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French science council lists deconfinement conditions

Ahead of President Macron’s national address tomorrow (Monday April 13) - which is expected to extend confinement to at least May 3 - we look at three factors that scientists say are necessary for deconfinement.

President Macron is to make a televised address to the nation at 20h tomorrow, the Elysée has confirmed. It will be his fourth televised address about the epidemic since March 12.

An extension to confinement is one of the major announcements expected to come out of the address.

It comes as the principality of Monaco, which is bordered by France on all sides, has announced that its confinement measures are to last until at least May 3. Monaco has 90 confirmed cases, with nine people in hospital including four in intensive care. Five patients have recovered. 

Its confinement rules are largely the same as France, with breaches punished by fines of up to €200. As its policies are often aligned with France, commentators suggest that this is likely to mean President Macron will announce an extension until the same date (May 3).

President Macron has also made a number of scientific visits in recent days, ahead of his speech, including a trip to see Professor Didier Raoult, the Marseille-based infectious diseases specialist and pioneer of the use of chloroquine against Covid-19.

Read more: President Macron visits 'chloroquine-treatment' doctor

The visit was reported as part of a wide consultation of experts by the President, ahead of Monday’s address.

Now, national advisory body le Conseil Scientifique has said that there are three conditions in which confinement could eventually be lifted in France.

They are: 

1. The healthcare system being able to regulate the number of people being admitted to hospital.

This is especially important for intensive care units, with confinement measures having been brought in largely to help ease the pressure on ICUs, explained a statement from le Conseil Scientifique on April 2.

The statement said: "The main objective of containment...was to help relieve intensive care units in the most affected regions such as Grand Est, Hauts-de-France, Corsica, and Ile-de-France. Before envisaging an exit from confinement, the government will have to ensure that the objective of confinement has been achieved.”

Hospitals and ICUs must be in a position to be able to admit new patients without risking overcapacity.

The number of people in intensive care is a key figure for health professionals, as it shows the extent of the pressure on the health system as a whole. Before the epidemic, France had 5,000 intensive care beds.

Health minister Oliver Véran said: “It’s an important indicator because it shows the pressure in our hospitals, on all the human and logistical resources."

2. A significant drop in the number of ill people / cases

The latest figures in France (April 11) show that 635 more people had died in the past 24 hours, bringing the total death toll to 13,832. The previous 24 hours reported 987 deaths.

According to le Conseil Scientifique, the number of positive cases overall of Covid-19 will need to be on the decline before deconfinement can happen, to help avoid a “second wave” of new infections.

It said: "Ideally, this decrease [in cases] should be large enough to make it possible to detect new cases in a systematic way again [as was possible at the start of the virus spread].”

A sustained drop in the number of deaths will also be necessary. Currently, the number of deaths is still increasing each day, but by much less than before. In the last week, the number of deaths was increasing by 9.56% per day, compared to 17.26% in the seven days before.

This is not enough to trigger deconfinement yet, but is a step in the right direction, le Conseil Scientifique said.

Read more: Covid-19 France: Confinement bringing results
Read more: France ‘must be extremely cautious’ as epidemic slows

3. Having a solid strategy in place for gradual deconfinement

France has now appointed Jean Castex, mayor of Prades (Pyrénées-Orientales, Occitanie) as Deconfinement Minister, to take charge of the process.

Deconfinement will likely happen in stages.

These may include: 

  • Maintaining social distancing measures (1-2 metres between people, wearing masks outside)
  • Protecting vulnerable and at-risk people, as well as people in precarious social situations, such as prisoners, and migrants - necessitating continued border checks
  • Continued isolation and checking of ill people and their relations or people in the same household, to avoid contaminating others

But the government is still debating what this third stage will look like in practice.

On Wednesday April 8, the government announced it would roll out a smartphone app called “StopCovid”, which would alert anyone who has come into contact with a confirmed case of Covid-19. This is intended to “strengthen the effectiveness of the monitoring of the epidemic”, the government said.

The government will also likely need to find a way to track and calculate the precise number of new cases, and has even discussed mass blood testing to track how far the virus has spread across the country - even among people who have now recovered, or asymptomatic carriers who may not even have been aware they were infected.

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