Communiqué
Published 28 June 2020

Let’s deconfine carefully for not having to reconfine in a hurry

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Let’s deconfine carefully for not having to reconfine in a hurry.

Press release of the French National Academy of Medicine

June 28, 2020

 

In metropolitan France, since the gradual lifting of containment that began on May 11, 2020, the main epidemiological indicators of the Covid-19 epidemic count of new confirmed cases, hospitalizations, transfer to intensive care units and deaths are decreasing throughout the country. Another indicator, the positivity rate of RT-PCR tests, transmitted by the SI-DEP (screening information system) since week 20, also shows a regular decrease (1.3% for week 24). Epidemiological surveillance has allowed the detection of 272 outbreaks (clusters) between May 9 and June 24, most of which have been circumscribed, thanks to the combined action of the ARS (Regional Health Agencies) and the regional cells of Public Health France, thus far avoiding any community spread.

At the same time, the French public health survey CoviPrev [1] reveals that compliance with recommended prevention measures (physical distancing, hand washing, wearing of masks) has continued to decrease since May 11.

At the world level, the Covid-19 pandemic is accelerating, according to the WHO Director General, with one million cases reported in the last eight days. While the situation in the United States raises fears of a second wave of the epidemic, Latin America has become the epicenter of the pandemic, with more than 100,000 deaths, more than half of them in Brazil. In Europe, despite a decrease in the epidemic curve observed in all countries, Germany has to re-contain more than 600,000 people in two cantons to control a major outbreak in the Europe’s largest slaughterhouse [2], while Portugal is re-establishing containment in part of the city of Lisbon.

This worrying international context and the general laxity observed in the large French cities, particularly on June 21 during the “Fête de la Musique”, raise fears of a switch to scenario 2 (appearance of one or more critical clusters indicating a local resumption of the epidemic) [3].

In order to avoid the prospect of a recontainment, the National Academy of Medicine recommends

– to reinforce epidemiological surveillance throughout the country by implementing a wastewater control program designed to locate communities with Sars CoV-2 circulation [4];

– to intensify screening in communities at risk (health establishments, companies, slaughterhouses, people in precarious housing [5], etc.) by making the maximum use of the resources currently available for screening by RT-PCR;

– to call out to the sense of responsibility rather than mandatory measures, which are often misunderstood, in order to maintain compliance with barrier measures and the wearing of masks, even during the summer months, and to conduct an information campaign targeting the youngest age groups to remind them that by protecting themselves, they are protecting those around them.

 

References

[1] https://www.santepubliquefrance.fr/etudes-et-enquetes/covid-19-une-enquete-pour-suivre-l-evolution-des-comportements-et-de-la-sante-mentale-pendant-l-epidemie

[2] Communiqué of the French National Academy of Medicine and Veterinary Academy “Slaughterhouses: a major target for Covid-19 prevention”, June 24, 2020.

[3] Opinion No. 7 of the Covid-19 Scientific Council “4 scenarios for the post-confinement period: anticipating for better protection”, June 2, 2020.

[4] Mallapaty S. How sewage could reveal true scale of coronavirus outbreak. Nature. 2020; 580 (7802): 176-7.

[5] Communiqué from the National Academy of Medicine and the National Academy of Pharmacy “Precariousness: an increased risk for Covid-19”,  June 21, 2020.