As a new school year begins in France, experts sound familiar alarm bells over Covid-19 rules
Beginning on Thursday, 12.4 million children and 866,500 teachers head back to school in France for a second school year to start under the spectre of Covid-19. Much has changed in the pandemic fight – for better and for worse – since last September. But with a Delta-fuelled fourth wave and millions of unvaccinated schoolchildren in the equation, experts worry the government's latest Covid-19 schools protocol won’t measure up.
There is some good news. Although France does not require inoculations for teachers, some 78 percent of them have been fully vaccinated and an additional 11 percent soon will be, according to education ministry figures. When schools let out in early July, relatively few teachers in France were fully vaccinated against Covid-19 – not least because educators under the age of 55 were only granted priority status for inoculation in late May, just days before all French adults became eligible.
Moreover, France's fourth Covid-19 wave has ebbed somewhat over the past two weeks, although the average of nearly 17,000 new daily cases remains substantial. Health Minister Olivier Véran has appealed for vigilance as vacationers return home – many after summering in precisely the areas hardest hit by infections – and as classes begin for millions. Experts cite the sharp spike in Scotland's cases after classes began in mid-August as a cautionary tale.
Les cas quotidiens sont en légère augmentation au Royaume-Uni, mais en réalité ils sont en baisse depuis plusieurs jours en Angleterre (plus de 80% des habitants du R-U) alors que la courbe grimpe très rapidement au Pays de Galles et surtout en Ecosse. #Covid19 pic.twitter.com/WvPHRWkY1Q— Nicolas Berrod (@nicolasberrod) August 30, 2021
Epidemiologist Daniel Lévy-Bruhl of the Santé Publique public health authority told reporters on Friday that children, especially those under 12, "may contribute in the weeks to come … to promoting the circulation of the virus" more than ever before, given the prevalence of the highly contagious Delta variant.
Indeed, with France on track to hit the milestone of 50 million vaccinated with at least one dose, kids make up the country's last major contingent of unvaccinated. Covid-19 vaccine approval for under-12s is still months away and only 40.5 percent of French 12- to 17-year-olds have been fully vaccinated, with 20 percent more partly vaccinated, as the school year begins. France's Institut Pasteur has said under-18s could account for half of all Covid-19 infections in France this autumn.
One member of the Scientific Council, the panel of scientists advising the French goverment on Covid-19, has said infections in children alone would reach 50,000 per day with classes beginning again. "That's colossal," panel member Lila Bouadma, who is also an intensive-care doctor at the Bichat Hospital in Paris, told BFM-TV.
Outlining the official Covid-19 protocol for the new school year last week, Education Minister Jean-Michel Blanquer nevertheless promised a rentrée scolaire that would be "as normal as possible", assuring reporters that one could be "completely serene" about kids returning to class.
The ministry released a new four-category Covid-19 protocol in July outlining the levels (green, yellow, orange, red) of Covid-19 precautions, but observers were left puzzled as no guidance was provided on the criteria used to prescribe a level or to progress from one to the next.
Blanquer confirmed last week that the school year will begin at Level 2 (yellow), meaning in-person learning with full classes for all grades and mandatory masking indoors from primary school onwards (age 6 and up). Indoor sports are allowed (sans masks), albeit with social distancing, and contact sports are prohibited.
If a Covid-19 infection is detected in a primary school class, the entire class is sent home and switches to remote learning for seven days – as was the case when schools let out in July. But for older children, in high schools and from age 12 in middle schools, a new deciding factor is vaccination status: Unvaccinated contact cases will be sent home to do remote schoolwork for a week, while vaccinated contact cases will be allowed to keep attending in person.
"We want students to lose the least classroom hours possible, so we will not close a class in secondary school – we will simply protect the students who need protecting," Blanquer explained. The government also pledged to facilitate vaccinating the eligible on school time.
"We worked all summer with the prefects and regional health authorities so vaccinations will be on offer for all those 12 and over in French schools, as well as for the adults who work there, all through the month of September and up to the Toussaint holidays (which begin October 23)," Blanquer told France 3 television on Sunday.
The education minister also recommended the use of carbon dioxide detectors, which measure volumes of exhalation and thus signal when a room should be ventilated to limit the aerosol transmission of Covid-19. After initial reticence, Blanquer reversed course on the devices last spring, although he has left it up to local authorities to decide whether and how to implement the option.
Blanquer has also pledged to provide 600,000 Covid-19 screening tests per week for primary schools. In secondary schools, the government has promised to adopt a "targeting strategy" to offer self-tests to middle- and high-schoolers in areas where Covid-19 is circulating actively. School personnel will be provided with two home tests weekly.
But just as they had throughout the last school year, French educators and health professionals alike – and indeed the government's own scientific advisory panel – have taken issue with key parts of Blanquer's plan.
Testing 'not sufficient'
The Scientific Council, in a note submitted to the government on August 20 and released publicly a week later, lamented the "abandonment of testing". It suggested that testing twice a week could, presuming 50 percent compliance, allow primary classes to stay open even as infected children are sent home.
"In this unvaccinated population, the risk of intense circulation of the virus when school begins again is very high and the rule of closing a class when the first case is detected could make reopening primary schools very complex, notably in the case of a single class being closed repeatedly,” the Council said. The arithmetic is clear: Blanquer's 600,000-test-per-week pledge for the 4 million primary school students falls millions short of the mark the government's advisory panel proposed.
"It's not sufficient," Guislaine David, secretary-general of the SNUipp-FSU union representing kindergarten and primary school personnel, told FRANCE 24. "All pupils must be tested, since we know the Delta variant is much more infectious. That's what the Scientific Council's doctors advise and it's what some European countries do," she said. "In Austria, all the pupils were tested twice a week last spring and positive cases weren't admitted inside their schools."
The union leader is also dismayed by the decision to let primary school children unmask on school playgrounds, suggesting the rule doesn't account for how schoolchildren behave together in the yard between classes.
"When pupils spend their time playing very close together, especially the youngest children, we know there is crowding that will allow infections," David said.
Taux de vaccination par tranche d’âge (au moins une dose) :— GRZ (@GuillaumeRozier) August 31, 2021
0 - 11 ans : 0 %
12 - 17 ans : 62 %
18 - 29 ans : 83 %
30 - 49 ans : 82 %
50 - 64 ans : 88 %
65 - 74 ans : 92 %
+ 75 ans : 89 % pic.twitter.com/ROJY1vPTpx
Other education-sector unions spy trouble in other aspects of the plan. On paper, the new rule says middle- and high-school contact cases will only be barred from in-person learning if they aren't vaccinated. But in practice, medical secrecy laws mean schools don't have access to a student's vaccination status; they can only rely on what parents tell them. "Verifying vaccination statuses via parents' testimonials is delusional," said the Snalc union, which represents public school personnel.
Another point of contention is the one-size-fits-all protocol. Back to school has been delayed until September 13 in Martinique, Guadeloupe and parts of French Guiana – French overseas territories where Covid-19 is tearing through still largely unvaccinated populations. But schools in mainland France have all been given the same marching orders, despite pandemic situations that sometimes vary wildly.
"We're at Level 2 of the protocol everywhere (in mainland France) when there are some areas where, when you look at the health indicators, everything indicates situations degenerating rapidly," Sophie Vénétitay, secretary-general of the Snes-FSU union representing secondary school personnel, told Agence France-Presse, citing high Covid-19 rates in southeastern France in particular.
A collective of doctors and educators co-signed an op-ed in Le Monde in August to "set alarm bells ringing", calling it "unthinkable today, for the majority of French departments, to envisage the return to school at 'Level 2' of the health protocol when the (Covid-19) incidence rate among 0- to 19-year-olds is five times higher than it was for the return to school in 2020".
They questioned the very existence of a Level 1 without masks in primary school and called for class closures to be extended to all grades from the first detected case, even among vaccinated high-schoolers.
"With Delta, [vaccinated students] will certainly be more protected, less easily infected. But as it stands, as long as we don't have a population with 85 or 90 percent completely vaccinated, it is not worthwhile to say we can leave vaccinated [contact cases] in class," Eric Billy, an immuno-oncologist who signed the op-ed, told FRANCE 24. "I think we don't yet have the perspective to take that decision."
The signatories also took issue with a perceived lack of attention to aerial transmission, now considered the primary vector of Covid-19 infection.
"The prevention of transmission by aerosols remains largely insufficient in this protocol, which hasn't changed despite a more transmissible virus," they wrote in Le Monde. They called for windows to be opened much more frequently – the official recommendation puts the minimum figure at five minutes per hour – and said simply recommending CO2 detectors isn't enough. Education unions have long flagged disparities on the ground between have and have-not municipalities as long as CO2 detectors remain optional and aren't financed by the government.
"This summer, Ireland and Quebec equipped all of their classes with CO2 detectors while New York, Philadelphia and Frankfurt installed air purifiers in theirs. Finland, Austria, German länders and US states are also financing such measures," wrote the experts, many of whom belong to the Du Côté de la Science collective of scientists. They also called out the government on allowing indoor sports at school – with the dual threat, as Billy explained, of shedding masks in cramped locker rooms and aerosol-spouting huffing and puffing while playing sports in the gym. They also slam what they deem "the absence of a veritable screening strategy". "In France, 18 months into the pandemic, schools must not remain the Achilles' heel of the health strategy," the group concluded.
"We know that, unfortunately, the Delta variant is much more infectious and that you are infected much more quickly," Dr. Jérôme Marty, a general practitioner in southwestern France who heads the UFML doctors' union, told FRANCE 24. "Before it was about 'close and prolonged contact'; now we know that in a few seconds you can become infected. When you have a super-spreader individual, even outdoors, you can become infected. With Delta, for the first time, we are encountering clusters originating outdoors," explained Marty, who also signed the appeal in Le Monde. He argues that an audit should have been done over the summer to ascertain the ventilation needs of individual schools and cites playing sports inside school gyms and canteen lunch hours, where kids from different classes mix unmasked, as outstanding risks.
"We know pupils when they're young talk loudly in canteens," Marty said. "You just have to walk into a canteen and measure the decibel level and you see it's pretty staggering. And when you talk loudly, you spread a lot of aerosol particles and you create this cloud that means a number of pupils can be infected," he explained, suggesting that if lunch hours can't be staggered or canteens ventilated properly, that kids eat at their desks in class instead.
Apart from the risk of children being hospitalised due to a Covid-19 infection – which is "very low in percentage but not negligible in number" as paediatric cases climb – Marty also points to another recent finding that pleads for better protecting kids: "Children develop long Covid, including children who had very few symptoms (from a Covid-19 infection) or were even asymptomatic," he said. "The problem there is that we don't yet have enough perspective to know how long that long Covid will last and what damage it will do. It is clear that if you suddenly have a kid who, for months and months ends up very fatigued – a bit like infectious mononucleosis – they'll have trouble following the school curriculum, so it's troublesome."
>> Read more: Young people hit hard by long Covid as Delta variant surges
Experts have long been frustrated by what they see as a tendency to interpret pandemic-mitigating proposals as code for wanting to close schools down, even by those in charge. Blanquer famously blasted critics back in May, saying, "People have to stop being obsessed by the role that schools play in infections." The education minister has a new book coming out on September 9 pointedly entitled, "Open school".
Between the Delta variant and the under-12s who remain unvaccinated as classes begin this week, "we are in a tense situation that will see a lot of kids crossing paths with the virus and becoming sick”, Billy told FRANCE 24. “That is very much what awaits us."
"Solutions exist to mitigate that – because the objective, of course, is for school and education to continue. But what needs to be done is, as much as possible, to reduce viral spread inside schools," which the researcher says can be done, in part, with screenings twice a week.
"The measures aren't in place today in France to ensure the total securing of schools," said Billy, whose own daughter contracted the Delta variant at school in June. "We don't want to close schools, we want schools made safe. That's very, very different."
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