After Christmas, comes the puzzle of the equation of The new year and you Covid-19 for the executive. The contaminations curve is not weakening in France, and some regions – like the Grand Est – find themselves in situations of high tension.
While a Defense Council where the government will discuss potential new binding measures, Philippe Amouyethe epidemiologist and director of the public health service of the Lille University Hospital, offers solutions for a gradual return to normal life.
Did the second containment fail?
When we look at the evolution curves, the slopes of those of the second and first confinement go at the same speed, the curves of hospitalizations during the two periods are very comparable. But the difference lies in that of contaminations: we suddenly saw, during the confinement of this fall, the downward movement stop and a plateau of contamination set in from December 1.
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This is not logical, and we tried to understand by looking at the previous evolutions of the first containment. It can’t be the reopening of businesses [N.D.L.R. : qui a commencé le 28 novembre en France], we can only observe the health consequences of this measure two weeks after its implementation, but the stagnation began in early December.
How to explain, then, that the contaminations do not decrease?
When we look the Comcor study by the Institut Pasteur at the contamination sites, ultimately, it is not public transport, schools or the workplace that are the major contamination sites. There is the story of the weather and the impact of temperatures on the epidemic, but that connection is not clear at this time.
Once all these factors are eliminated, what remains are meetings in the private sphere with family exchanges – beyond the nuclear sphere – and with friends. Above all, it is the fact of having meals together.
According to the study, the thing that could explain this plateau, this “crest line”, is the behavior of the French.
Are you worried that contaminations will start to rise again after the holidays?
For Christmas, several elements show that the risks of contamination are measured: a lot of people were tested for these holidays and we were able to detect in particular a lot of asymptomatics, hence the peak of contamination until December 24.
The incidence around Christmas began to rise while the number of hospitalizations did not rise. The contamination rate is increasing because we find more tests, but in reality, the test positivity rate is collapsing: we test more people, there are more positives, but the population seems less affected on average.
What about the New Year?
On December 24, people knew they were going to see vulnerable people, they were given a lot of advice, people were massively tested. We should have repercussions but not as big as we can imagine on the New Year. New Year’s Eve is a less intergenerational holiday, people will likely be less careful, and there may be more meetings than necessary.
Celebrating the New Year is a kind of resilience for the French, you may not always be at the bottom of the pool without trying to come to the surface. People want a little freedom, to mark the end of this special year.
The attitude of the French to the restrictive measures seems to have changed in recent months
The French are less afraid of the Covid, less afraid of sanctions, it will be more and more difficult to enforce them, and in such difficult times, we must protect people against themselves, without putting their morale down .
Should there be specific measures to prevent people from celebrating the New Year?
As Olivier Véran says: “The best way to celebrate the start of the New Year is not to celebrate it! “
I can imagine two solutions: either an extended curfew, or a three-day express lockdown that would begin Thursday afternoon, December 31, and end the following Saturday, to reduce the circulation of the virus as much as possible. Do not confine for 45 days, but only for 72 hours, to prevent a third wave. To avoid the phenomenon that we observed in the United States with Thanksgiving [N.D.L.R. : après la fête traditionnelle où de nombreux Américains se sont retrouvés en famille, les cas ont flambé à travers le pays]. But it’s up to the government to see what is more acceptable.
More generally, what strategy should be adopted in the coming weeks?
At the moment, we are on a daily basis, when we have to anticipate, monitor the progress in a less biased way than we do when we look only at the positive cases.
For example, we should also look at the amount of virus found in wastewater, via the study of the Obépine network. We realized that when we are contaminated by the virus, it is also found in our stool, which they end up in wastewater. The techniques at our disposal allow us to identify the virus in the wastewater of the French population. Measures are taken in 150 wastewater treatment plants in France. The researchers realized that the virus was then visible within six days of symptoms. We must use these data to anticipate the evolution of the epidemic.
We must also know if we are dealing with a virus more aggressive in its transmission, car the English variant already arrived on French territory. For this, it is necessary to set up a network which sequencing at regular intervals.
Finally, we should also continue to implement the “test tracer isolate” strategy, to isolate asymptomatic people. But mass screening was not a great success at Le Havre.
What about the reopening of bars, restaurants and cultural venues?
You have to think about protocols and gauges. If the rules are well respected, the risk is relatively low. An American study dating from November 11 has been done on millions of Americans, whose phones have been traced. The researchers followed their movements by having defined points of interest: what made the epidemic progress the most, it was the frequentation of bars, restaurants, sports halls. They subsequently modeled with decreases in gauge in these places, and this allowed to slow the progression of the epidemic.
To sum up, you have to think about these decisions in advance, to anticipate the course of the virus, until everyone has been vaccinated.
A Defense Council is scheduled this morning. What solution should the government turn to?
The government must be thinking about containment right now, without necessarily knowing what to do. It’s complicated to make a political decision that will be unpopular, but the most unpopular would be not being able to offer anything on January 20 for the cultural community, for restaurants, for bars.
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