According to the Minister of Health, this is a "new stage in the epidemic crossed" in France. Friday evening, the country was placed in "stage 2" of the coronavirus epidemic, on a scale that includes three, announced Olivier Véran. What does this mean in concrete terms? The Parisian takes stock.
There are three levels of epidemic in France. They were developed after the H1N1 pandemic, which particularly affected France in 2009, and are part of a plan created to deal with a possible influenza pandemic. Matignon specifies that these stages concerning the Covid-19 are identical to those linked to the flu and the Prime Minister wanted to be reassuring: "The transition from one stage to the other should not worry them," said Edouard Philippe , Thursday, stressing that "each stage calls for different and appropriate responses".
Stage 1: "prevent the virus"
Since the beginnings of the spread of the virus and until Friday therefore, France was at the first stage of the pandemic. On Thursday, the Prime Minister defined this level as the time of the epidemic when "the virus is not in general circulation in the population". During this first stage, the objective is to "prevent the virus from entering the national territory", summed up this Saturday the Minister of Health. It is therefore necessary to block isolated cases which would be detected. This was what was done when six contaminations were discovered in Contamines-Montjoie, in Haute-Savoie, in early February.
According to the document preparing for the epidemic risk of Covid-19, distributed by the Ministry of Health to health establishments and private doctors, at stage 1, the authorities are responsible for identifying suspect patients as early as possible, particularly they return from an area of circulation of the virus, like China, the epicenter of Covid-19. It is then necessary to treat these cases when they are known and to place them in containment, as well as to trace their recent activity, in order to identify the people with whom they have been in contact and to treat them if necessary. The authorities are also mobilizing international airports and ports, responsible for checking the health of travelers.
Stage 2: prevent spread
Since Friday, the situation has changed. The country has passed stage 2 of the epidemic, because there are foci of contamination, also called clusters, on French territory. This Saturday, the Minister of Health announced that France now lists 73 cases of infections, including 59 hospitalizations and two deaths. The two clusters are located in two departments, Oise, where 18 people have been infected in five communes, and in Haute-Savoie, where there are six contaminations in the commune of Balme-de-Sillingy.
The measures for detecting and treating sick patients remain the same, but at this stage, "the health strategy consists in slowing down the introduction of the virus on the national territory and slowing down its spread by containment measures", details the document from the Ministry of Health. As with stage 1, all patients classified as "possible cases" and proven must be managed in health establishments authorized for the Covid-19 virus.
Measures are also taken in areas of contamination. In the six municipalities of Oise and Haute-Savoie concerned, rallies are prohibited and schools closed and the minister called on residents to make the least possible trips. At the national level, the ministry also announced the cancellation of events gathering more than 5000 participants including the half-marathon and the carnival of Annecy in order to avoid possible contacts between healthy populations and other patients .
The services of 15 and Samu must already create "a device to increase the power of (their) capacities", notes the document of the ministry, in order to be able to respond to an increase in incoming calls and Covid-19 cases. Each establishment that has a Samu is asked to be able to answer a tripling of calls.
Towards stage 3?
The Minister of Health is convinced that the passage from France to stage 3 of the epidemic is now inevitable. This level is triggered when the virus is actively circulating on the territory and it is then a question of reducing its spread. The strategy no longer targets individual care, but "a logic of collective action", points out the document of the Ministry of Health, avoiding saturation of the system. The entire French health system (city medicine, health establishments and medico-social establishments) "must be able to act by mobilizing all the resources they are able to deploy", in order to "be able to participate in the diagnosis and taking care of Covid-19 patients ”, in particular by placing them in quarantine.
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Clearly, even city doctors must be able to provide outpatient care for patients of least concern and allow as much as possible to provide care at home, in order to avoid congestion in hospitals. Health facilities not authorized to manage patients with Covid-19 could also be mobilized to take care of certain patients with less severe forms of the virus.
It is necessary, from stage 2, to anticipate and compensate for a possible future lack of medical personnel, likely to cause an unprecedented health crisis in the country. Because another epidemic, influenza this time, also affects France. Its peak "is behind us, but there are still a lot of sick people, including in our hospitals", stressed this Saturday the Minister of Health, adding that it is important that "the two events do not overlap" . "We are not sure we will get there but we are doing everything to succeed," he also said the minister.