From ‘under control’ to ‘critical’: Four potential scenarios for Covid-19 in France

A nurse attends to a patient at a hospital near Paris, April 22, 2020.
A nurse attends to a patient at a hospital near Paris, April 22, 2020. © Gonzalo Fuentes, Reuters

France’s national Scientific Council has envisioned four likely futures for the country’s Covid-19 epidemic, from a situation where the virus remains “under control” to a “critical” health crisis. FRANCE 24 takes a look at the possible scenarios.

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The Scientific Council, responsible for advising the French government on how to deal with health emergencies like the coronavirus crisis, set out its four potential scenarios on June 4 in an effort to “anticipate the measures needed” to avoid having to re-impose a lockdown.

France began lifting its lockdown on May 11 and is progressively easing social-distancing measures. The second and most recent stage in the process began on June 2, when the country’s cherished restaurants, cafés and bars were allowed to reopen but for terrace-only service in the hardest-hit areas, including Paris.

Below are the four potential scenarios the Scientific Council has foreseen for the future of Covid-19.

An epidemic ‘under control’

This is the most optimistic scenario of the four – and fortunately, the one that the French authorities say is unfolding right now. On May 29, France’s Public Health agency stated that there were “no signs” of a resurgence in Covid-19 despite the initial easing of lockdown measures that began on May 11.  The head of the Scientific Council, Jean-François Delfraissy, said on June 5 that the virus remained “under control”.

If the key signs – such as hospitalisations for Covid-19, the number of patients in intensive care and the number of positive tests – are still encouraging after at least two months, “without problematic clusters” of the virus re-emerging, France can declare that the situation remains under control, the council said.

Even so, the council recommends that France maintain its current level of social distancing, the use of face masks and the continuation of the “test, trace, isolate” approach to stamping out the virus’s spread as famously pioneered by South Korea, with notable success in the early stages of the pandemic.

‘Critical clusters’ in local areas

On the basis of what has happened in Germany and some Asian countries over recent weeks, the Scientific Council said this intermediate scenario is likely to arise “in the coming weeks”. In particular, it said public authorities should be vigilant about locating small “critical clusters” of contamination  where the virus could spread “very quickly”. 

In this scenario, the Council proposes an “early, quick, massive response” in any areas where Covid-19 is spreading. Social-distancing measures should be reinforced, with a proactive approach to isolating vulnerable sections of the population such as the elderly. The “test, trace, isolate” approach should be stepped up in such areas of rapid contamination; testing “cannot be limited to people with symptoms within the clusters”, the council said.

The overarching goal in this scenario would be to limit the number of cases coming out of particular clusters to prevent the coronavirus from resurging nationwide.

France has already put in place particular policies for hard-hit parts of the country – for example, lockdown measures stayed in place longer in the Val d’Oise area near Paris because there was still a cluster of Covid-19 cases there.

A ‘low-level’ epidemic

In the case of a “low-level epidemic”, Covid-19 would spread throughout a whole region of France or even the entire country. The disease would spread through different local clusters, straining authorities’ ability to monitor transmission chains.

The council said that this outcome might arise if people fail to heed social-distancing measures; in particular, a significant amount of unnecessary travel between French regions threatens to encourage the virus’s spread. 

If there is a major increase in the proportion of people testing positive, the council recommends strengthening existing measures such as social distancing, ramping up “test, trace, isolate” programmes, increasing hospital capacity and implementing measures to protect those in nursing homes. If those measures do not go far enough, the council said re-imposing a full-blown lockdown might be necessary.

A ‘critical’ health situation

This is the most pessimistic of all the scenarios put forward by the Scientific Council. It would stem from the failure of the measures to contain Covid-19 at the third scenario. The government would have to consider a second lockdown to alleviate “overwhelmed intensive care units”.

The council noted that another lockdown would be undesirable on “social and economic” grounds. But it said it should be considered to prevent the severe strain on intensive care units that was seen in eastern France and the Paris region at the height of the epidemic.

If the government’s sole objective is to reduce the number of people dying from Covid-19, it will “always be preferable” to introduce a lockdown “early”, the council said. However, limiting rises in mortality caused by overstrained intensive care units is an “alternative objective”.

The council emphasised the importance of tracking the virus’s spread to avoid the fourth scenario.

The government has a seven-part plan dealing with a potential uptick in cases over the coming weeks. These measures must be “drawn up now” so that they can be put in place “as quickly as possible” if need be, the Scientific Council said.

This article was translated from the original in French.

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