Serge Blondel (University of Angers) and François Langot (University of Le Mans, Paris School of Economics and University Institute of France), economists and members of the Theory and Evaluation of Public Policies (TEPP) federation.
Our governments have become accustomed to making decisions under duress and respect politically correct “egalitarianism”.
Managing the COVID-19 crisis is no exception.
In his interlocution of October 28, President Macron took care to explain that the track of a measure aimed at isolating only the most vulnerable people
"may be relevant, but it is not sufficient".
Generalized containment has therefore been announced, putting everyone on an equal footing.
As this measure is extremely costly economically, exemptions have been granted: even if teleworking is compulsory for all who can, those who have to work and study away from home are not confined to the hours of their activities.
Obviously, this implies that all those who do not have an employer, retirees in particular, cannot leave their homes beyond the authorized limits.
This confinement for all, therefore "egalitarian", but accompanied by many exceptions in its application, is it the right way to present things to a population which is afraid, which listens to its leaders, and which sinks into an economic crisis? acute?
No because it does not reassure, does not inform effectively about the epidemic, and it amplifies the economic crisis.
The virus when it leads to the fatal outcome, hits the population very unevenly.
It is extremely difficult to decide at this time when scientific knowledge on an unknown subject can only very partially shed light on the way.
In this fog, strict containment of all is the ultimate precautionary measure, as no one can then be contaminated or contaminating.
But is it really necessary to go that far?
Since the first confinement, we have learned things that must be shared with the French so that they can best adapt their behavior.
First, the virus when it leads to the fatal outcome, hits the population very unevenly: those between the ages of 60 and 70 are 1,000 times more likely to die from COVID-19 than those under 20. , and those over 80 are nearly 10,000 times more likely to die from COVID-19 than those under 20.
As a result, since November 1, more than 96% of daily deaths affect a person over 60 years old.
Is this dark trend, highlighting the greatest fragility of people over 60, also present in other statistical indicators?
Yes, people hospitalized with a COVID-19 diagnosis are increasingly older: there was one hospitalized person over 60 years old per 1,000 inhabitants over 60 years old in the first week of September, they are now 10 per 1,000 (ten times more), while this ratio has fallen, between early September and today, from 0.1 to 0.5 per 1,000 people aged 30 and 59 (five times more).
For those under 30, today there are “only” 0.005 people per 1,000 individuals aged 0 to 29 hospitalized with a COVID-19 diagnosis.
In other words, if we exclude the over 70s from the COVID-19 statistics, we reduce hospitalizations by 69% and the number of deaths by 88%.
In addition, EHPAD deaths are on the rise again after the summer plateau: on September 20, France recorded 30 more deaths per day there, reaching the figure of 142, on October 30, knowing that there was until 'to 309 additional deaths in one day at the peak of the first wave.
It is therefore obvious that we need to protect our elders more so that they do not further enrich the “hunting table” of COVID-19.
To do this, we must immediately stop the “egalitarian” discourse advocating that everyone is affected: no, we must indicate that everyone can be positive, and moreover, young people are more positive than seniors, but that victims will be the seniors.
It is therefore urgent to make this message heard so that the population becomes aware of the extent of inequalities in the face of the virus: they will then be able to better adapt their behavior and accept more targeted strict measures: i) immediate cessation of visits and meeting with the grandparents and great-grandparents, ii) close EHPADs, iii) arrange circulation hours in public spaces specific to the inactive and ultimately the most vulnerable, iv) offer assistance to the elderly to prevent them come out.
Impact of the two waves according to age (hopsitalization on the left, resuscitation in the middle, death on the right) Source: Santé Publique France
Second, those under 60 seem less affected in the second wave than in the first.
Those under 60 have gone from 35% of resuscitations and 6.6% of deaths during the first wave to 21.7% and 3.6% currently.
Since the first Monday after the October 17 curfew, the number of deaths among those over 60 has risen from 1 in 1,000 to 2.5 in 1,000 on November 5, which is exactly the same increase as that of observed between March 17 and April 3 for this population.
On the other hand, since the October curfew, the death rate has dropped "only" from 0.02 per 1,000 to 0.04 per 1,000 individuals aged 30 to 59, whereas during the first confinement, we went from 0.02 deaths per 1000 to 0.18 deaths per 1000 individuals aged 30 to 59 years.
On this population, it therefore seems that "those absent" from the first confinement, barrier gestures, wearing of a mask, and tests, were effective measures for this population.
Not going to school or to work, which characterized the first confinement, did not allow to have the same results on this population.
Source: Public Health France
On the economic front, the almost total cessation of activity during the first confinement led to gigantic economic losses, partly ensured by a no less gigantic increase in debt.
During this second wave, the second confinement gives the authorization to working people and to schools to go to their place of work, when telework is not required.
It thus makes it possible to envisage lower economic and social losses.
However, this confinement could be optimized by imposing, on the inactive and therefore on the elderly, specific timetables for frequenting public places (transport, shops, etc.).
The establishment of these time slots, stopping the mixing of populations at very high risk with others, will thus make it possible to re-open so-called “non-essential” businesses and activities.
Of course, all these efforts would be destroyed if family reunions with grandparents and great-grandparents were organized.
COVID-19 has already cost public finances nearly $ 200 billion.
These age-specific targeting measures are most effective when you do not give yourself the opportunity to test 100% of the population over a short period of time, as was done for example in Slovakia over a weekend.
Admittedly, it is a small country, but it is less well endowed with health infrastructures than France: health expenditure represents only 6.7% of the wealth produced in this country against 11.3% in France.
A generalized test over a short period of time is being done in Liverpool.
While being pessimistic, with 4 tests per hour per operator over 40 hours per week, 445,000 people will be mobilized over 5 days, or 40% of French doctors, nurses, pharmacists and laboratory technicians.
Being optimistic, 12 tests per hour are possible, ie the mobilization of 150,000 people, 14% of our health personnel.
The soldiers can also be mobilized as reinforcements and the self-tests made available.
The unit cost of a test in France being 70 €, it will cost 4.7 billion, which remains modest compared to the sums already spent since the start of the pandemic: COVID-19 has already cost nearly 200 billion to public finances.
The Social Security balance will be a deficit of more than 40 billion this year, against a surplus in 2019, without counting the losses of the SNCF and the transport authorities, museums and national monuments, the list of losses will be long.
It also goes without saying that they are also the most effective if one seeks to minimize economic and social losses: confining the inactive remains the measure which least reduces present and future economic activity.
With these measures, the pandemic would be better contained, and would also have a lower economic cost, which has been demonstrated, among others, by Daron Acemoglu, eminent economist at MIT.
By applying them as soon as possible, it would allow you to calmly plan the Christmas holidays: there is still time!