A reconfinement against the Covid-19 yes, but for how long?

A reconfinement against the Covid-19 yes, but for how long?
A reconfinement against the Covid-19 yes, but for how long?

SCIENCE – It would only be a matter of time.

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The hypothesis of a third confinement to stem the Covid-19 epidemic seems more and more likely. If the government – which meets in defense council this Wednesday, January 27 – blows hot and cold, few researchers think that the current health situation is satisfactory. Especially with the coming dominance of the more contagious English variant.

If confinement seems inevitable, everything is a question of time. When to put it in place but especially when to stop it. Because from a health point of view, the question at the beginning seems quite clear. “If the objective is purely health, more stringent control measures would be more effective,” said the HuffPost epidemiologist Dominique Costagliola, research director at Inserm.

For Samuel Alizon, Director of Research at the CNRS, specialist in the modeling of infectious diseases, waiting will not bring anything good vis-à-vis the epidemic. “In a ‘stop and go’ model, where you alternate the phases of relaxation and tight control, if you put in place the controls very early, they will be more frequent but will last less. Conversely, if you wait as long as possible to strengthen control, you will have to wait longer to release ”.

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Obviously, the question is not only health and the government is trying at all costs to avoid a third confinement, in particular hoping that the national curfew at 6 p.m. will have a sufficient impact.

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The evolution in the coming days of the monitoring indicators should quickly tell us more. “

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The problem is that we are not starting from zero but from a high plateau”, recalls the researcher.

If containment there is, which unfortunately seems to be the most likely option, the real question is therefore how long. Can it last only three weeks, as mentioned by some government sources? Should we focus on the same duration as for the first confinement, more than seven weeks?

After winter comes the vaccine

“I had the idea that if we managed to vaccinate the people most at risk, over 65s, or even over 50s if we wanted to reduce hospitalizations, and if we succeeded to properly circumscribe the circulation of the virus, then one could imagine a cautious exit, as during the first deconfinement ”, analyzes Dominique Costagliola.

In view of the vaccination schedule, this would imply confinement … until the end of March. A timing that unfortunately sticks with the dynamics of the Covid-19 epidemic anyway, believes the epidemiologist.

“We don’t really know why, but we see that winter favors this virus, this has been seen in the concomitant resumption of the epidemic in most of the countries of Europe. And winter lasts until the end of March. I’ve been thinking about it for a long time, but I didn’t necessarily say it, because we will say that I am pessimistic. ”

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The worst part is that the picture could still darken. “All this does not take into account the risk posed by variants” which could make vaccines less effective, warns Dominique Costagliola. “But it is too early to judge on this subject”.

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The rapid emergence of several variants has effectively reminded us in recent weeks that this risk is indeed present.

But even if the vaccines are late, even if variants of the coronavirus escape them in part or entirely, can we not imagine controlling the epidemic manually, as most countries have tried to do after the first containment, especially with the mildew?

“This kind of health policy, like what we see in some Asian countries, New Zealand, Australia, is only possible with considerable means, with a program of isolation and tracing of cases therefore and with a very low level of circulation of the virus ”, warns Dominique Costagliola.

What confinement for how long?

“We spent a relaxed summer of 2020 because there was an extremely strict containment before. If we approached the summer with the current situation, it would be problematic ”, recalls Samuel Alizon. “What threshold is acceptable? It should be a real democratic debate. ”

Above all, whatever the threshold chosen, the confinement time to reach it actually depends on the nature of the confinement. “

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The level of control in November (with schools open and non-essential stores open secondly, note) may not be enough.

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The longer we wait, the more likely we will have to impose strict measures. In December, while we were still confined, the epidemic was no longer on the decline ”, warns the researcher. “On the other hand, the level of control outside confinement is important: the more strict it is, the less time you spend confined”, he recalls, criticizing the too light measures of the government between periods of confinement, in particular concerning teleworking or still ventilation in schools.

In the graph below developed by his team, we see the evolution of an interesting indicator: the doubling time of the epidemic. In short: after how many days the number of hospitalizations is multiplied or divided by two. And if the decline was rapid at the start of the second confinement, it stopped very quickly.

Especially since in the meantime, a sword of Damocles has been added: the more contagious English variant. “I think we need strict containment, similar to that of March, with a global closure, including schools,” said Dominique Costagliola for his part. If the exact role played by children in the spread of the epidemic remains a subject of scientific controversy, it is accepted that the youngest can be infected and can infect others.

“It is difficult to disentangle the role of each measure, but several elements in the literature show that one of the most effective measures is to close educational institutions”, explains the epidemiologist.

Several works published in recent months go in this direction, even if it is always difficult to distinguish between the different measures, their acceptance, or the targeted establishments (nursery, primary, college, high school, university) . Despite the obvious cost of closing schools, Dominique Costagliola recalls that today we are “in a special situation, and when we see what is happening elsewhere, we would not want to end up like them”.

See also on

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The HuffPost: how to control an epidemic, instructions for use

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