Are curfews effective or a palliative? Is it inevitable to go towards new quarantine strategies? Given the new variants that are spreading in the world, those that produce an acceleration in the increase in the spread of COVID-19, curfews or confinements are projected for the coming months of the year, beyond the vaccination plans faced with greater or lesser speed.
It is inevitable, even with more or less severe restrictions and closures, that a country is immune to the arrival of new variants. This is how the infectologist advances it Gilles Pialoux, a medical authority in France, who ensures that situations identical to those facing the United Kingdom can spread to other countries as new strains spread.
Head of the department of infectious diseases at the Tenon Hospital in Paris, spoke with Infobae in the French capital, and explains that it was “well known that in mid-January we were going to have the consequences of light confinements. It’s mechanical“, alluding to the light restrictions decided to make the end of the year celebrations possible.
Analyzing the data from France, one of the countries most affected by the coronavirus, the infectologist said that “the first wave was 30,000 deaths, the second wave, 30,000 deaths, but we improved care. We decrease mortality in intensive care. So that means that ultimately, the waves are more and more shocking“.
The fear of a stagnation with high numbers of infections, a situation that is being registered in several countries, is another point of concern for Gilles Pialoux. The doctor, one of the most consulted by the French press, said: “Obviously, we are very concerned about the arrival of a third wave to a high level plateau”
Regarding the effectiveness of confinements versus curfews, issues or dilemmas that the world health authorities discuss at this time, he argued that it is “Difficult to compare strategies to reduce the circulation of Sars-Cov-2 in the population from one method to another and from one country to another. And in particular to compare the effective effectiveness of containment and the different curfews ”.
“In France, we tested two types of confinements and different more or less extensive curfews on the two temporal-spatial axes. What is clear is that, as the analysis by Arnaud Fontanet’s team at the Institut Pasteur underlines, the confinement of the first version was extremely effective in reducing the R index, that is, the transmission rate, which started at 3 for reaching 0.7, in addition to a reduction in pressure in hospitals and also in intensive care ”, he explains.
Are curfews effective? For the head of the Tenon Hospital, a reference center in Paris, “we know that the effect of this measure that was gradually implemented in France as of October 17 and spread to 54 departments and an overseas community, the curfew had a more modest effect“.
With a movement restriction that extends from Saturday, now throughout the country from 6:00 p.m. and not 8:00 p.m., the infectologist prefers to remain cautious regarding speculation about its results. “It is currently under analysis,” he says.
For Pialoux, the effectiveness of curfews depend “on the forms of confinement and restrictions, and on coercive measures or not as the regions, populations and countries impose them.”
Measures, such as time limitations or partial or total confinement to avoid the explosion of markers, on which public policies are currently dictated in France and in several countries, must be related to the rates to evaluate their performance and incidence of infections.
Currently several countries are in a plateau situation with an ascending phase, the equivalent of a “false turn” on a bicycle. This vision must be completely revised with the circulation of variants, in particular with the English strain and the South African variant, which considerably increase the contagion between 50% and 70%, thus being able to produce an acceleration of transmission and therefore scenarios of decision of restraints or curfews.
What will be the strategy that will control the virus? For the infectologist it will not only depend on the restrictions. The associated barrier measures, strategies of stop and go with curfew or confinements, a strategy of screening and isolation adapted to the circulation of the virus and mutations, plus the acceleration of the vaccination process to obtain herd immunity as quickly as possible, are the answer.
Concern for variants
The British mutation, found today in 1.3% to 1.4% of positive tests for COVID-19, should dominate in two to three months in France. “It is an inevitable change”, explains the professor Bruno Lina, who coordinates the mapping of its circulation nationwide. The projection is something that could happen in other countries of the world.
“All the measures we take will not eliminate the British mutation that will replace the current virus” , continued the professor of virology at the CHU de Lyon, director of the National Reference Center for respiratory infectious viruses at the hospital. de la Croix-Rousse and researcher at the International Center for Research on Infectious Diseases.
For experts this scenario is inevitable. The challenge for the medical community is that it happens at no cost to public health. “By pursuing barrier gestures, masks, distancing and vaccination, in the first place of the most fragile, this will reduce its dynamics,” says Lima.
The new variant in Brazil has also put world health authorities on alert. He even anticipated the closure of the United Kingdom’s borders, a situation that could be decided in Germany in the coming hours.
To be reassuring, virologists focus the challenge on “managing the epidemic.” The results of “the latest flash surveys” reveal the slightest movements of these variants, but also a possible control if the sanitary measures move with speed, determination and intelligence.
Finally, the great strategy will be the efficiency and unanimity of health and vaccination management. For Pialoux, the first delays in the inoculation campaigns have multiple factors: anti-vaccine pressure, distrust in vaccines in general (a fairly French specificity), delay in decision-making compared to epidemiological data that are elements that They have moved on since then and they should normally influence the prioritization of access to RNA vaccines. You also have to defeat “A bureaucracy that takes little into account the viability of decisions.”