Lifting of health restrictions: "We will never return to the pre-Covid situation"

France is back below 100,000 contaminations. The figure, recorded in just 24 hours, is still very high, however it has been in continuous decline for several weeks now, after a peak reaching half a million cases. Same dynamic at the hospital, but more recently. Healthcare establishments are currently treating 29,843 patients, after a peak of more than 33,000 hospitalized on February 7. The Institut Pasteur issued some optimistic models on Wednesday. The thinning could be lasting in the hospital, which is prompting the government to review its health measures.

Thus, the abandonment of the mask in closed places subject to the vaccination pass will be effective from February 28. As for the pass, a deletion is envisaged from the end of March, or the beginning of April. These initiatives are not new in the world: the United Kingdom, Portugal, Denmark or even Israel have also abandoned the majority of their constraints.

For Yves Buisson, epidemiologist and president of the Covid-19 cell of the National Academy of Medicine, these relaxations are welcome in France. Up to a point, because it must be remembered: the Covid-19 will not disappear anytime soon.

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The Express. The gaze of the epidemiologist, first. What dynamics are we currently on regarding the epidemic?

Yves Bush. We are in a very positive phase, the epidemic is in great decline, and rapidly. This dynamic also encourages optimism because we do not see the shadow of a threatening variant that could take the place of Omicron. The fact that the epidemic is regressing, coupled with the arrival of spring and the absence of new variants, seem to be advancing us from the stage of the pandemic to that of the endemic.

France is easing massively, like other countries. Isn’t it too early? We have the impression of living a “Happy End worthy of Netflix”, as Professor Gilbert Deray recently remarked in our columns…

In closed places subject to the vaccination pass, this gradual lowering of restrictions is rather justified. Circulation of the Omicron variant appears to be in full swing. A very large number of people have now been infected, the population is well vaccinated. It’s a wise decision, even if, like all easings, it seems difficult to set caps. There, for example, we could reasonably estimate that by giving ourselves a few extra weeks, we will perhaps be even more convinced of going towards the endemic than we are today. The electoral deadlines, the presidential election which is played in April, may have played its role in this communication. And this then contributes to a certain distrust of official discourse. We feel all this ambiguity around the removal of the vaccination pass, which immediately would represent an error.

A trend, “Yes to masks” has recently appeared on social networks, as a sign of resistance. Is this the key to the future of this epidemic: to maintain individual responsibility in the face of the epidemic and to continue to protect oneself in case of need? It should be remembered that the Covid is not without danger, and that its “long” forms remain as dangerous as they are unknown…

This long Covid will pose a long problem. Within the Academy of Medicine, we work on it in an interdisciplinary way: cardiologists, endocrinologists, psychiatrists, and many other specialties are on deck, because this disease is polymorphic and very poorly defined. We tended to believe, at first, that it was only chronic fatigue. This long Covid comes close in some ways, but it turns out to be much more complex than that.

For the rest, if we end up living in a form of normality, we will never return to the pre-Covid situation. The entire population has now been educated in gestures and attitudes to limit the circulation of respiratory viruses. We learned to wear a mask. Apart from the doctors, no one was seen wearing them before the illness. I lived in Southeast Asia for a long time, as soon as someone is sick, someone wears a mask, it’s automatic. You have to wear it for an altruistic purpose, and no one knew how to do that. It’s become commonplace, and that’s good. There will be new pandemics in the future. So I understand this “resistance” to wearing a mask. But what I hope, beyond personal behavior, is that the health authorities of the different countries will also prepare themselves, protect themselves against the dangers, more than they have ever been able to do on the flu for example.

Will this significant abandonment of restrictions, masks and passes, ultimately signify the end of vaccination, as in Denmark?

I hope not, because we still need the vaccination. It must be maintained for as long as possible, especially for children, who have benefited very little from it so far, as well as for vulnerable and/or elderly people. We know that we will not eliminate the virus, it is perfectly well adapted to the human species, with mutation capacities that allow it to dodge our natural defenses. It will continue to do damage. In addition, we would be very annoyed in the event of a strong resurgence in the near future. Scientifically, it is therefore important to maintain good immune coverage. Especially when you know that the one acquired after an infection is not very long lasting. When it is added to that obtained thanks to the vaccines, the immunity is of much better quality, it is more durable.

Does screening as we know it still make sense?

No, the number policy, launched in July 2020, has had its day. This was also expensive, without any use or effectiveness in controlling the circulation of the virus. Today, targeted, oriented screening is now more interesting, whether in schools or among the elderly. Perhaps it is also time to accelerate investments in new detection methods, such as in wastewater, which have been neglected so far. Only 200 centers are monitored today. It is, however, a tool for early detection of any resurgence, of any cluster. The idea now is to test to achieve something behind it, and not just to get numbers.