Coronavirus: quarantine "is not effective" and "can spread evil"

Text by: Romain Philips Follow

The spread of the Covid-19 virus now affects around fifty countries and territories. It makes WHO fear a "possible pandemic". This Thursday, February 27, the World Health Organization called on countries to "act now aggressively" to stem the epidemic.

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The Covid-19 coronavirus continues to spread. Worldwide, millions of people, particularly in China , Italy and Japan, are still under quarantine. A measure taken to limit the spread of the virus which is beginning to be the source of many criticisms. Interview with Patrick Zylberman , health historian, professor emeritus at the School of Advanced Studies in Public Health of Rennes (EHESP) and author of the book Tempêtes microbiennes (Éditions Gallimard) .

RFI: Is quarantine the best system for stemming the spread of an epidemic ?

Patrick Zylberman : Quarantine is not effective in itself. She has too many faults. It is impossible to enclose everyone in a closed perimeter. It is very difficult at that time to keep everyone in their 40s. In addition, quarantine also has sometimes very negative consequences which consist in locking together people who are contagious without knowing it and people who are free. It can therefore propagate evil instead of containing it.

In this case, which solution is best suited to fight against an epidemic ?

The ideal is precisely to fulfill the essential conditions to support a quarantine that is not effective in itself. The first condition is to shorten the time between the onset of symptoms and hospitalization as much as possible. The isolation of patients in negative pressure rooms is different from quarantine. We are talking about the isolation of individuals and not about quarantining groups. Isolation of the sick is the only way to combat the spread of contamination, provided that they have adequate hospital equipment.

►Read: Coronavirus: in China, new technologies to fight the disease

The second condition, which directly affects caregivers on the front line of the fight against the epidemic, but also on the front line of contamination, is to reinforce infection control measures within hospitals. . It should not be forgotten that, in China as in Italy, the hospital is on the front line. There are not many general practitioners to consult and people rush to the hospital, which becomes a "broth of culture". Controlling infection with personal equipment for caregivers through procedures is absolutely essential. Quarantine is quickly lost sight of in all this.

You talk about individual isolation, but quarantine in Hubei province concerns around 60 million people ...

This is one of the two points we face today. One, the lack of necessary equipment. And two, the problem of detecting cases in people who are not very symptomatic or not symptomatic, but nonetheless contagious. Indeed, the big problem for hospitals is the influx of patients while it is advisable to avoid emergencies so as not to infest people who are there and who are vulnerable because of their very condition health. There is indeed an equipment problem.

►To listen: the RFI correspondent in Beijing recounts his quarantine

But even in France, the minister announced last week that 38 hospitals were on the war footing ready to act. 38 hospitals, it seems, 150 negative pressure rooms, according to the information I have. We are very far from that, because we only have a few sporadic cases in France today. But in the event of a true epidemic we would very quickly exceed the 158 cases to be hospitalized and therefore the problem of equipment would arise in an extremely acute manner.

The quarantine on the liner Diamond Princess, in confinement in the port of Yokohama, Japan, has attracted much criticism. A professor at the University of Kobe even denounced a " totally chaotic situation ". Was it a mistake to put quarantine on board the boat and not on dry land ?

On this boat, we can see that we did exactly everything we shouldn't have done. The Japanese authorities, to avoid the landing of contagious people who risked spreading the epidemic among the Japanese population, blocked the ship, not far from the port. They forbade passengers to alight and in doing so, the Japanese authorities are clearly responsible for the spread of the disease on the boat and therefore the infection of a large number of people. There is also a problem with the WHO who did not protest against these methods when there is clearly a contradiction between the need to protect the population against viruses and other human rights go.

► To read: The Covid-19 coronavirus in 7 points

► François Renaud, CNRS researcher: " For environmental health observatories "

" I don't see what we can do better to protect populations when the epidemic is declared than to put people in quarantine, " said François Renaud , researcher at the Infectious Diseases and Vectors laboratory at CNRS. However, if he defends quarantine as an emergency means when an epidemic breaks out, he pleads for a strengthening of preventive measures.

In the fight against epidemics, “ we act when the fire is declared , according to François Renaud . We are waiting for the epidemic to start spreading to wave the flags of fear and anxiety ”. The fight against infectious diseases lacks a political vision and requires " reflection ", because this kind of epidemic " risks starting again ". “ It's a global problem. The world must ask the question "what can we do together?" But not when there is an epidemic, it is before there is one that we have to think about it ”, considers François Renaud.

This specialist in health ecology and in the transmission and evolution of pathogens therefore wants the creation of " veritable observatories of environmental health ". With current demographics, diseases such as Sars-CoV-2, which is a zoonosis - a disease that is transmitted naturally from animals to humans - is likely to recur. " Today, analyzes the researcher, what I see is an increase in populations and a deterioration of the ecosystems in which man lives. And these deteriorations generate imbalances whose consequences are completely unpredictable, but can be of the type that we observe today. "

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