PARIS, March 10 -- With nearly 1,800 coronavirus infection cases and 33 deaths confirmed, France, the second worst affected European country, favours a proportional and progressive strategy to handle the virus crisis and hopes to avoid drastic measures as long as possible.
"We are at the beginning of this epidemic. We must be very clear, lucid," said President Emmanuel Macron on Tuesday morning when visiting the ambulance service in Paris, stressing that France is "organized" and urging the French not to panic.
The president reiterated the necessity "to remain extremely adaptable (to the virus evolution)" and ruled out a "big change" in the country's national strategy on epidemic emergency.
STILL AT STAGE 2
Since the virus reached Europe in January, the French government has taken a wide range of measures based on its "influenza pandemic national prevention and response plan," a decision-making guide adopted in 2011.
The plan defines the general preparation and response framework, and the measures to be taken at various stages of a pandemic. Policymakers and health professionals are called to anticipate gradual health strategy to determine in advance how, where and when measures should be implemented.
As of Tuesday, France has been in stage 2, or "pre-epidemic level" as defined by the plan, for 12 days. The authorities stopped short of raising the alert to the highest level of "stage 3," arguing that drastic measures under stage 3 such as those taken by Italy is not yet necessary for France.
"We are managing to not take such action," Health Minister Olivier Veran told state-run France info radio after Italy decided to place all the country in lockdown until April 3, affecting some 60 million people.
"We are taking gradual measures adapted to each territory," he explained. "The difference with Italy is that we do not prevent social, economic and democratic life when it is possible to continue."
For Francois Bricaire, epidemiologist and member of the Academy of Medicine, "the government has taken a certain number of perfectly legitimate and reasonable measures" to contain the coronavirus outbreak.
"We must of course take into account the need to protect (the people against the virus), but there is also the need to live and maintain a certain number of activities. This can be done provided that the infectious phenomenon is not severe enough," he told France info radio.
MEASURES STEPPED UP
Guided by the 2011 epidemic plan, France has ordered travel restriction to affected countries and isolation of infected people and suspect cases since the first coronavirus case was detected on Jan. 24.
Officials and health experts repeatedly reiterated the need to respect "simple and effective barrier gestures" including frequent hand washing, using one-time tissues, coughing or sneezing into the elbow, avoiding handshakes and hugs.
As the flu-like illness rapidly spread in neighbouring Italy, France stepped up measures. Since Feb. 28, all gatherings expected to draw 5,000 people in confined spaces as well as certain events in an open environment have been prohibited across France. Some 150 schools were shut down in l'Oise in northern France, and Haut-de Savoie near Italian borders where the virus was rapidly spreading.
Nearly one week later, tougher measures were announced as the COVID-19 tally exceeded 1,000 cases. Some 300,000 students were called to stay at home. All public gatherings of 1,000 people are banned across French cities until April 15, except public services and events considered "useful to national life."
New measures also included a decree to facilitate access to teleconsultation to help hospitals better manage influx of patients linked to the coronavirus.
In addition, hospitals would trigger the "white plan" of extra mobilization which allows to reinforce nursing and administrative staff, offer more beds and limit patients visit.
"We have a system adapted and proportional to the crisis. Measures are implemented based on the spread of the virus. We have anticipated a lot and we are learning from the experiences of others," said Rafik Massmoudi, emergency doctor at the European Georges Pompidou hospital in Paris.
DRASTIC STEPS NOT EXCLUDED
In the latest update, Health General-Director Jerome Salomon announced 1,784 positive cases and 89 patients hospitalized in intensive care, up by 372 and 66 respectively in one day.
France offers around 4,500 beds in intensive care units. The figure could increase to 11,000 to treat critical situations, according to Professor Jean-Michel Constantin, deputy secretary general of the French academic association of anaesthesia and resuscitation.
"Each hospital has already set aside an intensive care service for COVID-19 patients, but we know that more units (such as recovery rooms) will soon need to be opened and equipped with respiratory devices. The material aspect does not worry us. All the large hospitals have reserves of ventilators," Constantin told Le Figaro newspaper.
"We are preparing to face that without sacrificing other patients, such as road accident victims or patients requiring emergency surgery," he said.
Meanwhile he admitted that "the situation will be complicated". "The hospital is already in a situation of permanent tension. We cannot count on the professional conscience and the abnegation of our teams forever."
Speaking to France 3 television, Eric Caumes, infectious disease specialist at the Pitie-Salpetriere hospital in Paris, said "we must draw inspiration from what is done in Italy."
"Containment when it is seriously respected, probably in the same way that China has done, will be certainly effective. We saw that it has broken the epidemic curve (in China), " he added.
Macron, stepping out of the teleconference with European leaders on Tuesday evening, cautiously remarked that draconian steps, when justified, will not be excluded.
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