Containment in France: for how long and how to get out of it?

Text by: Caroline Paré Follow | Ophélie Lahccen

How long will containment last? Will we have to go through massive screening in France to remove this confinement? Professor Fontanet gives some answers.

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Professor Arnaud Fontanet is head of the unit for epidemiology of emerging diseases at the Institut Pasteur and professor at the National Conservatory of Arts and Crafts. He is a member of the Scientific Council in the management of the health situation linked to the coronavirus, installed on March 11 by the French Minister of Health, Olivier Véran, at the request of the President of the Republic.

Monday, March 30, he was the guest of the program Priorité santé , live on RFI.

► Read also: Édouard Philippe evokes a “probable” deconfinement in stages

RFI: How long will confinement in France last?

Pr Arnaud Fontanet: Containment and release from containment will depend on the situations for which this containment strategy has been decided. If we take the situation of France, confinement was decided around March 15, because we saw a massive influx of patients to the intensive care units, in the regions most affected by the epidemic: the Great East , Île-de-France, Hauts-de-France… It was necessary to block this influx in anticipation of a possible saturation, two to three weeks later. To block the influx, we decided in France to set up this containment. We hope to see the results later this week. This should allow us to see the number of admissions to intensive care beds decrease in the most affected regions. It also depends on respecting the confinement.

Other countries do not yet have an epidemic, but they decided to implement containment as a preventive measure, after having seen what was happening in Italy, Spain or France… They therefore put in place places a containment to immediately limit the circulation of the virus on the territory. It is a measure that will slow down and perhaps prepare you a little better. Containment provides a short-term solution, but it is not a long-term solution. The day you remove the containment, the virus begins to circulate again since no one has been infected. You find yourself a bit in the situation you were in before confinement. In these countries which have set up confinement, when they did not have an emergency situation with regard to their resuscitation beds, it is time saved to prepare. This can increase the capacity to carry out diagnostic tests, prepare logistics teams to go and identify cases and their contacts, place them in isolation, prepare hospital beds (and possibly resuscitation beds). ..). They will gradually lift the containment when they are able to cope with an increase in the number of cases.

These are two different situations and their criteria for lifting containment are different.

Will we have to go through massive screening in France to lift the containment?

There are two types of tests that can be performed. Tests that tell you if you have an acute infection: this is the test that is done with a sample from the nose and / or throat (PCR test). The result allows you to know if you are sick and in this case, to isolate yourself.

There will be other tests that will be available soon enough (end of April, editor's note). These tests will find out if you have been infected or not. These tests are based on the detection of antibodies in the blood. The body produces these antibodies when it has been infected. One can imagine, in the short term, that people with antibodies will be protected for this coronavirus, as they are for other coronaviruses. We don't have solid data on this yet, but this is the most likely scenario.

We can hope that with these different tests, we will be able to reflect on our strategies for leaving containment. I will not say that the massive test would be a solution, because the PCR test, which we use today, gives an answer at a given moment, but on the other hand absolutely does not indicate if you will be infected three days later . You cannot repeat massive screenings all the time. When the containment is lifted, the virus will circulate much less in the French population, but outbreaks will reappear from cases that have gone unnoticed, or from the importation of foreign cases ... We will go there, we will test immediately, we will isolate, we will look contact cases.

And fragile people who have not been contaminated will not want to expose themselves by coming out overnight ...

When we talk about lifting containment, we are talking about a very gradual lifting. Vulnerable people (people over 65, those with co-morbidities, etc.) will probably have far more cautious ways of getting out of confinement than others. Anyway, it will be something progressive, graduated and supported in parallel by the availability of tests to monitor the appearance of new outbreaks.

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