If Emmanuel Macron should announce the extension of the confinement, Monday during his televised speech, the government is already thinking about the future deconfinement.
When? How? 'Or' What ? Epidemic specialists anticipate the lifting of restrictive measures, warning against any hasty exit. We take stock of the different conditions necessary for deconfinement.
The risk of a second epidemic wave
"Lifting the restrictions too quickly could lead to a deadly resurgence" of the pandemic, warned the boss of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus. He is not the only one to alert to any early optimism and the risk of a second pandemic wave.
"You have to be very humble and very careful with this virus because you have already made a mistake," warns in France the former boss of Inserm (National Institute of Health and Medical Research) Christian Bréchot. "It is not clear with a pandemic of this magnitude how everything could miraculously return to normal," added the virologist on Franceinfo.
Partial lifting in some countries
However in Europe, the first continent affected by the number of deaths (more than 70,000 dead), several countries are already announcing partial lifting of containment. Austria will reopen its small businesses after Easter, believing that it has sufficiently "flattened" its infection curve. Denmark will reopen nurseries, nursery and primary schools on April 15 while the Czech government has already relaxed its rules.
These countries are following in the footsteps of China, which lifted the strict sanitary cordon surrounding Wuhan, the epicenter of contamination, on April 8, and which seems to have halted its epidemic.
Don't let your guard down
Elsewhere in Europe, the time has come to respect strict confinement, as in the United Kingdom where the epidemic wave is breaking with violence. In France, the Director General of Health, Jérôme Salomon sees only a "pale ray of sunshine" with the slight decrease in admissions to intensive care and the start of "a very high plateau". Countries where the human balance sheets are the heaviest on the continent, Spain and Italy also seem to have approached a "high plateau" with stable or slightly declining figures.
But neither of these two countries dares to lower their guard: Rome has extended until May 3 its general confinement, Madrid until April 25. Same trend in Ireland, Portugal and Belgium. In France, Emmanuel Macron should reiterate, Monday evening, the watchword "Stay at home" during a televised address. Will the French President risk giving an exit schedule?
Pass the tray
"It is not when we have reached a plateau that we have to deconfinate, while the measures have made it possible to avoid the massive congestion of hospitals," says epidemiologist Antoine Flahault. The exit from confinement can only take place later "when we see a decline" adds the one who heads the Institute of Global Health at the University of Geneva (Switzerland) on the France 2 channel. Researcher Christian Bréchot "hopes that from mid-May we will be in a situation of deceleration "which would allow a" gradual relaxation ".
"We are not going to go from black to white, but from black to gray with continued containment, in particular for certain populations," anticipates Jean-François Delfraissy, president of the Scientific Council which is shedding light on the French government on the epidemic. “We can start to discuss (…) post-containment. But the essential and capital element is the pursuit of strict confinement over several weeks, ”he puts forward.
Decrease in transmission rate, decrease in resuscitation and influx of masks
This expert poses several prerequisites for lifting the containment. First, have a proven decline in serious cases of Covid-19 in the intensive care unit. The aim is in particular to allow the carers to breathe after the intense effort they have provided and the hospitals to replenish their stocks of equipment and products.
At the same time, the circulation of the virus must have dropped in the population, with an “R” transmission rate of less than 1, which means that on average, an infected person transmits to less than another person (compared to 3.3 people at the start of the epidemic). Third prerequisite: the availability in sufficient number of masks to protect themselves and tests to be able to closely monitor the circulation of the virus. In France, screening capacity should increase from 30,000 tests / day currently to 100,000 or even 150,000 / day by the end of April, according to Pr Delfraissy.
An application to track contaminated people
New variable in this equation with multiple unknowns: the hypothetical arrival of new electronic tools to trace the contacts of contaminated people. Paris is cautiously advancing on the subject as the German government prepares to launch a mobile application, inspired by Singapore, to facilitate the individual monitoring of cases and the identification of contamination chains.
Summer as a brake on the spread of the virus?
Another major unknown is the importance of "summer braking" in the spread of the new coronavirus. Respiratory viruses generally don't like summer. Thus, there is no flu epidemic after April in the northern hemisphere. Will it be the same for the SARS-CoV-2 virus?
The announcement of a strong resumption of contamination in recent days in Singapore, would doubt, the temperature in the city-state currently around 30 °. "If there is no summer brake, then it will be more complicated" to get out of confinement, anticipates the epidemiologist Antoine Flahault.
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