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Why are Covid cases in France still higher than in most of Europe?

France, Andorra and Denmark are currently experiencing the highest infection rates in Europe, according to figures from the Oxford-based research body, Our World in Data

Covid case numbers are significantly higher in France than in other European countries including the UK and Italy Pic: GiulianiBruno / Shutterstock

Covid cases have been rising steadily in France since December 27, and by January 20, the country’s weekly average was 337,446 per day, while Italy’s was 180,373 and the UK’s was 92,000.

France, Andorra and Denmark are currently experiencing the highest infection rates in Europe, according to figures published by Oxford-based research body, Our World in Data.

Daily case numbers exceed 5,000 infections per million people in all of these countries, while in Spain the rate is 2,700 per million and in the UK and Germany it is approximately 1,300 per million.

France’s infection numbers have continued to increase while in other places they have begun to plateau, and experts have suggested that this is due both to the Omicron variant but also to a lack of effective infection control measures in schools. 

“Whichever way you take the figures, this observation remains a mystery for us,” Hajo Zeeb, professor of epidemiology at Brême university in Germany told Le Monde.

“It either comes from testing or from the opportunities that the virus has to circulate in France.”

Are high testing rates the culprit?

French Health Minister Olivier Véran did say on January 3 that “there are nearly no other countries which test as much as we do,” and Prime Minister Jean Castex has stated that France’s testing regime is the second most rigorous in the world. 

The more one tests, the more positive cases one finds, and so this could explain France’s high case numbers. 

However, Le Monde published an article on January 7 which claimed that Mr Castex’s statement was incorrect, and that several countries, including Portugal and the UK, whose case numbers are currently lower, test more than France. 

Some experts have suggested that France’s infection numbers are pushed up by the fact that people who return a positive result using a self-administered test have been encouraged to take a confirmatory PCR test, meaning that there could potentially be two results recorded for the same person.

Read more: Do I need to report a positive Covid self-test in France?

Relaxing barrier gestures 

However, others believe that the current infection rates have less to do with testing systems than with public behaviour. 

Professor Gilles Pialoux, who heads up the infectious diseases department of Paris’ Hôpital Tenon, told Le Monde that there is now a “reduced adherence to barrier gestures, reflected in all lines of enquiry. Masks, hand-washing, social distancing, working from home: since the last four months of 2021 we have seen a relaxation of these behaviours.

Prof Pialoux also cited “the mind-blowing rate of circulation among children, which increased by 56% in the second week of the year, just after they went back to school.

“This is considerable. Their parents are the next to be affected through familial contact, and then comes everyone else.”

France’s Conseil scientifique government advisory body has also suggested that the sharp rise in Covid cases observed throughout this month is in part linked to the return to school after the Christmas holidays.

“If it is proven that the epidemic resurgence observed is indeed linked to a very active circulation of the virus in primary schools, nurseries and creches, it would be useful to allocate additional measures to reinforce the Covid testing and prevention rules in educational settings as soon as possible,” it said.

Finally, Prof Pialoux added that: “The incapacity to hear anything other than the reassuring idea that Omicron is not that bad, that this ‘bad cold’ will provide herd immunity, that we have avoided the worst” has perhaps led people to relax their infection control efforts. 

“It is true that we in our hospital group had envisaged converting our cafeteria into an intensive care unit and we have not had to do it, but the strain on hospitals remains considerable. 

“Intensive care units are mainly occupied by patients with Covid, Delta and Omicron, and some are dying. And things will stay like this for as long as we have such a high infection rate.”

Samuel Alizon, who is a researcher into the evolutionary ecology of infectious diseases, added that France’s extensive vaccination coverage enables the population to withstand higher infection rates without hospitals being overwhelmed, because fully vaccinated individuals are less likely to become seriously ill with Covid. 

Because of this, the government has not introduced strict Covid restrictions during the Omicron wave, and so the virus’ spread has not been prevented. 

This comes in a context where the Omicron sub-variant BA.2 has been detected in various European countries including France. 

Read more: Leading French scientist: variant of Omicron may cause new Covid wave

Only 17 cases of this sub-variant have been detected so far through sequencing in France, but the real figure is almost definitely larger.

“Will we experience the happy scenario that everyone is hoping for: a decline in case numbers accompanied by a reduction in hospitalisations from February or March?” wondered public health Professor Antoine Flahault. 

“Or will we return to a situation similar to that of mid-December, with a new case surge linked to the arrival of a new variant, which escapes any immunity conferred by the previous variant?”

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