doctors torn between relief and worry

Prime Minister Jean Castex announced the end of wearing masks outside on Thursday and the abandonment of the curfew from Sunday, “the health situation improving faster than expected”. While it relieves most French people, this significant reduction in restrictions worries some doctors.

In view of the decrease in contamination and the progression of vaccination, the health authorities have paved the way for a return to normal life. From Thursday, wearing a mask outside will no longer be compulsory in France despite a few exceptions, and the curfew at 11 p.m. will be lifted on Sunday, announced Jean Castex on Wednesday.

Ads deemed “pleasing” by several doctors, like Dr. Bruno Megarbane, head of the intensive care unit at Lariboisière hospital in Paris.

“So much the better! We can only rejoice […] This shows that the epidemic is currently under control and in good regression, with an improvement in the level of contaminations at the level of infected patients, at the level of the situation of hospitals, “he said on BFMTV.

“A little surprised”

“The figures indeed show that there is currently a control of the epidemic”, also noted Yves Coppieters, epidemiologist doctor and professor of public health on our antenna. It is true that these are two very important measures, and this reduction is proportional to the current situation “.

“It’s going in the right direction, it’s going in the direction of the evolution of the epidemic”, meanwhile judged Jacques Franzoni. The coordinating doctor at the Jean Mineur vaccination center in Valenciennes felt that “this message of hope was necessary for everyone, we all need to have positive data”.

Other health professionals did not hide their astonishment at this rapid easing of restrictions. If he readily acknowledges that the indicators are “much better” than they have been in recent months, Professor Jean-Louis Teboul, head of the intensive medicine and intensive care unit at Bicêtre hospital in Paris, is said “a little surprised” at the government announcements. “I would have expected that we take the period from June 15 to 30 as a period of observation of the evolution of the Delta variant”, referring to the relative caution of the Minister of Health the day before.

The mask still needed outside “in some cases”

The story is the same for all doctors: the French must continue to be cautious, because the risk of an epidemic rebound does exist.

“Yes, we always have this risk of a more contagious variant which could have a small immune escape compared to vaccination (…) We of course fear the Delta variant which is penetrating more and more in Europe”, still recognizes Pr Yves Coppieters, while Olivier Véran announced the day before that this strain of the virus now represented “between 2 to 4% of new cases detected in France”.

According to Yves Coppieters, however, you should not be afraid to go out without a mask, because the risk of the virus spreading outdoors is still reduced. He recalls that “the end of wearing a mask outside is not everywhere outside: it is still necessary in certain situations”. Jean Castex indeed announced on Wednesday that the mask would remain de rigueur outside, in crowded situations such as queues, transport, crowded places or even stadium stands. The epidemiologist Yves Coppieters invites everyone to always have a mask on them, in their bag or in their pocket in case they “find themselves in a more risky situation”.

But on this specific point, his colleague Christian Rabaud, infectious disease specialist at the Nancy CHRU, is optimistic. According to him, “after 15 months of the epidemic, the French no longer have the same reflexes as in March 2020. I believe that the French now know how to use a mask. They have understood the value of it and they will know how to use it. ‘use wisely”.

“It therefore seems reasonable to me to continue to reduce the measures that remain in the weeks to come, on the eve of summer,” he adds.

“The risk of rebound is not zero”

The head of the intensive care unit at the Paris-Lariboisière hospital indicates that it is absolutely necessary for this collective vigilance “to be accompanied by the continuation of the vaccination”. It is, according to him, “an important point”, because “the risk of rebound which is not null, and could be real if the vaccination was not sufficient and that one does not reach a level of significant collective immunity, of the order of 80 to 85% “. He recalls: “we are playing again what will happen in September-October with the vaccinations we are doing today”.

Wednesday afternoon, Emmanuel Macron estimated that the government could only “congratulate itself on having had the right strategy”, ensuring that the goal had always been to move forward “in a manner always pragmatic and proportionate in view of the results which are ours”. “Nothing is won and I really insist on it and I invite all our fellow citizens to continue to be vaccinated, to go for the vaccination which is the only way to fight this epidemic in the long term”, finally recalled the head of state.

Bruno Megarbane also calls for “to encourage the vaccination of all adults in order to limit the serious risks associated with the disease”, but also “that of young people and adolescents to be able to achieve this collective immunity and finally live normally as soon as possible”.

According to him, the opening of this new stage in the fight against the epidemic also signals the return of the “test-trace-isolate” strategy. This will be important to “avoid any community spread of the virus”. However, he fears the limits of this strategy: “for it to work, the most important thing is that the population adheres to it and agrees to isolate themselves if they are in contact with or carry the virus”, underlines Professor Bruno Megarbane. “However, we know from experience, compared to last summer, that it is unfortunately difficult, despite the goodwill of the authorities,” adds the doctor.