# Covid 19: Mandatory Requirements in France

Anne-Marie Duguet

► To cite this version:

Anne-Marie Duguet. Covid 19: Mandatory Requirements in France. WAML Newsletter, 2021, 50, pp.5. hal-04338130

HAL Id: hal-04338130

https://ut3-toulouseinp.hal.science/hal-04338130v1

Submitted on 19 Dec 2023

HAL is a multi-disciplinary open access
archive for the deposit and dissemination of sci-
entific research documents, whether they are pub-
lished or not. The documents may come from
teaching and research institutions in France or
abroad, or from public or private research centers.

L'archive ouverte pluridisciplinaire HAL, est
destinée au dépôt et à la diffusion de documents
scientifiques de niveau recherche, publiés ou non,
émanant des établissements d'enseignement et de
recherche français ou étrangers, des laboratoires
publics ou privés.

<figure><img src="image_1.png" /></figure>

Distributed under a Creative Commons CC BY 4.0 - Attribution - International License
The reasoning behind the decision to introduce a third boost is the Delta variant of Covid, which is less prevented by the vaccines. The first three variants (Alfa = the British, Beta= the South African and Gamma= the Brazilian) variants were protected from by the vaccination, but it was found that although vaccination reduced severity of illness, the Delta variant infects all population layers even children.

The main challenges to Israel in the coming months are as follows:

* Reducing the numbers of people who are at risk from Covid.

* Convincing a third of the population that refused vaccination to receive vaccine that seems to be the ultimate cure to overcome the pandemic.

* Balancing between the protection of human rights (freedom of movement and religion) and autonomy to refuse vaccination V. public health interests and solidarity between people.

* Balancing between protecting public health and maintaining life routine.

* Recovery of the Health and Education systems.

* Reducing the economic blow that the world has suffered due to Covid.

Israel was the first to introduce the vaccination to its citizens, and first in the world to introduce, the third shot but is still a long way before overcoming the above challenges. The world can overcome these challenges in social solidarity and the knowledge that vaccination can end the battle against Covid.

# Covid 19 : Mandatory Requirements in France

<figure><img src="image_2.png" /><figcaption>Anne-Marie Duguet MD PhD</figcaption></figure>

Emeritus Senior Lecturer Insem CERPOP UMR 1295
Paul Sabatier University Toulouse France
WAML Governor

Since the beginning of the epidemic, 6.47million cases of Covid 19 have been recorded in France (first in the European Union ahead of Great Britain, Italy and Spain). There were 3 epidemic peaks: in April 2020, November 2020 and April 2021. Since June 2021, the number of cases has increased and a fourth wave is expected in autumn 2021 with different characteristics from the previous ones as it develops from a much more contagious variant, the delta variant (94.6% of tests on the 21,200 cases per day currently) and on a partially vaccinated population.

The previous waves were contained with restrictive measures put in place under the State of health Emergency.

## Restrictive measures for freedoms

The State of health Emergency is an exceptional measure, of limited duration, promulgated in the event of a health disaster and regulated by law. It was introduced in France by the Law of 23 March 2020, extended until 16 February 2021 and then until 1 June 2021 and under a transitional regime from 2 June to 30 September 2021. It allowed the government to take the following exceptional measures:

- The confinement of the entire population, requiring citizens to remain at home, with travel limited to what is strictly necessary: food purchases, medical care, professional activity if teleworking is not possible. Three periods of confinement followed one another from 17 March to 11 May 2020, from 30 October to 15 December 2020, and from 3 April to 3 May 2021, during which the only outings authorised were for individual sporting activities for 1 hour a day within 1 km of the home.
- The wearing of a mask has been compulsory in transport since 11 May 2020 and in enclosed spaces since July 2020. Some cities have imposed it even outside, under the authority of the mayor, depending on the rate of circulation of the virus.

- Prohibition or limitation of certain indoor activities, shows, sports halls, certain non-essential businesses, etc. In addition, certain outdoor activities and gatherings of more than 50 people have been prohibited, even in places of worship, except for funeral ceremonies (20 people authorised). Travel and movement between EU and non-EU countries was restricted or prohibited.

Each containment has been effective in reducing the number of cases, but has had a major impact on the economy. Since June, in order to avoid saturation of hospital services and a new confinement, the vaccination campaign has been accelerated and specific measures have been implemented, maintaining barrier gestures (masks) and creating a Health Pass.

## Vaccination

Vaccination began slowly in January 2021, with priority given to protecting vulnerable people, mainly those over 75 years of age in homes for the elderly, and then those with comorbidities. The French vaccination strategy has been criticised in comparison with countries that have widely opened up vaccination without prioritisation (Great Britain, Israel). In reality, the health authorities started cautiously because of a climate of vaccine hesitation: only 40% of the people questioned in November intended to be vaccinated. This hesitation is the result of previous mistakes for the H1N1 vaccination in 2009 (large doses of vaccine ordered for 7.9% of people vaccinated) but also the uncertainty about the long term side effects of RNA vaccines. The gaps with other countries closed as soon as the vaccine supply stabilised. As of 15 August 2021, 45.78 million people have received the first injection and 38.50million are fully vaccinated, i.e. 66.8% of eligible people (aged over 12 years). In order to maintain sufficient vaccine protection, a third dose of vaccine will be offered in September for those over 80 years of age whose immunity declines more rapidly.

There is a segment of the population that traditionally opposes vaccination : the anti-vaxers. They are present even among health professionals, and compulsory

vaccination of certain professions is regularly mentioned, but has not been submitted to Parliament.

The resumption of significant circulation of the virus shows that vaccination is not currently sufficient to stop the epidemic and that economic and social activities must continue in a supervised manner with controls.

## The Health Pass

A European Health Pass has been set up to facilitate travel between European Union states on 1 July 2021. France has also introduced a similar health pass on 25 July 2021. It is an electronic certificate with a QR code, attesting to a complete vaccination or a negative PCR test of less than 72 hours or the cure of COVID. It is required for adults from 9 August 2021 onwards to access bars and restaurants (even on the terrace) and to travel by train, plane and bus. It is also required for access to medical and care facilities (except for emergencies) and for certain large shopping centres (20,000 m2). From 30 September, it will apply to people over the age of 12.

The Health Pass will be compulsory for employees in establishments open to the public from 30 August. If the employee refuses to present the Health Pass, the employer can interrupt the salary and suspend the employment contract, without entitlement to unemployment benefit.

## Reactions from the public and professionals

Protests against the mask requirement were held in France and in some European cities in August 2020, but with a modest turnout. In 2021, anti-Health Pass demonstrations are taking place every Saturday in 200 cities and brought together around 215,000 people for the fifth edition on 14 August.

This protest is part of a social and political context already deteriorated before and during the crisis: protest of the Gilets jaunes since 2019, malaise in the hospital due to lack of staff and insufficient remuneration long before the Covid crisis. Legal actions have been filed against the government measures of prefects and mayors, the majority of which have been rejected.

## Support and incentives for vaccination

Economic support was introduced as soon as the effects of the containment began to be felt, and