The government is studying several possible scenarios for deconfinement. - JEAN-FRANCOIS MONIER / AFP

  • The lifting of containment in France could take place "in stages", said Prime Minister Edouard Philippe.
  • Age, region or immunity criteria to Covid-19 could be chosen to control the conditions for gradual release from containment.
  • The possibility of extensive blood tests or even population tracking are also being studied.

"Deconfinement is not for tomorrow morning". Regularly, and this Thursday evening again, Prime Minister Edouard Philippe hammers him: it is necessary for everyone's health to stay at home, and probably well beyond April 15, the date until which confinement is planned. A confinement which could very probably be extended for two more weeks, which is still unknown to this day. On the other hand, "what is almost acquired at this stage is that this deconfinement can only take place gradually," repeated the head of government, emphasizing the need to avoid that "we are struck by a second wave [of coronavirus] which would again force us to carry out confinements ”.

And the reflection on the deconfinement strategy will be led by Jean Castex, "a senior civil servant who knows the world of health perfectly and who is formidable in efficiency", who is responsible here for the minister for deconfinement. To avoid this dreaded second wave, the Prime Minister indicated that deconfinement would depend on several factors, including the existence of treatment or the country's ability to conduct massive tests, and that "several possible scenarios" are at stake. 'study. By region? By age group? Or by "passport" of immunity? Several criteria for gradual release from containment are being studied.

Passage of the epidemic peak as a prerequisite for any exit from containment

If the government is thinking today about the most suitable deconfinement strategy, the end of the confinement that came into force on March 17 is not yet on the agenda. In practice, it is only when France has passed the epidemic peak of the Covid-19 wave that a gradual lifting of containment will be possible. Because the whole challenge is to smooth out the peak of the epidemic and consequently contain the number of patients hospitalized. The objective: to allow hospitals, in particular resuscitation services, to avoid over-saturation. However, for the time being, resuscitation capacities are already exceeded in several regions, starting with the Grand-Est and Ile-de-France.

A deconfinement by region or by age?

"We are studying the advisability and the feasibility of a deconfinement which would be regionalized, (…) or in function, who knows, of age classes", declared Edouard Philippe during his hearing by the fact-finding mission of the 'National Assembly. If a regionalized deconfinement were adopted, it could be established according to the geographic axis of propagation of the Covid-19. Thus, the Grand-Est region and Ile-de-France, close to the epidemic peak, could be deconfigured first, when the curve of new contaminations and hospitalizations will be descending.

The age criterion is also considered. The evolution of the profile of severe Covid-19 patients admitted to intensive care units has changed in recent weeks, with more patients under the age of 60, compared with the first weeks of the epidemic in France. But the oldest people remain the most vulnerable to the disease. And this is also the case for people with chronic diseases or who are immunocompromised.

Massive screening, blood tests and immunity passport

But how can the containment be lifted without first knowing who is carrying the Covid-19 and who is cured, and therefore potentially immune? Jean-François Delfraissy, president of the Scientific Council which whispers in the ear of the executive the measures most adapted to the management of this major health crisis of the coronavirus, recommends to resort to the “strategy of massive tests, used in particular by Koreans ”. South Korea thus sets an example in the fight against the epidemic, which it has managed to contain quickly by increasing the number of screening operations and isolating positive cases. "We have several contacts with Korean experts" with a view to "breaking out of confinement", revealed Jean-François Delfraissy, on March 20 at La Croix .

Because today, the current lack of massive screening prevents a clear vision of the spread of the coronavirus, while 80% of infected people have little or no symptoms. “We have no idea how much of the population has been infected. It is not known how many people are positive, are cured. It is therefore difficult to predict anything, "laments epidemiologist Catherine Hill, insisting on" the urgency of carrying out tests on a representative sample of the population ". For the moment, nearly 30,000 tests are conducted each day.

Very quickly, the availability of serological tests will also be taken into account in deciding which deconfinement policy to implement. However, these blood tests, which will check the level of antibodies and therefore everyone's immunity to the virus, will only be available "in the next few days, the next few weeks," said the Minister of Health. Olivier Véran. As for the "rapid tests", which will give results in a few minutes, their real ramp-up (100,000 per day) is not expected until June. “The deconfinement must be conditioned to a massive screening campaign. This will determine the percentage of the population that has been infected and calculate whether this has resulted in group immunity. If this is not the case, it will be necessary to decide on the prolongation of the confinement of people who are not immunized, ”says Dr Benjamin Davido, infectiologist at the Raymond-Poincaré hospital in Garches.

The tracking track

Big Brother is watching you! Finally maybe soon. The deconfinement strategy could be enhanced with an "Orwellian" touch if the tracking track was chosen. A policy already adopted in South Korea, where the authorities track the recent movements of its nationals by crossing GPS data from smartphones, surveillance cameras and bank information. In France, President Macron asked the Care expert committee to examine "the advisability of implementing a digital strategy for identifying people who have been in contact with infected people".

For his part, Edouard Philippe recalled that these tracking devices did not exist in France "because they would not be legally permitted". But "we could perhaps, on the basis of a voluntary commitment, use these methods to better trace the circulation of the virus and the contacts", he added, opening the way to a possible digital monitoring of the movements of French.

What possibilities for movement of people after the containment is lifted?

After a confinement which could, who knows, last several weeks almost everywhere on the planet, if there is one desire that is not in mystery, it is that everyone, in particular us Westerners, will have the desire to sun, escape and getaways after all these weeks cloistered at home. But it is not certain that this is logistically possible. Asked this Thursday about France Info Augustin de Romanet, CEO of the Aéroports de Paris group, believes that a return to normal air traffic should not be possible before September. “In order for an airport to function, there must be another airport opposite ready to welcome passengers. However, with more than 160 countries affected by this pandemic, each country seems to me to have a tendency to have its own rules for welcoming passengers, he explains. My fear is that there is a great disparity in the rules applied by the airports and which means that it restarts rather slowly ”.

But in addition to the logistical problem, deconfinement raises the need for global reflection and international cooperation in its implementation. "Up to now, the evolution of the pandemic shows that fires are igniting all over the globe and that many countries are not able to mount mass screening campaigns of the population, underlines the infectiologist Benjamin Davido . In the absence to date of treatment and vaccine, one cannot imagine a total deconfinement and a resumption without limits of the circulation of people. In my opinion it is not excluded that the track of the orders of restriction of exit of the territory is retained by the executive, advances Dr Benjamin Davido, infectiologist. Pragmatism would call for a border freeze, perhaps even until the end of the year. ”

For now, France has decided to extend border controls until the end of October.

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