She took up residence at the beginning of September, and she is taking her ease. The eighth epidemic wave of Covid-19 is gaining momentum, with more contaminations, and more hospitalizations. This Thursday, 65,537 new cases were recorded, against 51,366 a week earlier. And the total number of hospitalized patients, at more than 16,000, has returned to its level of mid-August.
But if the figures are racing, respect for barrier gestures is at the level of the daisies. Wearing a mask is strongly recommended in transport, but it is largely shunned. Why ? Is it just out of weariness? Or is it the result of a lack of pedagogy from the health authorities? Before arriving at an obligation, can we improve compliance with this recommendation to slow the spread of the virus? And how ?
A widely ignored recommendation
It is a quantified reality, “since wearing a mask is no longer compulsory in closed public places”, the proportion of French people wearing a mask in public fell in September to the lowest level since the start of the health crisis. . This is shown in the new edition of the CoviPrev survey of Public Health France on the evolution of behavior during the epidemic, published at the end of the week.
A majority of French people say they no longer wear it or wear it less often, especially in closed public places (76%, compared to 58% in May), at work (70%, compared to 57%) and on public transport ( 61%, versus 23%). An abandonment also observed in the presence of elderly or vulnerable people (58%, against 44%), according to the survey, carried out from September 12 to 19 with a representative sample of 2,000 adults. Still according to the survey, some French people would be ready to respect these barrier gestures this winter, if the epidemic was still racing a notch. But “out of forgetfulness”, “weariness” or feeling of excessive constraint, they could also not do it.
Why this general “forgetting”? “For most people, the coronavirus is considered something benign, and after almost three years of pandemic, there is also a form of trivialization of the virus, we have become used to it, although it has caused more 30,000 deaths since the beginning of the year, observes Antoine Flahault, epidemiologist and director of the Institute of Global Health in Geneva. In addition, the authorities have not based the obligation to wear the mask, nor its lifting, on health indicators and specific scientific arguments, he continues. This has not been correlated to the incidence rate or precise thresholds on the degree of viral circulation, at the risk of having great difficulty in reinstating it later if necessary. And today we are paying the consequences: people do not see why the masks were removed or why it should be put back on, since this has never been clearly explained to them. »
A “Covid weather” to improve pedagogy and membership
So, how to improve pedagogy and the adhesion of the general public to the mask? “By explaining the situation in a simple, clear and direct way, says Dr Jérôme Marty, general practitioner and president of French Union for Free Medicine (UFML) . In practice, this could be in the form of a “Covid weather forecast”, with each day a bulletin, with colors to illustrate the degree of viral circulation, such as the weather the next day with temperatures and rain. Except that there, when the Covid weather turns orange or red, it would mean that you have to put the mask back on. »
A proposal hailed by Antoine Flahault. “The image of the weather is very telling! We understand very well when rain is announced that you have to take an umbrella. Covid weather would make it possible to manage risk in a more informed and wise way. » A pedagogy to be supplemented by precise indicators. “At some point, it would be time to model this type of measurement on figures, a scientific basis”, insists Dr. Marty. “It is true that if there were rules indicating that from certain thresholds, certain barrier measures are reinstated, it would be clearer for the public”, adds Antoine Flahault.
In the meantime, “we must hammer the three situations in which we must take the reflex to wear the mask, adds the epidemiologist. When you have symptoms, you put it on, especially since it limits the transmission of all respiratory viruses, as we could not see in the winter of 2021-2021, where strict respect for barrier gestures with the wearing of Mandatory mask extinguished other winter epidemics. Then on public transport, all the time. And when the numbers soar, in closed places that receive the public and which are poorly ventilated: meeting rooms, shared offices, classrooms or even lecture halls, due to the lack of investment to improve them indoor air quality”. And “remember that we wear the mask to protect others, and that if everyone wears it, the others protect us in return”, underlines Dr Marty.
“A political responsibility”
But while waiting to arouse the adhesion of the French, should the mask again be made compulsory? “We are thinking about it, not thinking about it, but calculating what would be the benefits of wearing a mandatory mask compared to wearing a recommended mask”, explained Thursday Professor Brigitte Autran, president the Health Risk Monitoring and Anticipation Committee (Covars), the body that succeeded the Scientific Council.
A possibility considered by the government. The Ministry of Health “does not forbid” such a measure, said Minister François Braun on Tuesday, nevertheless ensuring “to trust the French” to take protective measures themselves.
“We are now in a situation where experts are giving the alert, pointing out that the simple recommendation is not being followed and that we should perhaps move to a more regulatory stage to finally manage to curb hospitalizations, deaths and Covid long, observes Antoine Flahault. But making the wearing of a mask compulsory is a political responsibility. And with the end last August of the state of health emergency in the context of which this obligation had been put in place, the government no longer has a legal instrument to do so, develops the epidemiologist. This measure should certainly be submitted to Parliament. »