What could the French government do next as Covid-19 cases show signs of rising again?

Health chiefs have warned that France seems unlikely to meet its targets to lift lockdown on December 15th given that infections are no longer falling, so what could happen instead? Here are the options the government is believed to be considering.

What could the French government do next as Covid-19 cases show signs of rising again?
Christmas decorated streets of Bordeaux, southwest France, filled up with pedestrians on November 28th when the French government eased lockdown and let shops reopen. Photo: AFP

With the big day just five days away, France has not yet reached its goal of passing below the target threshold of 5,000 new Covid-19 cases per day in order to lift lockdown on December 15th.

“Today's projections for the coming seven days no longer allow for the hope that we will be below 5,000 cases per day on December 15th,” Antoine Flahault, epidemiologist and director of the Institute for Global Health at the University of Geneva, told The Local.

“We hope to be below 10,000 and even that objective risks becoming difficult,” he said.

In the past couple of days daily case numbers have climbed rather than shrunk. On Wednesday evening, health authorities recorded 14,595 new Covid-19 positives, up from 13,713 on Tuesday. The previous week daily cases hovered around the 11,000 mark.

The national incidence rate, which measures the level of Covid-19 cases per 100,000 inhabitants, had increased to 107.5 after dropping below 100.

“It would be a miracle” to reach the goal of 5,000 cases per day by December 15th, Daniel Camus, a professor at the Pasteur Institute, told The Local.

(The chart below shows how the steep fall in infections in France has levelled off over the last week, before showing signs they are on the rise again in recent days.)

What is the government planning to do?

At present although shops in France have reopened, travel or social gatherings are not allowed and an attestation (permission form) is still needed for every trip outside the home.

When President Emmanuel Macron set December 15th as a date for lifting lockdown he also said this would only happen if case numbers dropped below 5,000 per day, along with intensive care patient numbers at a level of less than 3,000. 

While the first goal this week was looking increasingly far away, the second was nearly achieved on Wednesday, when the country's hospitals recorded 3,041 intensive care patients in total.

Macron held a Defence Council meeting on Wednesday to thrash out the road ahead before the prime minister's speech at 6pm on Thursday. We will follow the PM's speech here.

What happens if the government lifts lockdown too early?

Senior health official Jérôme Salomon said earlier this week that France was “still far off” from its health objectives and “faced with a high risk of (epidemic) rebound”.

Lifting lockdown with a case level above 5,000 could cause a third wave of Covid-19 infections, according to epidemiologists. That would cause a third round of mounting pressure on hospitals, which are already struggling with overworked and often exhausted staff.

Five thousand “is the threshold where it is possible to control the epidemic,” Epidemiologist Mircea Sofonea told AFP, explaining that 5,000 was a number that regional health authorities can manage, where contact tracing was possible and clusters could be tracked down before they multiplied and got out of hand.

Several health experts have echoed her warning, with epidemiologist Mahmoud Zureik telling France Info that case numbers risk doubling or tripling after the Christmas and New Year's celebrations.

“The important thing is to arrive at the lowest case number possible before the holidays,” Zureik said. “Otherwise it won't be manageable.”

Here's a look at the scenarios the government is considering:

Before the second lockdown entered into effect, Paris and several other cities were under a night time curfew that will likely be repeated on a national level when the government decides to ease this lockdown. Photo: AFP

1. Ease lockdown as planned

One option is to go ahead and lift lockdown even if cases and/or intensive care patient numbers remain above the set thresholds to see if the epidemic is manageable even at a higher level.

If the government chose this path, cinemas, theatres and museums would be able to reopen their doors and welcome customers as planned on December 15th – albeit while complying with strict health rules.

Lockdown permission slips would be scrapped and people would be able to move around freely, travelling and visiting friends and family without restrictions.

A planned night time curfew from 9pm to 7am would enter into effect with the exception of December 24th and 31st, when people would be able to celebrate as they please however without large gatherings in public.

Bars, restaurants and gyms would remain closed.

READ ALSO: Lockdown lifting: What kind of Christmas can we expect in France this year

Whatever happens on the 15th, bars and restaurants will have to remain closed until January 20th at least, the government has previously said. Photo: AFP

2. Keep the current rules

Another option will be to do nothing and keep the current rules in place to see if cases stagnate, decrease or – in a worst case scenario – continue to rise.

From the outset France's second lockdown was more relaxed than the first, with schools remaining open and looser rules allowing for more economic activity. This lite-version of lockdown proved to be efficient and caused case numbers to plunge.

On November 28th, businesses selling “non-essential” goods and services, such as bookshops and hairdressers, were allowed to reopen and rules on outings for exercise were relaxed. 

Social gatherings and non-essential travel are still banned, working from home is advised where possible and permission forms are needed for every trip outside the home. Still, the relaxation seems to have seen case rates stagnate and, lately, potentially increase.

3. Partial easing of lockdown

The government could decide to keep some rules in place while lifting others.

One option outlined by French media would be to allow for more travel and reopening cinemas and other cultural centres, but keeping the attestation (permission slip) in place for the time being to avoid people leaving their home too much.

Several reports in French media have suggested that the government is determined to let families gather for the holiday season, fearing the social and political consequences of preventing the country from coming together for Christmas.

“Everyone agrees that the French must be able to celebrate Christmas with their families and move around,” MP Olivier Becht told Le Monde.

Reports suggest they want to December 24th – the main day for family Christmas gatherings in France – as an exceptional date, whatever the rules they decide to keep in place, however the same thing is not certain for New Year's Eve.

Some reports suggest the government might keep some kind of attestation rule in place on December 31st to prevent too large gatherings of people. 

Cinemas are hoping to reopen on the 15th, but currently nothing is certain. Photo: AFP

4. Delaying the lifting

It's also possible that the government could delay the decision, or push back the easing of restrictions from December 15th.

French schools finish for the Christmas holidays on December 19th, so the weekend of the 20th/21st was predicted by SNCF to be the peak weekend for travel, but it's possible that the government could decide to lift restrictions only for a few days over the holiday period, or simply delay the planned easing of restrictions.

5. 5pm curfew

Then there is the alternative of lifting lockdown as planned while toughening the rules of the night time curfew.

Instead of 9pm, some reports have suggested the government is considering introducing a 5pm curfew in order to limit the movement of people outside work hours.





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French doctors to stage more strikes in February

General practitioners in France are planning another industrial action that will see doctors' offices closed as they call for better investment in community healthcare.

French doctors to stage more strikes in February

Primary care doctors in France announced plans to strike again in February, after walkouts in December and over the Christmas-New Year holidays in early January.

The strike will take place on Tuesday, February 14th, and it comes just a few weeks ahead of the end-of-February deadline where France’s social security apparatus, Assurance Maladie, must reach an agreement to a structure for fees for GPs for the next five years.

Hospital doctors in France are largely barred from striking, but community healthcare workers such as GPs are self-employed and therefore can walk out. 

Their walk-out comes amid mass strike actions in February over the French government’s proposed pension reform. You can find updated information on pensions strikes HERE.

Previous industrial action led to widespread closures of primary care medical offices across the country. In December, strike action saw between 50 to 70 percent of doctor’s surgeries closed.

READ MORE: Urgent care: How to access non-emergency medical care in France

New concerns among GPs

According to reporting by La Depeche, in the upcoming strike in February primary care doctors will also be walking out over a new fear – the possibility of compulsory ‘on-call’ hours.

Currently, French GPs take on-call hours on a voluntary basis. Obligatory on-call time for primary care doctors was scrapped in the early 2000s after GPs mobilised against the requirement.

However, representatives from the Hospital Federation have called for it to be reinstated in order to help relieve emergency services.

Additionally, GPs are calling for Saturday shifts to considered as part of their standard working week, in order to allow for a two-day weekend.

Striking primary care doctors are more broadly calling for actions by the government and Assurance Maladie to help make the field more appealing to younger physicians entering the profession, as the country faces more medical deserts, and for working conditions to be improved.

Those walking out hope to see administrative procedures to be simplified and for the basic consultation fee – typically capped to €25 – to be doubled to €50.

In France patients pay the doctor upfront for a visit, and then a portion of the fee is reimbursed by the government via the carte vitale health card.