It's the question on everyone's lips – when will France's daily coronavirus death toll start to fall and when can things go back to normal?
French experts have been wary of predicting when the coronavirus epidemic will reach its peak in France. Some have said it is a matter of days, others have said weeks.
Some say it’s impossible to know and that anyone who is saying they do, is deluding both themselves and others.
“The first 15 days of April will be even more difficult than the past 15 days,” Prime Minister Edouard Philippe said on Saturday, in a gloomy warning of what awaited France the coming two weeks as its lockdown period was extended until at least the middle of April.
“We have made so many predictions that turned out to be wrong that we don't want to announce things that won't happen,” said Eric Caumes, Head of Infectious Diseases at the Parisian hospital Pitié-Salpêtrière, as he attended a live TV debate on the French news channel LCI on Wednesday.
“But I think that by eight days we will see the peak. I am convinced of that.”
— 24h Pujadas (@24hPujadas) March 25, 2020
That was on Wednesday, March 25th. The day after, France saw its daily coronavirus death toll make a disconcerting jump when, in 24 hours, 365 people died.
The record-high number included the youngest coronavirus victim in France so far, a 16-year-old girl.
France’s daily coronavirus death toll stayed at over 300 this weekend. A trend resembling that of Italy, where, in a very short time, the number of people dying from the coronavirus every day quickly climbed to around 700.
Italian authorities they believe the coronavirus curve is reaching its peak, at least in the north of the country, meaning the hope is that the growth in the number of deaths, seriously ill patients and people infected should slow down day by day, and ultimately decrease.
France has kept about eight days behind Italy throughout the coronavirus crisis. Caumes and several other medical professionals have predicted the peak in France to arrive by early April – this week.
French health workers have been working non stop to ensure care for the rapidly growing number of coronavirus victims in France. Photo: AFP
Varies across regions
But the peak is likely to vary between regions, depending on how early and hard they were hit by the contagion.
In the east of France, the first and so far hardest hit area, Bernard Dupont, General Director of Centres Hospitaliers Universitaires (CHU) in Nancy, told LCI that he believed the peak would arrive in the middle of this week and last for “15 days, three weeks.”
In Paris, Julien Gottsmann, Director General of the Rotschild Foundation, told BFMTV on Friday that doctors believe the peak will hit at the beginning of this week.
Julien Gottsmann (DG de la fondation Adolphe de Rothschild): “Les médecins pensent que le pic épidémique devrait arriver en Ile-de-France d'ici 3 ou 4 jours” pic.twitter.com/4owP3XxDZ9
— BFMTV (@BFMTV) March 27, 2020
In the northwestern region of Normandy, Christine Gardel, Director General at the regional health agency, said the peak would arrive at the end of this week.
“We have had more time to prepare than other regions that have seen a more precocious peak,” she told France 3.
— France Bleu Normandie (Seine-Maritime, Eure) (@fbleuhnormandie) March 26, 2020
In the south of France, one of the least-hit areas so far, hospital chiefs say they too expect the peak to hit in the beginning of April.
“Currently, the demand is still less than we expected,” Jean Olivier Arnaud, Director General of the Hospital in Marseille, told French journalists on Thursday.
Arnaud said they expected a surge over the weekend that would “probably” reach “its maximum at the end of next week.”
?Les hôpitaux de #Marseille anticipent un pic début avril.
«Pour le moment la sollicitation est encore en-dessous de ce que nous attendons», a déclaré aujourd'hui le directeur général de l'AP-HM, Jean-Olivier Arnaud.
— Le Figaro (@Le_Figaro) March 26, 2020
'Impossible to set a date'
But some say it is impossible to know when a peak will happen.
“We cannot know when the peak of an epidemic occurs before it has passed,” a press officer of Santé Publique France, France’s national health agency, told The Local in a statement.
“Even more so in the case of a novel epidemic such as the coronavirus, of which we have no history,” she wrote.
“If you tell people that ‘in 15 days the peak will arrive and 15 days go by without it happening, they will be very disappointed,” said Daniel Camus, a professor at the Pasteur Institute in Lille.
“The peak will occur some day or the other. But for the moment it is impossible to set a date,” he said.
Camus believes France – “lagging approximately a week behind” its southern neighbour” – could be headed the same direction as Italy, but he stressed that any kind of forecast of what was lying ahead was at high risk of proving faulty.
“We must analyse the data every day because they change every day. I don’t want to create disillusionment,” he said.
“We need to provide the people with the information we have without being too optimistic or pessimistic and acknowledge that there are things we do not know.”
Camus, who said he was “old enough” to have worked on the hospital frontline during an especially aggressive and deadly flu epidemic in the winter of 1968, said France was undergoing an “unprecedented” challenge.
“We have never seen this kind of pressure on the health system,” he said.
“It’s not a wave, it’s permanent stress.”
“Back in 1968 we lacked ventilators too and doctors had to make very difficult decisions. But not like what we’re seeing today.”
Camus underlined that reaching peak did not mean that the epidemic was over.
“The epidemic does not stop at the peak,” he said. “There will be just as many cases after the peak as before.”
For hospitals, that means admitting many new patients every day for a long period of time. It’s a huge logistical problem, as French hospitals in several parts of the territory have long since seen their capacities overstretched.
A military hospital has been raised in Mulhouse to help ease the pressure in the Grand Est, the hardest hit northern region. Efforts have been stepped up to evacuate patients from overwhelmed hospitals, but more and more hospitals have sounded the alarm bells that they too have reached their limit.
“We are starting to lack beds across the entire (Paris) region,” said Célestin-Alexis Agbessi, a doctor at the Bichat Hospital in the 18th arrondissement in Paris.
As they brace for a surge in the number of coronavirus patients in the coming days, Paris hospitals have issued an urgent plea for anyone with medical professional experience to come to the capital to help.
“We have 26 intensive care beds. They’re all full,” Agbessi said.
Health authorities for the greater Paris Île-de-France region have said that 1,300 of its 1,500 intensive care beds reserved for coronavirus patients were already occupied. This weekend, the number of such beds increased to 2,000, but Agbessi said it would still not be enough.
“If the epidemic follows a growth pattern comparable to what we have seen in Italy and China, it’s clear that we’re only at the beginning,” he said.
The French government has mobilised the army to help deal with the virus. Photo: AFP
Hospital Bichat had transformed into a coronavirus-only treatment centre, Agbessi said.
“It’s only (coronavirus patients). We have transformed all sectors of the hospital to an intensive care unit,” he said.
Agbessi called The Local from work, late on Friday evening. He and the rest of the medical team were working nearly incessantly to ensure care for too many patients.
Coronavirus represented a particular challenge in that the patient recovery time was very long, Agbessi said. Each patient needed 15 to 20 days of hospital care. That meant equipment and health workers had to be dedicated one single patient for weeks.
Agbessi expected the coronavirus epidemic to reach its peak in France around April 6th, but said a ‘roof’ was a more accurate term.
“A peak goes up and down. This is a long term situation,” he said. “The lockdown is a means to limit the height of the epidemic.”
When the coronavirus epidemic reaches this roof it would “last between four to six weeks, perhaps until the end of April or beginning of May,” Agbessi said.
”This is not a wave,” he stressed, referring to the term the PM and had used to describe the epidemic.
“A wave hits you and leaves. This is a flood – the water is slowly rising, filling all the rooms until there's nowhere to escape.”
'A possible second lockdown'
Only after the peak would France see results of the lockdown, Agbessi and Camus said.
“We must certainly not tell people that in 15 days you can go back to living as normal,” Camus said, adding that expected the lockdown period to be extended beyond April 15th.
“We are currently experiencing the first wave of the epidemic and there is a second wave that will come after. That could lead to a second round of lockdown,” Camus said.
Agbessi said the coronavirus would “reach everyone,” either way, as researchers expected about 60 to 70 percent of the population to get the virus.
“The lockdown prevents it from contaminating everyone at the same time. But the day we ask people to leave their homes there will be new cases.” he said.
“We don't want this wave to arrive right now, but it is inevitable that it does.”