EXPLAINED: How does France’s Covid-19 alert system work?

France is using a local alert system and map that sees the areas with the highest level of Covid-19 infections subject to strict new restrictions including the closure of bars.

EXPLAINED: How does France's Covid-19 alert system work?
Photo: AFP

As Covid-19 infection rates continue to soar in France and hospitals are coming under pressure, the government is determined to avoid another nationwide lockdown.

Instead it has decided on a localised 'alert' system that imposes strict restrictions on areas with the highest number of cases. Separate to the alert system, but linked to areas with high numbers of cases, are local curfews (see below).

Here's how the system works.

*Note that for both the heightened and maximum alert status are related to cities and surrounding area (metropoles) rather than the whole département (see more below).

Colours – there are four stages to the system, coloured pink, red, dark red and dark grey on the Health Ministry's map.

The levels are – alert, heightened alert (alerte renforcée) maximum alert (alerte maximale) and state of emergency.

Those areas coloured light grey on the map are where there is no alert in place.

Alert – there are 72 départements concerned by this, coloured pink on the map.

An area is classed on alert if there is an infection rate of 50 cases per 100,000 people.

Local authorities in these areas can take extra “pertinent” measures to curb the spread, but they are not obligated to do so.

However all these areas must limit weddings, parties and social events to 30 people maximum.

Heightened alert – There are eight metropoles on this alert level; Bordeaux, Rennes, Rouen, Nice, Toulouse, Montpellier, Dijon and Clermont-Ferrand.

Areas are classed as being on “heightened alert” if there is an infection rate above 150 cases per 100,000 inhabitants and a high level of spread among elderly (above 50 cases per 100,000 inhabitants), as well as a moderate pressure on the areas hospitals.

Local authorities must take a string of toughened measures in these areas.

These include: closing bars at 10pm at the latest, limiting the number of people allowed to gather in public spaces to 10 maximum, lower the threshold for big events from 5,000 to 1,000 and ban all large parties such as student parties. 

Restaurants are for the time being not affected by the early closing rule.

Gyms and sports halls will also close in most cases, along with community halls. Visits to Ehpad nursing homes will only be possible with appointments.

Maximum alert – In the first round of health briefings only two areas received this designation, the overseas département of Guadeloupe and Aix-Marseille – the southern port city and its surrounding areas. The initial designation is for 15 days, but local authorities have announced that Marseille's alert level has been extended until October 27th.

But on October 4th Paris and the petite couronne – the surrounding départements of Seine-Saint-Denis, Val-de-Marne and Hauts-de-Seine – were also moved up to maximum alert.

On October 6th four more areas joined the maximum alert list; Lille, Lyon, Grenoble and Saint-Etienne. The cities of Toulouse and Montpellier followed on October 11th.

This means there is an infection rate above 250 cases per 100,000 inhabitants and a very high level of spread among elderly (above 100 cases per 100,000 inhabitants), plus pressure on hospitals with intensive care units that have filled up over 30 percent of their beds with Covid-19 patients.

The highest level of alert means local authorities must close all bars for at least two weeks, although the period could be prolonged if the health situation required. Initially restaurants were included in the closure, but the government later announced a compromise that some could stay open under strict health conditions.

All other public spaces that do not already have strict hygiene rules in place must also close, although cinemas, museums and theatres will be exempt from this if they have sufficient hygiene protections. Cinemas and theatres already have strict rules on mask-wearing for the audience.

Metropoles not départements

It's important to note that for both the heightened and maximum alert status are related to cities and surrounding area (metropoles) rather than the whole département.

EXPLAINED: What is a French metropole

So for example in Bouches-du-Rhone – the département that includes Marseille – people who live in the Aix-Marseille metropole are on maximum alert level while people in the rest of the département are on alert level (pink).

State of Emergency – no areas received this designation and no measures were outlined for them. During the first wave of the virus the whole of France was placed in a State of Health Emergency, but this designation seems to open the way to declaring a State of Emergency in certain areas only.

Curfew – In addition to the restrictions brought about by the alert system is the curfew. As of Friday, October 23rd, 54 of France's 96 mainland départements are covered by a 9pm to 6am curfew. During those times everyone must stay at home unless they have an essential reason for being out, and any trip outside requires a permission form. Police are patrolling and breaking curfew means a €135 fine or €3,750 for repeat offenders. For full details on the curfew and which areas it covers – click here.

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Carte vitale: France to adopt a new ‘biometric’ health card

The French parliament has approved a €20 million project to launch a 'biometric' version of the carte vitale health insurance card.

Carte vitale: France to adopt a new 'biometric' health card

As part of the French government’s package of financial aid for the cost-of-living crisis, €20 million will be set set aside to launch a biometric health card, after an amendment proposed by senators was approved.

Right-wing senators made this measure a “condition” of their support for the financial aid package, according to French left-wing daily Libération, and on Thursday the measure was approved by the Assemblée nationale.

While it sounds quite high tech, the idea is relatively simple, according to centre-right MP Thibault Bazin: the carte vitale would be equipped with a chip that “contains physical characteristics of the insured, such as their fingerprints” which would allow healthcare providers to identify them.

The carte vitale is the card that allows anyone registered in the French health system to be reimbursed for medical costs such as doctor’s appointments, medical procedures and prescriptions. The card is linked to the patient’s bank account so that costs are reimbursed directly into the bank account, usually within a couple of days.

READ ALSO How a carte vitale works and how to get one

According to the centre-right Les Républicains group, the reason for having a ‘biometric’ carte vitale is to fight against welfare fraud.

They say this would have two functions; firstly the biometric data would ensure the card could only be used by the holder, and secondly the chip would allow for instant deactivation if the card was lost of stolen.

Support for the biometric carte vitale has mostly been concentrated with right-wing representatives, however, opponants say that the implementation of the tool would be costly and lengthy.

It would involve replacing at least 65 million cards across France and repurposing them with biometric chips, in addition to taking fingerprints for all people concerned.

Additionally, all healthcare professionals would have to join the new system and be equipped with devices capable of reading fingerprints. 

Left-leaning representatives have also voiced concerns regarding the protection of personal data and whether plans would comply with European regulations for protecting personal data, as the creation of ‘biometric’ carte vitales would inevitably lead to the creation of a centralised biometric database. Additionally, there are concerns regarding whether this sensitive personal information could be exposed to cybercrime, as the health insurance system in France has been targeted by hackers in the past.

Finally, there is concern that the amount of financial loss represented by carte vitale fraud has been overestimated. The true figures are difficult to establish, but fraud related to carte vitale use is only a small part of general welfare fraud, which also covers unemployment benefits and other government subsidy schemes.

The scheme is set to begin in the autumn, but there us no information on how this will be done, and whether the biometric chip will just be added to new cards, or whether existing cards will be replaced with new ones.