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Deconfinement is progressing in most Western countries affected by the coronavirus pandemic. An unprecedented period is coming to an end, and once the astonishment is over, languages are being loosened. Some twenty-fifth hour workers are coming to give lessons and rewrite history, while others had always questioned the containment methods decided by several countries, including France. Whether widespread containment really prevented the pandemic from wreaking further havoc will remain a never-ending debate. The fact remains that the choices made were no doubt based on the precautionary principle, but also on fear. Have we yielded to panic, and will the economic and social damage of widespread containment not prove to be greater than the initial health threat? Complaints are beginning to accumulate in the courts and the Court of Justice of the Republic as eminent personalities turn their jackets upside down and open the umbrella.
Hundreds of thousands, if not millions, of Covid-19 deaths in every country? This black scenario has convinced some governments to opt for generalised containment, but voices are being raised to criticise the "alarmism" of the simulations on which it was based.
" Too much weight has been given to these models... ' John Hultquist, director of intelligence analysis for the cybersecurity company FireEye, ensures at AFP Jean-François Toussaint, professor of physiology and director of Irmes. « The most blatant case is the 500,000 reported deaths that have toppled governments: this is a typical example of a not very serious use of science. "says another French scientist opposed to containment, Laurent Toubiana. He is referring to work that had a considerable influence after its publication by Imperial College London on March 16. Signed by Prof. Neil Ferguson's team, they predicted up to 510,000 deaths in Great Britain and 2.2 million in the United States if nothing was done to contain the epidemic.
" Instead, we listened to the most alarmist people... ", sighs Laurent Toubiana, pointing out that the actual number of deaths is much lower than these worst-case scenarios. The latter have been elaborated thanks to modelling, computer simulations based on what is known about the disease at the time they are carried out (in terms of contagiousness, mortality, etc.). « These mathematical models depend on too many factors to be reliable. ", said Professor Toussaint. In the case of Covid-19, a new and therefore little-known disease, " the basic conditions escape us ", which can lead to " extremely high deviations "between model predictions and reality.
In the United Kingdom, the models of Neil Ferguson, a distinguished Fellow of Imperial College, have become the subject of a bitter political battle between proponents and opponents of containment. The battle was fraught with scandal: in early May, the man the tabloids had dubbed "Professor Containment" was forced to resign from the body that advises the British government. The cause of his disgrace was the revelation by The Daily Telegraph that he had broken the rules of confinement by allowing a woman, presented as his mistress, to visit him. Beyond Professor Ferguson's personal case, computer specialists have criticized his model, accusing it of being obsolete and even erroneous.
Imperial College responded on June 1. It announced that this computer program had successfully passed an evaluation by independent experts, who were able to reproduce the results of the famous March 16 report. A week after this announcement, the rest of the report was published on Monday 8 June, co-signed by Prof. Ferguson. Its conclusion: containment has prevented 3.1 million deaths in 11 European countries, compared to initial estimates of potential deaths in the absence of any measures.
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While it had directly made public its previous reports on Covid-19, Imperial College has this time submitted this work to a prestigious scientific journal Natures to be validated by other independent scientists beforehand.
The article estimates that the containment measures have reduced the reproduction rate of the virus (the number of new cases for each infected person) by an average of 82%, bringing it below 1, the threshold below which the number of new cases decreases. Researchers also calculate that as of May 4, 12 to 15 million people have been infected with Covid-19 (an average of 3.2% to 4% of the population, with large variations between countries). The authors point out that because of the short time frame of the measures, it is difficult to assess the impact of each measure separately. Nevertheless, they conclude that "[t]he authors conclude that the containment had a substantial effect "on the control of the epidemic."The Imperial Plantage of London tries to justify its wanderings in hindsight."" The Imperial Plantage of London tries to justify its wanderings after the fact. ", mocks Professor Toussaint.
For their part, modelers argue that they are not crystal balls, but tools that consider the worst in order to avoid it. « A model should not be interpreted as giving an absolute result: it is a photograph at time T based on the latest known data, a bit like a survey. "Nicolas Hoertel, a psychiatrist and modeler at the Corentin-Celton hospital near Paris, told AFP in mid-May. « There are certainly important limitations "to modeling," but at this stage they are the only scientific tools available to inform a decision on the health aspect. ", he continued. This is why the equation between science and politics is " still missing " wrote the mathematician Cédric Villani in UP'.
Political choice? Umbrella opening ?
Faced with the measures to be taken to combat the pandemic, political decision-makers have gradually changed their discourse. In France, in mid-March, political decisions were justified by the "advice" of the medical authorities. There was no speech by the Minister of Health, the Prime Minister or the President of the Republic who did not hide behind the advice of doctors. So much so that one wondered whether the white coats had not taken power.
Today, the speech is different. Decision-makers say that modelling was not the only criterion for moving to containment in March. « Of course, we relied on the models (...) One of the models, for example, estimated that we would, if we did not confine, around 120,000 or 150,000 deaths... "said on Sunday 7 June on BFMTV Jean-François Delfraissy, president of the Scientific Council in charge of enlightening the French government during the epidemic. « But models are just models. "He was quick to add, noting that field observations had also been important, as there was a massive influx of Covid-19 patients into hospitals. Moreover, the final choice was a good one. a political decision ", he points out."For weeks, the Scientific Council has been calling for extreme caution, and now that people are starting to grumble about how to deconflict, now that the economic disaster is looming, he is turning around and giving up on the government! »" For weeks, the scientific council has been calling for extreme caution, and now that people are starting to grumble about how to deconflict, that economic disaster is looming, it is turning around and letting go of the government! "outraged in Le Point a ministerial advisor, relaying an opinion shared by several editorialists. « To put it plainly, he tells us that we've gone too far by following his advice, and he protects himself! "
Is that really the case? The truth is, as is often the case, more nuanced. Politicians have certainly based their decisions on the advice of scientists, but ultimatelythey kept control of the decision. Thus, while it appears as early as March that nine out of ten Covid-19 victims are over 65 years old, Emmanuel Macron refuses to follow the advice of the scientific council, which pleads for a differentiated deconfinement of the population. « 17 to 18 million people [elderly or polypathology] will remain at risk. In the absence of preventive treatment, these people will surely have to be kept under relatively strict confinement. ' John Hultquist, director of intelligence analysis for the cybersecurity company FireEye, states Professor Delfraissy before the Senate on April 15. The president hesitated at first before backing down, writes Point journalist Géraldine Woessner: "The president hesitated at first before backing down. the pressures exerted by his relatives from these so-called "vulnerable" generations (such as Daniel Cohn-Bendit) and the fear of hurting the hearts of his retired electorate are imposed by "scientific reason". ".
The price of choice
In order to be useful for public decision making and proportionate to the response, relevant models should have taken into account the emergences and interdependencies between all levels. The course of the epidemic showed, from the outset, that the disease could be experienced without major symptoms in four out of five people, but it turned into a bitter 15-day battle for the fifth. The aim of an effective prevention measure would then have been to provide confinement for those who could not endure the ordeal: people over 65 years of age, people with heart and vascular disease, diabetics, people with respiratory or renal insufficiency, transplant recipients, obese people, etc. The aim of the epidemic was to prevent the spread of the disease to the population at large, and to prevent the spread of the disease to those who could not endure it.
Without immobilizing 80% of the active population and especially not those who come out of it cured and immunized after two weeks - and contribute, along with the young and most active, to extinguishing the epidemic by reducing the size of the target population - prevention could then have been directed solely at those at high risk.
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The authors of the simulations and modelling that have flourished during this period, while having to demonstrate the quality of their models, will have the greatest difficulty in accepting to include the collateral damage of the generalised containment that they have advocated.
Because the note of containment is salty. After its shutdown during containment and its gradual recovery, the French economy will take time to recover from the Covid-19 pandemic, warns the Banque de France, which anticipates a record drop of around 10% in GDP this year. « Like the rest of the world, (it) suffered a shock of unprecedented magnitude in the first half of 2020. The Banque de France notes in its macroeconomic projections up to 2022, published on 9 June, that "with the strict confinement implemented in mid-March and lifted in mid-May, the Banque de France
The rebound in the economy from the third quarter onwards will therefore not be enough to prevent an unprecedented recession in the economy this year. Evaluated at -10%, this forecast is close to the -11% anticipated by the government in the third draft amended budget bill that it presented to the Council of Ministers on 10 June.
While the massive short-time working scheme put in place by the government will somewhat slow down the impact of the crisis on employment and purchasing power this year, the unemployment rate is expected to exceed 10% by the end of 2020, and to rise to a peak of over 11.5% in mid-2021, a level "... that is not expected to be reached by the end of the year". above historical precedent "The Banque de France projects.
The economic consequences are measurable and can be translated into figures. But the human consequences, those related to mental health, to the organisation of families, to the impact on children and the very elderly cannot be measured with curves and figures. Yet widespread confinement has undoubtedly saved lives in ways that may just as well have destroyed them.
A spate of complaints
This paradox is at the origin of an avalanche of appeals that are beginning to accumulate in the courts. Thus, Paris public prosecutor Rémy Heitz announced to AFP on Tuesday 9 June the opening of a vast preliminary investigation into the criticised management of the Covid-19 crisis in France, targeting in particular the charges of "manslaughter" or "endangering the lives of others".
This investigation is a first judicial response to some forty complaints, more or less detailed, received by the Paris Public Prosecutor's Office during the confinement. They were filed by relatives of victims, professional organisations or, in a "petitioning process", via standard complaints published on the plaintecovid.fr website.
These complaints against X sometimes target government officials by name, including the Director General of Health Jérôme Salomon, who was on the front line of the media during the epidemic in France, or Santé Publique France. The prison administration and the Ministry of Labour are also targeted, among others.The following terms are used in this report: "manslaughter", "involuntary manslaughter", "unintentional injury", "endangering the lives of others", "wilful failure to fight a disaster", "failure to assist a person in danger".This vast investigation with a national scope does not concern crisis management in the Ehpad, which is currently the subject of local investigations, including two in Paris, but also in Nanterre or Grasse (Alpes-Maritimes). These new investigations relate to the main grievances expressed regarding the management of the epidemic: protective measures in the workplace, the provision of protective masks and tests. The investigation by the Paris Public Prosecutor's Office, which continues to receive new complaints, has been opened for "manslaughter", "involuntary injuries", "endangering the lives of others", "wilful failure to combat a disaster", "failure to assist a person in danger".
The Paris Public Prosecutor anticipates "considerable" work in a "historical situation": " This is the first time that complaints have been filed in the midst of a crisis. ", he points out, whereas until then " in major public health cases (contaminated blood, asbestos, etc.), the justice system intervened a posteriori. ".
Already, several voices have been raised calling for the appointment of an independent investigating judge to conduct the investigations. « In a case involving the political authorities, it is completely abnormal for the Public Prosecutor's Office, which is itself dependent on the political authorities, to conduct an investigation, even a preliminary one, since it determines the entire follow-up. ", says the association Coronavictimes in a press release.
While some have vilified the supposed lack of foresight of the current executive but also of its predecessors in the face of this crisis, the investigation does not target the Head of State, who is criminally irresponsible, or the members of the government, whose possible criminal responsibility lies with the Court of Justice of the Republic, which has so far received 80 complaints. These complaints concern " most often the Prime Minister, the two successive Ministers of Health "as well as their counterparts in Justice, Labour and Home Affairs. « These complaints can come from very different backgrounds (...) from private individuals, trade unions, associations, doctors, etc...." detailed the public prosecutor at the Court of Cassation, François Mollins.
Header image from the John Sturges movie, Settlements at OK CorralParamount Pictures, 1957.