Science

Containment of the unvaccinated, curfew, vaccination pass: possible measures in France?

For the first time since September 11, France has registered more than 10,000 new daily cases of Covid-19. A worrying fifth wave, which also affects our neighbors on the old continent, particularly in Germany, Austria and Eastern Europe, where a series of new restrictive health measures are or will be implemented. Among them, the confinement of unvaccinated people and a possible curfew in Austria, the establishment of a vaccination pass in some German Länder, the massive return to telework or the reestablishment of free trials … Could these measures be applied in France? Asked about this possibility, government spokesman Gabriel Attal said on Saturday November 13 that he wanted nothing “to exclude in principle.”

But what are the measures that our neighbors are taking that could be of the greatest use to us? Response from Professor Antoine Flahault, Director of the Institute for Global Health and Professor at the Faculty of Medicine in Geneva, and Mahmoud Zureik, Professor of Epidemiology and Public Health at the University of Versailles-Saint-Quentin-en-Yvelines.

Confining the unvaccinated, inapplicable, and politically flammable

On Sunday, November 14, Austrian Chancellor Alexander Schallenberg announced the entry into force of a blockade for people who have not been vaccinated or who have not recovered from Covid-19. The two million people, over 12 years old, affected will not be able to leave their homes except to go shopping, play sports or receive medical treatment. An unprecedented measure in Europe, which should be ensured by reinforced police controls, according to local authorities. But will it be necessary in France, where the vaccination rate is around 75%, compared to 65% in Austria? Could it not be perceived as discriminatory and reactivate the already dominant social tensions?

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“From a health point of view, this is one of the most useful decisions to implement, because it is directed at a population that is at higher risk of transmitting, becoming infected and therefore of developing serious forms. But I am against France, because this could only exacerbate existing social problems … It would not be reasonable, “said Professor Zureik. The government also seems reluctant to fuel social unrest. On Sunday, Gabriel Attal already specified that the Confinement, directed or not, is for the moment “absolutely out of place.” […], because we have a very high vaccination rate. “On Monday, the head of the LREM deputies, Christophe Castaner, emphasized the point, stating that the presidential majority” does not want “a new containment of the French not vaccinated against Covid- 19 like Austria, even if “all the assumptions are on the table.”

The return of the curfew?

In the Netherlands, the prime minister announced on Friday, November 12, a new series of health restrictions for three weeks, including a curfew. Essential bars, restaurants and shops like supermarkets will close at 8pm, “nonessentials” at 6pm, while public events will be canceled. This measure, also considered in Austria and well known in France, has already demonstrated its ability to break the dynamics of the epidemic in the past. “The curfew can be useful, since it reduces the number of contacts in the population, but we are not in the same situation as Germany or Austria, since their percentage of unvaccinated elderly is two or three times higher than ours. ”Mahmoud Zureik points out, however.

Furthermore, this restriction, while useful for health purposes, also presents a not inconsiderable political risk. “All containment measures, and the curfew is partial containment, are aimed at reducing social interactions between infected people and healthy people, Professor Flahault emphasizes. We have seen that containment measures had been effective in the health plan, but all had a colossal social and economic cost. Therefore, it is understandable that the authorities want to do everything possible to avoid them again. ” Unless the situation gets even worse?

Request a “vaccination pass”?

In France, several scientists, including members of the Academy of Medicine, advocate that obtaining a health pass is conditional only on vaccination. In fact, only vaccination, and no longer a negative test, would allow access to cinemas, restaurants, etc. Less politically undermined, this measure would also be easier to implement, since the controls would be carried out thanks to the certificates and the TousAntiCovid application. In France, the measure appears to be on the government table. But during his televised speech on Tuesday, December 9, Emmanuel Macron was content to indicate that, to maintain a valid health pass, the third dose would be mandatory as of December 15 for those over 65 who have been vaccinated for more than six months. . However, other countries have taken the step, such as Austria, again, the Netherlands, in three weeks, and some German Länder, such as Bavaria and Saxony.

“It is not for scientists to implement public policies, everyone must remain in their role,” warns Antoine Flahault. What the scientists say in a fairly consensual way is that it is important to promote the strongest possible vaccination coverage in the population and limit contact between those infected and those who are not. After that, it is up to the authorities to decide how, in the context of their own country, to implement these kinds of recommendations. or the vaccination pass are possible answers, without having many elements to date to assess which of the two is the most effective and the best socially accepted “.

Teleworking as a barrier against covid

In Germany, where the infection rate has reached a new record with 289 cases per 100,000 people, a bill prepares a massive return to teleworking. According to the document consulted by AFP, German businessmen will be forced to offer the possibility of working from home in the absence of a “compelling professional reason” to go to the office. Anyone going to work will also be asked to prove they are vaccinated or have a negative test. Although teleworking can reduce social interactions and, therefore, the risks of contamination, it can nevertheless be socially or even economically restrictive.

“For my part, I would be more in favor of recommending first reducing the risks of contamination by better ventilation of closed rooms open to the public and where we spend several hours, says Professor Flahault. We must demand in these environments. systematic and continuous measurement of CO2 concentration, and prohibition of receiving the public above a certain standard, for example, above 1000 ppm. “According to the specialist, this would ensure that the premises are safer and allow people walk, eat or work serenely, without giving up the use of the mask. Pr. Zureik is more in favor: “If it is applied, we must prepare for an at least partial return. If our current, more favorable situation is simply a lag compared to Western European countries, then the measures that we take to see in these other countries could be applied in France, except that at this stage, we cannot predict it. ”

The return of free trials

Since October 15, unvaccinated people in France must pay out of pocket for the tests to validate their health pass. However, this end of free education appears to have had two negative effects. On the one hand, a decrease in screening, especially in unvaccinated and asymptomatic people, according to DREES data. On the other hand, an extension of the time between the appearance of symptoms and the sample, probably because reimbursement for the test can only be obtained after a visit to the doctor, indicates Public Health France. Thus, several researchers ask to restore free access to this device, as in Germany.

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“We can understand that the health insurance did not have to reimburse the comfort tests, it was only intended to be able to go to the restaurant or the cinema, but it is possible that in times of epidemic wave, we have an interest in reinstalling the free tests in a way Antoine Flahault suggests temporary, in order to better identify and isolate those who could be carriers of the virus, so all measures that will delay the spread of this terrible virus this winter will be welcomed, and at a final cost often much less than that of the days of intensive care or confinement of the country. “Asked by Le Parisien, the Ministry of Health indicated that this measure” was not on the agenda. ”

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