On Saturday, the French public health agency said that just over ten thousand new cases of Covid-19 had been confirmed in the past twenty-four hours. The epidemic rebound continues. Critical of the current government strategy, William Dab, doctor, epidemiologist and former Director General of Health (2003-2005), believes that it would be necessary to “put the package” on the epidemic centers and to encourage more case contacts to isolate.
The current measures to fight against the epidemic – a million tests per week, decisions taken locally according to the health situation… – do they seem sufficient to you?
I would favor two objectives: strongly control epidemic foci, les clusters. And protect the most vulnerable people, that is to say the elderly, diabetics and obese. We don’t have much time. But if we keep these first two objectives, perhaps we will prevent the flow of patients in hospitals from becoming too important.
How to control the epidemic in epidemic centers?
We must put the package on the clusters. However, currently we do not have the map of these homes. Public Health France communicates on their number, but not on their location. However, it is not the same thing if we say to people: Be careful, in your city, you have fifteen clusters or if you have one which is under investigation. Awareness is not the same.
Put the package and therefore do everything to find the contact cases. Which is no longer the case. Where five contacts were identified from a case of Covid-19, in July, there are only two now. People are reluctant to reveal themselves.
Jean Castex Yet has just announced the recruitment of 2000 additional people to find people who have contacted a contaminated person …
It’s not just a question of numbers, it’s also a question of training. Train these agents to talk to the people they call. This requires a certain empathy, human qualities so that the people contacted deliver parts of their life. This is what the AP-HP (establishment which manages hospitals in Ile-de-France) started doing or what they are doing in Austria.
And this may explain why the StopCovid application has encountered so little echo. Culturally, people are not ready to trust this technology.
Test, trace … And what about isolation?
Isolation is mostly not respected. Under these conditions, it is not surprising that the epidemic is progressing. It is however a centerpiece of the device. People who have been in contact with a patient must isolate themselves even before the result of their test.
For that, we must accompany them. It is not a question of tracking people like in South Korea to be sure that this isolation is respected. But we must help them during this period. For example, I was aware of a person who had to be isolated. She, living alone at home, asked if she could go out to do her shopping. And the ARS replied yes… Well no, that’s not right. We must mobilize communal social action centers, volunteers from the Red Cross, the Order of Malta, etc. so that they call these people two to three times a day. And if necessary help them.
Your second goal is to protect vulnerable people. But many elderly people in nursing homes complain of having been separated from their families…
This debate can be put on the table. I am not in favor of isolating vulnerable people, which is an authoritarian solution. In addition, we can hear that a resident in Ehpad says that she wants to continue to see her grandchildren. But we can also talk about it, explain to him that the risk is not only individual, that there is a risk of contamination. And for that, why not activate the general practitioners, by paying them, so that they call their patients, that they encourage them to better respect the washing of hands, the wearing of the mask and the distances. We must think about all the means to sensitize these vulnerable people.
Should we limit gatherings a little more, including family reunions?
We are not in a dictatorship. I don’t see how we could avoid family gatherings. But there again, we must convince. Explain that now is not the time to celebrate a birthday with thirty people in a 50m room2.
Regarding places closed to the public, they should be banned at this time. New York is avoiding a rebound in the epidemic because the interior spaces of bars and restaurants, for example, have not reopened, but the terraces, yes. We must still promote telework and break this epidemic rebound.
Are you optimistic?
We have two or three weeks before there is a major impact on hospitals.
– .
