When French President Emmanuel Macron announced that another nationwide lockdown would enter into effect, he set a tentative end-date four weeks ahead, on December 1st.
But Macron himself underlined that easing the lockdown on December 1st would depend on the health situation, and asked his country for a “massive effort” to respect the health rules in the coming days.
“If in two weeks we have the situation under better control, we will be able to re-evaluate things and hopefully open some businesses, in particular for the Christmas holiday,” the president said.
When France entered lockdown in March, it was for a period of two weeks initially. They quickly became four, then eight.
The big question on France's lips is therefore: How long will the lockdown last this time around?
Jean François Delfraissy, the President of the Scientific Council set up to advise the government on its coronavirus policies, did not say how long he believed the confinement should last, but said it would take longer than one month to reduce Covid numbers to a level low enough to ease the rules currently in place.
“The data we have in our models show that on December 1st, we will not be at 5,000 new cases per day. That I can tell you right off the bat today. So it's going to take more time,” Delfraissy told France Inter on Monday.
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Five-thousand recorded cases has been identified as a threshold that should be reached before easing restrictions on daily life. France currently counts tens of thousands new positives every day, more than 52,000 on Monday.
So if four weeks is too short, how long is long enough?
French hospitals had to postpone treatments of non-Covid patients during the first wave of infections, and worry that the second will be even longer and more deadly. Photo: AFP
'Let hospitals catch up'
“Six weeks,” said Célestin-Alexis Agbessi, a doctor at the Bichat Claude-Bernard Hospital in Paris.
Six weeks would not magically make the virus disappear, but it could, according to Agbessi, help hospitals catch up.
“Six weeks of lockdown would let us radically break up transmission chains, and let hospitals take care of the patients that come after the peak,” he told The Local.
A reference hospital for Covid-19 patients, Bichat has taken in a rising number of patients since the end of the summer, but Agbessi said thanks to lessons learnt from the first wave of infections this spring they had not yet become overwhelmed like they were in March. Yet.
France has 5,800 intensive care beds in total and on Monday counted 3,721 intensive care patients. The greater Paris region Île-de-France is among the most under-pressure regions in France, and the lockdown was a last resort to radically reduce Covid-19 numbers before it was too late.
But the numbers have kept rising, even after the lockdown entered into effect on October 30th. Because of the delay between a person getting the virus, falling ill and then potentially getting seriously ill enough to require hospital treatment, the peak would only come “in seven to 15 days,” Agbessi explained.
“Intensive care unit admissions could plateau in 15 days. Only then will we know whether we have succeeded in cutting the transmission chains,” Agbessi said.
By then, the seriously ill cases among those who got infected just before the lockdown would have arrived into intensive care wards.
A slower epidemic descent
Whereas the epidemic “peak” or “plateau” was a much-discussed topic during the first wave of infections this spring, there has been less obsession over it this time around.
“The situation is different from March,” said Vittoria Colliza, Research Director at the Sorbonne University and the French public health research institute INSERM, which recently published a report predicting the impact of the current lockdown in the greater Paris Île-de-France region.
There are significant differences between the first lockdown and the second. The government has kept schools open this time and allowed for more professional activity to go ahead to avoid shutting down the economy in the same way they did this spring.
As a result, the level of mobility around the French territory after the lockdown entered into effect was higher this time, as shown in the graphic below.
France entered lockdown on Friday. Mobility decreased by 33% compared to pre-#COVID19. In March, the first Friday into lockdown saw a drop of 63%. The difference is particularly visible during rush hours: -21% (now) vs -64% (March) in mobility 7am-9am. Data by @orange pic.twitter.com/cm5aMd07lm
— Eugenio Valdano (@eugeValdano) November 3, 2020
Colliza told French newspaper Le Figaro that whereas keeping schools open and allow for more mobility would not affect the arrival of the peak, “the number of new contaminations would drop less quickly after that.”
— Vittoria Colizza (@vcolizza) October 28, 2020
Bad weather makes it worse
That the drop in Covid-19 numbers following the peak is expected to be less steep could further be enhanced by the less favourable seasonal conditions during the second lockdown.
“We don't have the natural brake of the summer period anymore,” said Antoine Flahault, Director of the Institute for Global Health at the University of Geneva, which monitors the development of Covid-19 in the world.
Despite relaxing the rules of lockdown this summer, it was not until September that the number of new cases in France provoked a massive increase in the number of patients in the country's hospitals. The warm weather seemingly caused a natural summer break in the epidemic curve, not just in France, but across Europe.
“As long as we are in the cold season of the year, I don't see how we will manage without lockdown measures,” Flahault told The Local.
That was not to say that France should stay under lockdown until spring. By confinement measures, Flahault included softer measures such as a nighttime curfew, closing down bars and restaurants, or asking everyone who can to work from home which are also useful in reducing contact between people and, by extension, new cases.
“(The government) could choose to ease those restrictions that affect the economy the most,” Flahault said, referring to measures such as reopening shops when numbers look better.
The streets of Paris have been more crowded during this lockdown than they were this spring. Photo: AFP
What about Christmas?
The scientific consensus at present seems to be cautious optimism towards allowing for enough openness to avoid another economic downturn of the same crushing size as the one this spring, but not enough to provoke another wave in infections.
That could mean rethinking Christmas celebrations this year, Health Minister Olivier Véran warned this weekend did interview with the Journal du dimanche.
“Christmas celebrations will not me be normal this year,” Véran said, casting doubt as to whether families would be able to reunite for the holidays.
France's health minister Olivier Véran says “Christmas won't be a normal celebration this year”. I wonder whether this will be my first Christmas spent with my boyfriend and without seeing family. Certainly can't imagine going back to the UK any time soon. https://t.co/nvCNK1jdUd
— Catherine Bennett (@cfbennett2) November 1, 2020
“It's difficult to see how families will be able to gather for the holidays without a vaccine in sight,” Flahault said.
Delfraissy of the Scientific Council said: “The scenario is rather to have a month-long lockdown, observe at the various indicators, and then exit lockdown through a curfew that could continue through December, possibly covering Christmas and New Year, and come out only at the beginning of January.”