To stem the coronavirus epidemic and avoid a global reconfinement in France, the head of state announced on Wednesday the establishment of a curfew in Île-de-France and eight metropolises. A measure that has proven itself in Guyana but which generates a “social and economic cost”, according to the scientific community.
The announcement was expected. Wednesday October 14, the French President, Emmanuel Macron, imposed a curfew for at least four weeks in the Île-de-France region and eight French cities, from Friday midnight.
The stated objective: to slow the spread of the Covid-19 epidemic, as was the case, for example, in the overseas department and region of French Guiana. A curfew was established there in May, as the number of cases rose alarmingly and the measure apparently inspired the head of state.
An effective measure
As of May 11, Guyana experimented with an à la carte health curfew, and the measure has proven to be effective, according to various scientific opinions. “The numbers are clear: the curfew has had massive effects on the flow of the epidemic,” said Oct. 15 on France Inter Clara De Bort, director of the Regional Health Agency (ARS) of Guyana.
A study posted on October 12, but not yet published in a scientific journal, also attests to the effectiveness of the measure. Conducted by a college of researchers (CNRS, Inserm, Santé Publique France, Institut Pasteur, ARS Guyane and several universities), the twenty-page report assesses the impact of the curfew and other restrictive measures on the circulation of virus in Guyana.
Its conclusions leave little room for doubt: “In June and July, French Guiana implemented a curfew, containment and other restrictive measures. We have established that the combination of these measures reduced the incidence rate of Covid-19 from 1.7 to 1.1, which was enough to avoid saturation in hospitals “.
However, can we learn from this for the metropolis, with a demographic structure quite distinct from that of Guyana? The study underscores Guyana’s specific and local experience. Nevertheless, “mathematical modeling helps to build realistic scenarios (…) The information that we will draw from these local experiences will be essential to progressively optimize control strategies and determine sufficient interventions to control the epidemic rebounds of SARS-CoV-2” , assure the authors of the study.
A curfew that varies in time and space
So what is this “local experience”? The prefect of Guyana, Marc Del Grande, put in place on May 11, as soon as they left confinement, a curfew from 11 p.m. to 5 a.m. In addition, restaurants and bars could only be used outdoors, while schools, cinemas and places of worship were closed. Despite these precautions, the cases of Covid-19 have multiplied in the department. According to the above-mentioned study, the base reproduction rate or R0 – which refers to the theoretical number of people infected with a contagious case – rises to 1.7 around May 20.
From June, the prefect published dozens of successive orders, modifying the hours and adding municipalities to the list depending on the evolution of the epidemic. Between June 10 and 25, the curfew gradually started earlier and earlier and also spanned the weekends. At the end of June, it was in operation from 5 p.m. to 5 a.m. on weekdays and from 1 p.m. on Saturdays until Monday morning.
Radical measures but which work. According to the researchers, the transmission rate dropped from 1.7 to 1.1 around June 15. However, the authorities are ensuring that attention is not slacking off and are taking other measures. On June 25, they announced a complete closure of restaurants and borders, as well as a re-containment in some 20 very localized areas.
At the beginning of July, the number of hospitalizations began to stabilize, then slowly decline. In August, the prefecture divides the department into four zones with different hours and relaxes the curfew. But to date, 16 of the 22 municipalities in the department are still affected by nighttime restrictions, from midnight to 5 a.m. And for the moment, no lifting of the curfew in sight despite a steady improvement in the epidemic situation.
Fighting Covid-19 … and road accidents
Behind this political decision, there is a desire to stabilize the health situation, of course, but also to limit violence, alcohol consumption or road accidents, which would add pressure on hospitals.
“From midnight to 5 am, for 95% of the population this is not a particular effort but it does us a lot of service. It avoids social contacts sometimes alcoholic, the possibility of clusters … (…) We still have of Covid hospitalized patients, in intensive care, much less certainly. And the fewer road accidents we have, the more stable our hospital system is to manage the Covid “, declared Marc Del Grande, on October 12 on Guyana The 1st.
The implementation of the curfew came at a cost to the entire department, and its residents sometimes struggled to navigate. “These are massive efforts, the measure was hard for bars and restaurants”, also concedes Clara De Bort. Some also saw it as an obstacle to freedom. Contested by the Human Rights League, which saw it in particular as an attack on the freedom to come and go, the measure had also been, in part, canceled by the Cayenne Administrative Court on May 27 for 12 of the 22 communes of the department.
The CNRS / Inserm study also reminds us: “If confinements have proven their effectiveness, they nevertheless have a very significant social and economic cost. The restrictive measures are therefore not tenable in the long term and it is essential to identify effective measures but with a lower societal impact “.