Can a person's freedom be temporarily hampered if he or she poses a risk of contamination to the rest of the population? This question intermingling principles of individual freedom and public health is invited, while there are to date six people infected with the coronavirus 2019-nCoV in France. And it is all the more necessary since the 200 French returnees from Wuhan, the epicenter of the virus in China, won the tarmac at Istres airport on Friday.
Among them, two people presented symptoms during this repatriation, one on the plane, the other on the bus. But "brought to the university hospital center of Marseille, they were tested negative," reassured the evening the Minister of Health, Agnès Buzyn. All these returnees are asked to spend 14 days in confinement in a holiday center in Carry-le-Rouet, in the Bouches-du-Rhône, in order to acquire the certainty that they are not infected with 2019- Ncov. An essential precautionary principle, whereas to date this coronavirus has infected more than 10,000 people and left 213 dead.
The "deal" ... and the law
All these French people "made a deal before getting on the plane" which brought them back to France, reminds us of the Provence-Alpes-Côtes-d'Azur (PACA) prefecture. "They signed a document in which they undertake to respect this 14-day confinement". However, it is not inconceivable that some of these returnees will decide on their own to leave the holiday center before the scheduled period. The prefect can then force them to return.
A law, born from the lessons of the SARS epidemic (severe acute respiratory syndrome), which affected France in 2003, now frames these extraordinary measures of isolation.
Let's go back to understand its origins. We are in March 2003, the deadly SARS virus has spread to around thirty countries. A French cardiologist working in a hospital in Hanoi, Vietnam, has just joined France without knowing that he was infected with SARS. After a sharp deterioration in his condition, the 65-year-old man who did not show any symptoms during the trip was then placed in solitary confinement in Tourcoing hospital.
The trauma of SARS
"Very depressed" by this quarantine, when his condition improves, he makes the decision to return home "against the advice of the doctors", says the infectiologist Anne-Claude Crémieux in his book Gouverner the unpredictable - Influenza pandemic, SARS, health crises. Fighting at the highest level in the state: the cardiologist, always contagious, risks infecting other people. It is the Director General of Health himself who calls the patient to order him to return to the hospital. The latter is executed and will die a few weeks later, the only victim of SARS in France.
What could the authorities have done in the event of his refusal to return to a hospital center? Nothing, because the situation was so new at the time that there was no legal framework for it. "The same day, the services of the General Directorate of Health prepare a decree intended to allow the Minister of Health to take measures of isolation or quarantine", explains Anne-Claude Crémieux in his book.
Prefect, prosecutor, minister: who decides?
Article L3115-10 of the Public Health Code also authorizes the prefect to take, by decree, "any individual measure making it possible to combat the international spread of diseases". Or: "the isolation or quarantine of persons suffering from a contagious infection or likely to be suffering from such an infection. "
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VIDEO. Coronavirus: the first French returnees from China have arrived
This action is carried out on the proposal of the director general of the regional health agency (ARS) and the prefect must inform the public prosecutor. A decree in the Council of State regulates these conditions of constraint. This text is a national adaptation to the international health regulations of 2005, which remains the only international instrument of a binding nature in matters of public health.
Such coercive measures have been taken only once since 2003. In 2012, in Aveyron, a man suffering from tuberculosis, a highly contagious and potentially fatal disease, refused to undergo treatment and be placed in solitary confinement. In a decree of October 22, 2012, it was the then Minister of Health, Marisol Touraine, who authorized the prefect to force the man into confinement, believing that the Aveyronnais put "the health of his entourage in serious and immediate danger ”.
The epidemic, an exceptional legislative framework
Other powers are also conferred on the prefect in the event of an epidemic. It can compel a traveler arriving on French soil to submit to a health check. If the latter refuses and is not a citizen of the European Union, entry to the territory is refused. If he comes from an EU country, he can be forced, if necessary, to a medical service for examination. And finally, if this person's condition requires that he be transferred to a hospital, the prefect may "take the necessary measures to keep him confined", pending this transfer.
In the event that an epidemic risk is identified in a French or foreign means of transport - planes, buses, boats ... - State representatives are also authorized to divert it to a specific point, then to immobilize it, so that 'it is inspected and can isolate or disinfect its contents.