PARIS – France has also begun to reflect on phase 2. And an opinion that matters is that of Jean-François Delfraissy. The French immunologist leads the scientific committee that advises Emmanuel Macron in the health emergency. Delfraissy, 71, was a luminary of AIDS research, at the forefront of Ebola. His group of “essays” also includes an anthropologist and a sociologist. “It is important to have a multi-disciplinary approach and to evaluate not only scientific parameters,” explains Delfraissy. “I know from experience that every health crisis brings with it the risk of a political and social crisis”. The immunologist explains to Republic what are his recommendations for starting the end of the lockdown that started on March 17th. With a hope: “France and Italy must agree on a series of shared measures in this very delicate phase. It is one of the keys to success”. Yet the French government hesitated for a long time before following Italy in the choice of confinement. Was there a feeling of superiority?
“I have never felt superior to Italy, I have no lessons to give to my Italian colleagues, indeed I have to receive them. Personally, I realized the extreme severity of the epidemic precisely seeing the situation in Lombardy where there is excellence medical and scientific. I immediately understood that France would have had the same fate. And in fact when our committee took office on March 10 I immediately told Macron that the only way forward was confinement “.
Did the government consider other options?
“I am not responding to the tergiversation of politics. Instead, I can say that my opinion was trenchant. And I’m not proud of it because I know what sacrifice has been imposed on citizens. If we had had a daily capacity of 100,000 tests, perhaps I would have suggested doing it differently. It was not like this. On March 10, France’s capacity was 3,000 tests per day. Confinement was not the best solution. It was the least worst. ”
Did the amount of testing make a difference in Germany?
“It is so, and all the better for the Germans. Today in France, daily test capacity has increased to 30 thousand per day. The goal is to reach 100 thousand by the end of the month. The initial shortage dictated the choice of confinement and it still weighs in time. ”
Your recommendation was to close the country until the end of April. Will it go further?
“We will talk about dates only when we have the tools to deal with the increase in infections and the sick that will start again as soon as the confinement eases. There is no doubt about this: the epidemic will start running again. And we will have to be ready, contrary to what happened the first time “.
There is talk of openness by region, age, profession .. What is the plan?
“It’s the ongoing debate between our committee, the government and the Elysée. I can only tell you that we will not go from black to white. There will be shades of gray. We made the calculation of the people most at risk, including the elderly, cardiopaths, obese people and other pathologies. There are 17 million French people. This already makes you understand the complexity of the situation “.
Are we beginning to know how many French people are immunized?
“We have the first serological studies and unfortunately they are not encouraging. In the areas most affected by the epidemic we see that immunity is around 10 percent. From what I know it is the same in Lombardy. It is much less than what we we waited, and we hoped. We are very far from a natural immunity in the population. But there is another problem “.
Which?
“This virus is very particular. We noticed that the lifespan of the protective antibodies against Covid-19 is very short. And we see more and more cases of recurrence in people who have already had a first infection.”
So nobody is really protected against coronavirus, not even those who have already fallen ill?
“It seems so. This is why our committee no longer recommends an immune license, a sort of pass for those who have had a first infection.”
When will France be ready for phase 2?
“There are two indicators to look at. When intensive care is no longer under pressure, the medical staff will have breathed. And when we will have the ability to test massively, isolating the positives and making contacts. A prediction, only theoretical, is between the beginning and mid-May. ”
Is your model Korean?
“Yes, but South Korea has not only done traceability on mobile phones. It has also mobilized 20,000 people who have investigated and broken the transmission chains. Technological innovation must be accompanied by human effort.”
No reservations about tracking, electronic surveillance?
“Only on a transitory basis, on a voluntary basis and within precise rules. France is working with Germany on an application. The ideal would be to extend collaboration to other countries such as Italy”.
Can France and Italy make different choices on times and ways on phase 2?
“It would be a disaster. I do not say this only at the health level, but also to avoid a more serious social and political crisis. If we are coordinated it will be much easier to make accept measures such as tracking or isolating positive patients in ad hoc structures. Our citizens observe what is happening in neighboring countries. They would not understand contradictory measures. Furthermore, a certain uniformity is essential to start traveling again, leaving borders open. ”
Do you think that economic response has been given priority at European level?
“Unfortunately, this is the case, and we suffer all the consequences. Until a few days ago, the European countries quarreled among themselves to grab the masks in China. We decided to confine ourselves without coordinating between European countries. Now it is essential not to repeat the same mistake. It is the meaning of my appeal to Italy but also to the other countries of the founding nucleus of Europe “.
Speaking of masks, why does the French government still not recommend wearing them?
“Both the WHO and the government struggled to admit the truth, that there were no masks in sufficient quantities for everyone. I am convinced that masks are one of the essential tools to get out of confinement.”
Should they be mandatory?
“Any Frenchman should have them and wear them if he wishes. Today it is not so.”
In France too there are controversies against runners or people who break the rules. What do you think?
“The confinement is respected by the vast majority of the French. I also see that it is not one hundred percent, but remember that it is a delicate balance. France is not China, and I repeat that health crises always carry a political and social risk not to underestimate”.
Did the confinement give the epidemiological results you expected?
“We are in the times we had expected. At the beginning of March the R0 rate was 3.5, today it has fallen to around 1 and we plan to drop again between 0.7 and 0.8 at the beginning of May, when we can start talking about end of confinement. But only if we are also ready for tests, digital and human tracking, patient isolation, masks “.
Will summer help us?
“All the pandemics of the last century have subsided during the summer season. This time we see that the virus also spreads in warm areas. So be careful. The other thing we see from the history of the epidemics is that we must prepare for a rebound of the virus in the fall. “
Should we expect only bad surprises?
“I am optimistic by nature. I think that human intelligence will win against the virus in the end. And when I talk about intelligence I am not talking about us experts or politics, but about the citizens who must take up this challenge, and they are already starting to do it. During the AIDS emergency there were 45 million deaths, but we managed to find an answer in both developed and southern countries. That said, there is some good news. “
You are welcome?
“The virus has undergone only small mutations in these four months, it is quite stable. And this helps the vaccine race, unprecedented for rapidity. I am convinced that there will be a first vaccine by the end of the year. And in the meantime perhaps there will be positive news on therapies and I hope on forms of prophylaxis “.
“I have never felt superior to Italy, I have no lessons to give to my Italian colleagues, indeed I have to receive them. Personally, I realized the extreme severity of the epidemic precisely seeing the situation in Lombardy where there is excellence medical and scientific. I immediately understood that France would have had the same fate. And in fact when our committee took office on March 10 I immediately told Macron that the only way forward was confinement “.
Did the government consider other options?
“I am not responding to the tergiversation of politics. Instead, I can say that my opinion was trenchant. And I’m not proud of it because I know what sacrifice has been imposed on citizens. If we had had a daily capacity of 100,000 tests, perhaps I would have suggested doing it differently. It was not like this. On March 10, France’s capacity was 3,000 tests per day. Confinement was not the best solution. It was the least worst. ”
Did the amount of testing make a difference in Germany?
“It is so, and all the better for the Germans. Today in France, daily test capacity has increased to 30 thousand per day. The goal is to reach 100 thousand by the end of the month. The initial shortage dictated the choice of confinement and it still weighs in time. ”
Your recommendation was to close the country until the end of April. Will it go further?
“We will talk about dates only when we have the tools to deal with the increase in infections and the sick that will start again as soon as the confinement eases. There is no doubt about this: the epidemic will start running again. And we will have to be ready, contrary to what happened the first time “.
There is talk of openness by region, age, profession .. What is the plan?
“It’s the ongoing debate between our committee, the government and the Elysée. I can only tell you that we will not go from black to white. There will be shades of gray. We made the calculation of the people most at risk, including the elderly, cardiopaths, obese people and other pathologies. There are 17 million French people. This already makes you understand the complexity of the situation “.
Are we beginning to know how many French people are immunized?
“We have the first serological studies and unfortunately they are not encouraging. In the areas most affected by the epidemic we see that immunity is around 10 percent. From what I know it is the same in Lombardy. It is much less than what we we waited, and we hoped. We are very far from a natural immunity in the population. But there is another problem “.
Which?
“This virus is very particular. We noticed that the lifespan of the protective antibodies against Covid-19 is very short. And we see more and more cases of recurrence in people who have already had a first infection.”
So nobody is really protected against coronavirus, not even those who have already fallen ill?
“It seems so. This is why our committee no longer recommends an immune license, a sort of pass for those who have had a first infection.”
When will France be ready for phase 2?
“There are two indicators to look at. When intensive care is no longer under pressure, the medical staff will have breathed. And when we will have the ability to test massively, isolating the positives and making contacts. A prediction, only theoretical, is between the beginning and mid-May. ”
Is your model Korean?
“Yes, but South Korea has not only done traceability on mobile phones. It has also mobilized 20,000 people who have investigated and broken the transmission chains. Technological innovation must be accompanied by human effort.”
No reservations about tracking, electronic surveillance?
“Only on a transitory basis, on a voluntary basis and within precise rules. France is working with Germany on an application. The ideal would be to extend collaboration to other countries such as Italy”.
Can France and Italy make different choices on times and ways on phase 2?
“It would be a disaster. I do not say this only at the health level, but also to avoid a more serious social and political crisis. If we are coordinated it will be much easier to make accept measures such as tracking or isolating positive patients in ad hoc structures. Our citizens observe what is happening in neighboring countries. They would not understand contradictory measures. Furthermore, a certain uniformity is essential to start traveling again, leaving borders open. ”
Do you think that economic response has been given priority at European level?
“Unfortunately, this is the case, and we suffer all the consequences. Until a few days ago, the European countries quarreled among themselves to grab the masks in China. We decided to confine ourselves without coordinating between European countries. Now it is essential not to repeat the same mistake. It is the meaning of my appeal to Italy but also to the other countries of the founding nucleus of Europe “.
Speaking of masks, why does the French government still not recommend wearing them?
“Both the WHO and the government struggled to admit the truth, that there were no masks in sufficient quantities for everyone. I am convinced that masks are one of the essential tools to get out of confinement.”
Should they be mandatory?
“Any Frenchman should have them and wear them if he wishes. Today it is not so.”
In France too there are controversies against runners or people who break the rules. What do you think?
“The confinement is respected by the vast majority of the French. I also see that it is not one hundred percent, but remember that it is a delicate balance. France is not China, and I repeat that health crises always carry a political and social risk not to underestimate”.
Did the confinement give the epidemiological results you expected?
“We are in the times we had expected. At the beginning of March the R0 rate was 3.5, today it has fallen to around 1 and we plan to drop again between 0.7 and 0.8 at the beginning of May, when we can start talking about end of confinement. But only if we are also ready for tests, digital and human tracking, patient isolation, masks “.
Will summer help us?
“All the pandemics of the last century have subsided during the summer season. This time we see that the virus also spreads in warm areas. So be careful. The other thing we see from the history of the epidemics is that we must prepare for a rebound of the virus in the fall. “
Should we expect only bad surprises?
“I am optimistic by nature. I think that human intelligence will win against the virus in the end. And when I talk about intelligence I am not talking about us experts or politics, but about the citizens who must take up this challenge, and they are already starting to do it. During the AIDS emergency there were 45 million deaths, but we managed to find an answer in both developed and southern countries. That said, there is some good news. “
You are welcome?
“The virus has undergone only small mutations in these four months, it is quite stable. And this helps the vaccine race, unprecedented for rapidity. I am convinced that there will be a first vaccine by the end of the year. And in the meantime perhaps there will be positive news on therapies and I hope on forms of prophylaxis “.
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