France hardens coronavirus response to avoid Italy-like crisis

France’s hardening approach to combating the coronavirus outbreak, with steep fines for defiance of strict limits on movement, reflects both concern at its rising death count and fears that the country cannot rule out suffering as severely as Italy.

In Nice, one of France’s front lines just 30 kilometres from the Mediterranean border crossing near Ventimiglia, health professionals say the risk of degeneration to Italian levels of infection – 53,578 cases and nearly 5,000 deaths, including a record day-on-day rise of almost 800 fatalities, on Saturday’s figures - is possible.

“Some talk of a tsunami,” says Dr Patrice Melia, a cardiologist, pointing out that the effects of the virus in France remain some way from their likely peak. France’s tally for infection stood on Saturday at 14,485 including 562 deaths.

France’s response to the crisis is a nationwide lockdown with people allowed to leave home only for specific reasons, supported by official forms to be completed and handed to police. Beaches and promenades have been closed the length of France’s coastline and drones are being used to check for breaches. More than 4,000 fines have been issued in four days.

The conservative mayor of Nice and security hardliner, Christian Estrosi, imposed a 11pm-5am curfew starting on Saturday night. He barred all but essential health and emergency personnel, and people on genuinely urgent family missions, from leaving home at all.

French Interior Minister Christophe Castaner has described as “imbeciles” those who continued to flout the restrictions announced by President Emmanuel Macron last Monday by gathering in parks and other public places.

People may go out for reasons of employment if unable to work from home. They may also do essential shopping, act on family emergencies, observe police or judicial summonses or take limited individual exercise close to home.

Fines for failure to comply have increased from 38 euros (Dh150) to 135 euros with serious or repeat offenders liable to pay 375 euros or face court appearances and even imprisonment. But French media reports point out that other European countries, including Austria, Spain and Norway have imposed even harsher penalties, and the mayor of Paris, Anne Hidalgo, says more severe curbs are now necessary.

“Not just Nice but all over France, some people are acting as if to say ‘whoopee, it’s holiday time and the sun’s shining so let’s have a bike ride, go to the beach, prepare a picnic’,” says Charlotte, a 59-year-old retired nurse who lives farther along the Cote d’Azur.

Mr Macron said at the beginning of a crisis meeting at the interior ministry on Friday that France had taken exceptional measure to absorb the first wave of the virus – not expected to peak before early April - but rebuked those who were failing to take the lockdown seriously.

Time will tell whether Mr Macron’s leadership will enable him to regain some of the popularity he has lost while pursuing contentious reforms. But his clear, firm approach has brought him some respect in neighbouring European countries.

There are also signs that people are increasingly getting the message. Dr Melia was able to film Nice’s renowned seafront avenue, the Promenade des Anglais, and nearby city centre roads, all but deserted on a fine spring afternoon as he returned from a “desperate but successful search for face masks, single-use gowns and hand sanitisers for my practice”.

He said the measures taken by the government seemed “proportionate and reasonable, effectively declaring a health war in the face of an epidemic on a scale unparalleled for a century”. The problem, he added, echoing Charlotte’s words, was that many French people “took this lightly and confused confinement with vacation”.

Dr Melia said the risk of deterioration on a level experienced in Italy was “unfortunately possible” according to mathematical models and the disease’s evolution curves.

If proximity to Italy and Spain, the two worst affected European countries so far, represents a more immediate concern, professional and political opinion in France is also dismayed at the British response.

Only on Thursday did the prime minister Boris Johnson finally announce the closure of schools; it took another 24 hours for pubs and restaurants to be ordered to close. Currently, there is advice against non-essential movement but no formal restriction.

“French doctors can only be critical of the position adopted by the British authorities,” Dr Melia said. “The initial position of the government was one of laissez-faire as if divine protection would protect the nation. This demonstrated a sense of denial, the inability of a degraded system to cope and an unacceptably surreal approach.”

Misgivings have also been voiced in the UK.

A group of scientists, including infectious disease experts, signed a letter published last weekend by the British newspaper, The Times, complaining there was “no clear indication that the UK's response is being informed by the experiences of other countries in containing the spread of Covid-19”.

One signatory, Dr Richard Horton, editor of the medical journal The Lancet, wrote later in The Guardian that suggestions the British government had changed direction because of new modelling from scientists at Imperial College were wrong. “The science has been the same since January. What changed is that government advisers at last understood what had really taken place in China.”

He recalled that two Italian researchers, Andrea Remuzzi and Giuseppe Remuzzi, had set out the lessons of their own experience on March 12. “Italy’s health service simply could not cope. They did not have the capacity of intensive care beds to deal with the scale of infection and its consequences. They predicted that by mid-April their health system would be overwhelmed. The mortality of patients with severe infection was high. A fifth of health workers were becoming infected, and some were dying.”

Dr Horton argued that despite signs the same considerations could apply to other European countries, Britain initially followed a strategy of “encouraging the epidemic and the goal of herd immunity”. Its new course of action was correct but valuable time had been lost “and there will be deaths that were preventable”.

The Italian researchers spoke of an “unmanageable catastrophe”. Amid such fears, and each country’s pursuit of the most effective response, Mr Macron says France has now begun what he calls “a race against this virus”.