# The Fight Against Covid 19, The Strategic Orientations in France in 2021: Different Choices from our European Neighbors

Anne-Marie Duguet

► To cite this version:

Anne-Marie Duguet. The Fight Against Covid 19, The Strategic Orientations in France in 2021: Different Choices from our European Neighbors. WAML Newsletter, 2021, 44, 3 p. hal-04338052

HAL Id: hal-04338052

https://ut3-toulouseinp.hal.science/hal-04338052v1

Submitted on 19 Dec 2023

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# The Fight Against Covid 19, The Strategic Orientations in France in 2021: Different Choices from our European Neighbors

<figure><img src="image_2.png" /><figcaption>Anne-Marie Dauguet MD
Emeritus Senior Lecturer, UMR INSERM unit 1027
Paul Sabatier University, Toulouse France
WAML Governor</figcaption></figure>

After the Christmas vacations the epidemic situation did not evolve according to the government's forecasts announced in December. Cinemas and theaters that should have opened on December 15 remained closed, as well as museums. Bars and restaurants did not open on January 15. Even if the circulation of the virus did not explode after the holidays, as was the case in the USA after Thanksgiving, the rate of infected people remained too high to allow meetings in cultural places and restaurants.

The health authorities' strategy and the government's fight against the epidemic were significantly different from those of our European neighbors, leading to a series of new political and media criticisms in France.

## Measures for the population

There has been no containment throughout the country as in Germany, Spain or the United Kingdom, but binding measures have been proposed. In January, in spite of a significant circulation of the virus, the government's choice was not to confine the country, but to maintain the curfew implemented in November throughout the country, brought forward to 6pm from January 16.

The government chose to keep schools and secondary schools open so as not to deprive children of social contact and the benefits of traditional education. Keeping the children in school allowed parents to resume their professional activity in companies when teleworking was not possible. State support for economic actors has been extended. There have been few contamination clusters in both schools and companies. Business bankruptcies have been limited and unemployment has not increased excessively.

New variants of the virus have appeared, mainly in the very active areas of virus circulation: in the north of France, Paris and its region, the eastern and Southeastern regions. Localized measures in these regions were ordered with a total curfew during the weekend and additional doses of vaccine.

## Vaccination

The vaccination campaign began in France at the same time as the other European Union states at the end of December. The recommended vaccination strategy takes into account the specificities of patients' rights and the precautionary principle. Vaccine "hesitation" is a French specificity: on December 23rd, 6 out of 10 French people declared they were refusing the injection on the grounds that it takes at least 10 years to develop a vaccine. In 2009, vaccination against H1N1 was a bad experience: only 17% were vaccinated or intended to be vaccinated. Adults under 35 years of age were the most reluctant. Doubts about the safety of the vaccine (71%) and fear of side effects (68%) were the most common reasons for refusal. Those at risk were more likely to accept the vaccine (40%).

At that time, anti-vaccination leagues developed, sometimes supported by health professionals, and conspiracy theories began to circulate. For the Covid 19 vaccine, the technique with messenger RNA worried (confusion with GMOs). 15% of the population has lost confidence in health authorities, politicians and researchers. This is why the start of the vaccination campaign was deliberately slow and gradual, surrounded by precautions to avoid a recurrence of the H1N1 vaccination scenario.

Vaccination in France is a medical act, carried out by a healthcare professional after informed consent has been obtained. The subject is informed of the risks of vaccination and potential contraindications to vaccination are sought. Due to the context of public distrust, making vaccination against Covid 19 was not mandatory, even for health professionals. However, the choice was made to make the vaccination centers free of charge and to have them organized by the State. In addition, general practitioners have mobilized to vaccinate in their offices and pharmacists already trained in flu vaccination were authorized in early March to vaccinate in pharmacies.

Priority was given to the most vulnerable public and those likely to develop the most serious forms, i.e. the elderly in institutions and the staff working there (1 million people). Then people with a risk factor:
people over 75 years of age living at home or suffering from a chronic disease, and health care personnel over 50 years of age and/or with chronic diseases (14 million). While 80% of elderly people in institutions were vaccinated at the end of February, only 36% of the staff had been vaccinated. An incentive letter from the Minister of Health was sent to them individually to remind them of their duty of prevention and to urge them to be vaccinated.

The comparison of the vaccination rate with our European neighbors (UK 34.65%, Spain 10.08%, Italy 9.24%) is clearly to the disadvantage of France (8.56%), but the delay is being made up, the supply of vaccine doses is now sufficient, and the doubts that hung over the effectiveness of the AstraZeneca vaccine for the elderly have been removed by the President of the Vaccination Monitoring Committee. The effects of vaccination of the most vulnerable are being felt as deaths and hospitalizations of the over 75-year-olds have fallen by 10 percent.

## Some remarks to conclude

Depending on the different epidemic variations in European countries, the control strategy depends on the culture and acceptance of prevention measures. As explained above, the acceptance of measures is highly contested by the French population in some cases and a delicate balance has been struck. The government wanted to avoid at all costs what had happened with the H1N1 vaccination. The anti-vaccination reluctance is similar and some health professionals continue to resist.

The prospect of an electronic “health pass” that would facilitate access to cultural and sporting events and travel may convince some unsure people to get vaccinated. Such a pass would contain not only vaccination information, but also, for those who are not vaccinated, recent test results.

The Ministers of Health of the European Union countries wish to harmonize the European cooperation line that has been established with the centralized ordering of vaccines. The President of the European Commission acknowledged that these orders have been insufficient and late, but one must underline the initiative of the EU to increase its means to fight against pandemics that are likely to be prolonged or re-emerge in the future.

# World Association for Medical Law

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## SECRETARY-GENERAL REPORT

Friends and colleagues, it has been well over a year and we are still facing Covid-19, however, the spread of increasing vaccination gives us hope for a brighter future.

Unfortunately, there has been another casualty: our beloved Istanbul Annual World Congress Meeting.

The good news however, is that Istanbul and the boat trip down the Bophsphorus have survived and have only been merely postponed.

WAML does not simply live, but continues to thrive and accumulate far greater medical law challenges to experience, debate and solve during our ongoing future work together and at the next exciting World Congress on Medical Law in Gold Coast, Australia.

We look forward to Roy Beran hosting all of us warmly “Down Under” and we will have so much to discuss of where we have all been and where we continue to wish to go in our journey together.

It gives us hope and something to look forward to in 2022 that this terrible pandemic will be over and we will be back to our usual life, enjoying what we do and further collaborating together.

We have been able to transition some special events from Toronto to Istanbul and now to Gold Coast, including the launch of the book series and Davies award and many are rolling over their registration and starting to make plan for 2022.

The EC would like to thank all the Governors and Members for their ongoing dedication and commitments during these difficult times.