If any country should’ve been able to handle a coronavirus outbreak, you’d think it would have been France. One of Europe’s most powerful countries, France has a world-renowned health care system, immense wealth, ample social welfare, a centralized government, and a strong presidency.
Yet the country currently has the fourth-highest number of confirmed coronavirus cases and third-most deaths in the world. The country’s health care system is consistently ranked among the best in the world, yet France has experienced shortages of hospital beds, masks, and other critical products. As the number of confirmed cases and deaths continues to rise, popular food markets have been turned into makeshift morgues and high-speed trains have become Covid-19 patient transport vehicles.
Much of the blame lies at the feet of French President Emmanuel Macron’s government, whose slow response and critical missteps in the early days of the Covid-19 outbreak set the stage for France’s current crisis.
On Monday, Macron basically admitted as much. “Were we prepared for this crisis? On the face of it, not enough. But we coped,” he said in a televised national address in which he announced an extension of the nation’s lockdown to May 11.
“This moment, let’s be honest, has revealed cracks, shortages,” Macron said. “Like every country in the world, we have lacked gloves, hand gel, we haven’t been able to give out as many masks as we wanted to our health professionals.”
But for the nearly 15,000 people who have died in the country from Covid-19 so far, Macron’s realization came far too late.
“We were not worried enough” early on, Pierre-Yves Böelle, an epidemiology expert at the Sorbonne University in Paris, told me.
The coronavirus “time bomb” Macron missed
On January 24, France’s then-Health Minister Agnès Buzyn announced that two people in the country tested positive for the coronavirus, becoming the first known cases in all of Europe. They had just been to China, Buzyn said, adding, “We will probably have other cases.”
But if Macron’s government felt a sense of urgency, it didn’t show it.
February came and went with little action. Health officials advised citizens to wash their hands, keep a safe distance from others, cover their mouths when sneezing, and stay away from retirement homes. And Macron held video conference calls on the virus and inspected hospitals and clinics to see how his country was coping.
Yet few concrete actions were taken to impose strict social distancing measures or promote large-scale testing.
And Macron didn’t even follow his own government’s advice: During a late February trip to Naples, Italy, he and Italian Prime Minister Giuseppe Conte took a stroll through the city, swarmed by press and onlookers, with whom Macron chatted and shook hands. Macron also kissed Conte multiple times during the visit.
It wasn’t until March 3 that France took real action. The government shuttered 120 schools in two regions, one of them an area north of Paris, as they had become among the hardest-hit areas in the country.
But even as tens of thousands of students were told to stay home, Education Minister Jean-Michel Blanquer tried to downplay the move. “It wouldn’t make sense to confine everyone at home, to paralyze the country,” he told a local television station.
Indeed, the government still allowed gatherings of up to 1,000 people to proceed. Macron, for his part, attended a theater performance on March 6, partly to show that life could continue unperturbed. He also visited a retirement home that same day, even as the number of coronavirus infections in the country was at least doubling.
To make matters worse, France couldn’t get a clear picture of the growing problem thanks to a lack of tests.
As Politico reports, the country doesn’t manufacture its own testing kits, but rather “relies on China for their main components.” With China completely paralyzed by its own coronavirus outbreak at the time, France was unable to quickly get more tests. That severely limited the country’s ability to do widespread testing early on, which public health experts say is critical to slowing an outbreak.
The problem was compounded by a dearth of masks, leading the government to say only medical workers should wear them, not the general public. It turns out that, as France’s new Health Minister Olivier Véran (who took over in February after Buzyn abruptly resigned to run for mayor of Paris), told Parliament on March 19, France’s strategic supply of personal protective equipment wasn’t as robust as everyone had thought.
“It was decided in 2011 and 2013 that there was no longer a need to keep massive stocks of masks, considering that factories could deliver quite quickly, namely in China,” Véran said, according to Politico.
Macron, in effect, was sleepwalking toward disaster. Two events finally woke him from his slumber, experts say.
The first was Italy’s coronavirus situation. In late February, Italy had just three confirmed cases; by mid-March, that number had skyrocketed to around 15,000. That got Macron’s attention and caused him and his leadership team to worry that perhaps the disease was worse than China had let on.
The second was the discovery of some 2,500 coronavirus cases in the country that could all be traced back to a single week-long religious gathering that had taken place in mid-February.
As Reuters reports, during the week of February 17, hundreds of worshippers from around the world attended an annual celebration at the Christian Open Door evangelical megachurch in Mulhouse, a city in eastern France near the country’s borders with Germany and Luxembourg.
One of the congregants carried the disease.
At the time, though, the French government had yet to ban large gatherings. “There was no alcohol gel for the congregations to clean their hands, no elbow bumps instead of handshakes,” according to Reuters.
The first case linked to the church was identified on February 29. Over the following weeks, experts traced some 2,500 infections back to the event. “Worshippers at the church [had] unwittingly taken the disease caused by the virus home to the West African state of Burkina Faso, to the Mediterranean island of Corsica, to Guyana in Latin America, to Switzerland, to a French nuclear power plant, and into the workshops of one of Europe’s biggest automakers,” Reuters reports.
By the time researchers understood the extent of the outbreak, they knew bigger problems lay ahead. “We realized that we had a time bomb in front of us,” Michel Vernay, an epidemiologist with France’s national public health agency, told Reuters in March.
Macron was pressured into holding elections during the coronavirus outbreak
The French government tried to make up for lost time.
On March 12, Macron announced all schools, nurseries, and universities closed to keep the spread of the virus to a minimum. Two days later, Prime Minister Édouard Philippe said all nonessential businesses such as restaurants, movie theaters, and night clubs would be shuttered, while shops like supermarkets and pharmacies would remain open. “We must absolutely limit movement, meetings, and contacts,” he said at the time.
But as Macron struggled to respond to the growing epidemic in his country, he also had to contend with a brewing political crisis.
The government had decided to hold the long-scheduled first round of mayoral elections on March 15 in the country’s 35,000 towns and villages. Per Macron, experts told him it’d be fine for the election to proceed as planned.
“We are following the recommendations of scientists,” Macron said after leaving his local polling station on voting day. “The virus spreads when we spend more than 15 minutes closer than one meter to someone, which is the case at the restaurant, but we can continue shopping for food and stepping out to get some air, and so it was logical to go vote while respecting guidelines.”
His political adversaries at the time pushed for that decision, as polling showed Macron’s party in fourth place and his personal popularity around 33 percent. The center-right party Les Républicains, for example, declared Macron would be leading a “coup d’état” if he postponed the election.
“They were under a lot of pressure from the opposition,” said Benjamin Haddad, who represented Macron’s party in Washington, DC, during the 2017 election. “In retrospect, you probably feel that it would’ve been better to postpone or suspend it, but it was a really tough call to make in a fraught time,” added Haddad, who is now at the Atlantic Council think tank in Washington.
Macron’s party did horribly in the first round of elections, which saw record-low voter turnout. And the next day, on March 16, Macron announced that he was postponing the election’s second round and imposing a countrywide lockdown.
“I know what I am asking of you is unprecedented but circumstances demand it,” the president said in a televised national address. “We’re not up against another army or another nation. But the enemy is right there: invisible, elusive, but it is making progress.”
“We are at war,” he said multiple times.
For medical experts, the lockdown was the right decision. “Many of us by then were calling for it to happen,” Michelle Kelly-Irving, an expert at the Toulouse Epidemiology and Public Health Research Unit, told me. But that it took so long for him to do it was a crucial mistake.
And while some might think Macron shut down the electoral process because his party got trounced, Célia Belin, a France expert at the Brookings Institution think tank in Washington, told me all parties felt the coronavirus outbreak demanded a halt to the vote.
“By then, everyone was convinced,” she told me.
France’s health care system isn’t ready to deal with a crisis this big
France’s health care system is renowned as one of the world’s best. But Julia Lynch, an expert on that system at the University of Pennsylvania, told me that French leaders over the last 30 years have cut excess slack in health care because it was also one of Europe’s most expensive.
The goal was to make the system more efficient overall by providing the same level of service at lower cost. But, she said, “when you do that, you make [the system] unable to deal with large crises.”
Lynch said many hospitals in France, particularly in rural areas, have closed down over the last 20 years. That was also due to the funding cuts, which directed money away from hospitals and toward primary care physicians, who wield a lot of power in France. “There has been an overall reduction in [hospital] capacity preceding the Covid-19 epidemic,” she said. “Cuts made were precisely in the area where we now most need capacity.”
That’s become quite evident in recent weeks. Intensive care unit (ICU) space is at such a premium that patients are being transferred to Germany, Luxembourg, and Switzerland for treatment, sometimes transported on France’s high-speed TGV trains. The Rungis food market south of Paris is now serving as a morgue for the overflow of bodies. And there’s now a large field hospital outside Mulhouse, where the religious gathering took place.
The situation is so bad that physicians have criticized Macron to his face.
“When it was about saving Notre Dame, many were moved,” Dr. Francois Salachas told Macron during his visit in February to a Paris hospital, noting the cathedral had received massive funding pledges — approximately $1 billion — after it burned last year. “This time it’s about saving public hospitals, which are going up in smoke at the same speed as Notre Dame almost did.”
Macron has finally started to take serious action. Will it be enough?
Macron’s “war” against the coronavirus is now fully underway.
He launched “Operation Resilience,” which allows French military troops to provide logistical and medical support throughout the country. French armed forces are also authorized to use helicopters to reach French islands.
The government has also helped provide some 5,000 additional ICU beds around the country, and Macron’s team has proposed an aid package of 100 billion euros — about 4 percent of France’s GDP — to boost the economy.
The government also took strong measures to ensure no one traveled for the Easter weekend. Most visibly, around 160,000 law enforcement officials set up checkpoints on major roadways, ensuring the yearly grand départ for the holiday wouldn’t take place.
All of these efforts seem to be having an impact: The number of ICU cases in France is in decline, though the number of deaths still ticks upward.
But major challenges remain before Macron can declare a full turnaround.
First, the disease continues to impact retirement homes more than anywhere else in the country, especially in the hard-hit region of the Alsace in the east. Nurses and directors of these homes believe many deaths they witness may be due to the coronavirus but won’t be counted as such by the government.
“The tsunami has entered the building, it’s a disaster,” Pierre Gouabault, who leads a home in the central Loire Valley, told France 24 this month. Gouabault said 10 people in his care recently died from the disease and nearly 20 others have worrying symptoms.
Second, Macron continues to make some questionable decisions. Last week, for instance, he traveled to Marseille to meet with Dr. Didier Raoult, a famous French microbiologist. Raoult constantly pushes the use of the antimalarial drugs chloroquine and hydroxychloroquine to treat Covid-19, just like President Donald Trump does.
But the evidence of those drugs’ effectiveness against the disease is incredibly flimsy, and health experts warn that rigorous clinical trials are needed before using the drug to treat Covid-19 widely.
Macron hasn’t touted the drugs himself, but critics contend that his taking time to visit Raoult only helps promote the doctor’s controversial stance on the drugs.
Finally, France’s political situation will continue to constrain Macron’s actions. Macron is up for reelection in two years, and though experts say he still retains a slight edge in the country’s fractured political environment, he is fairly unpopular, and opponents on all sides question his every move.
That could lead him to make critical decisions like reopening the country based more on how they will impact his own political fortunes rather than how they’ll impact public health.
Still, experts say the best way forward for the president is to solve the crisis before it gets entirely out of hand. “If he stays the course, I don’t think he’s going to be that much weaker,” said Belin.
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