covid restrictions last Thursday. Between now and 30 June the French can look forward to eating out, shopping, going to cultural events and an end to the evening curfew.
There are however conditions to such freedom and French authorities will be able to activate 'emergency brakes' in areas where the virus is circulating at too high a rate.
Those emergency brakes can be applied in any town or département that has recorded a 7-day incidence rate of more than 400 new cases per 100,000 people.
A sudden jump in rates and intense pressure on local health services could also slow down the reopening.
At present, eight departments have an incidence rate above 400.
That's Paris, several areas in the Ile-de-France region and the southern department of Bouches-du-Rhône which includes France's second-biggest city Marseille.
Booking a prime spot on a candle-lit terrace or a trip to the theatre may be premature.
'Risk of fourth wave'
What’s more, some doctors and health experts believe it is simply too soon to be lifting health restrictions at all.
While the number of Covid infections and ICU admissions has dipped slightly in the last two weeks, the latest official data shows France still has more than 25,000 new cases per day (way above the target of 5,000 fixed in autumn 2020) and just under 6,000 patients in intensive care (double the target fixed by Macron at the end of 2020).
“It’s clearly too quick given what we’re living through,” said Jean-Francois Timsit, head of the intensive care unit at Bichat hospital in Paris. “We can see the curve is going down but hospitals are saturated, it's absolutely terrifying.”
Like many hospitals in Île-de-France, Bichat remains under severe pressure with intensive care units at full occupancy rate. Timsit told France Inter radio there would be severe consequences on patients needing non-Covid medical care.
“There is not the slightest space for anyone, neither those with Covid nor patients suffering from other pathologies,” he said. “Patients remain in intensive care at least three or four weeks when they’re intubated […] So it's unthinkable that we'll have emptied the ICUs in a few days.”
Djillali Annane, president of the union of intensive care doctors (SMR), agreed that the lifting of lockdown was premature. "It will clearly complicate the handling of the health crisis and run the risk of a fourth wave in the autumn, he told Le Monde. “Allowing everyone to move around from 3 May will certainly not slow down contaminations, on the contrary."
The vaccination factor
For epidemiologist Karine Lacombe, head of infectious diseases at the Saint-Antoine hospital in Paris, Macron was taking “another political gamble”. “The only way we can get away with it is if the vaccine programme is enlarged,” she told Liberation daily.
Macron may well be taking a risky decision and whether it proves to be the right one will depend on the success of France’s vaccination programme.
Painfully slow to take off, the vaccination roll out has gathered pace over the last few weeks. According to Covidtracker, more than 15 million people in France have now received a first jab (29.7 percent of the adult population) and more than 6 million, just over 12 percent of adults, are fully vaccinated.
From 15 June Covid jabs will be available to all adults.
Choice, not a gamble
In his interview last Thursday Macron said he had taken a balanced decision, "a choice, not a gamble", adding that there was "more to the life of the nation than curves on a chart".
But there is an element of risk nonetheless.
“The president set himself a strategy a few weeks ago and he does not want to go back on it,” said Dr. Timsit. “I hope I’m wrong and that we will manage to vaccinate enough people, that everyone will be outside and there won’t be a catastrophe. But we are nonetheless very worried.”
Above all, he says the test, trace and isolate protocol has to be much better respected in France and the follow up of contact cases more drastic than at present. “If we want the lifting of lockdown to be successful, we have to lose a bit of the sacred individual freedoms for a few weeks.”
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