“Coronavirus weather”, quantified thresholds … Against the background of the 8th wave, how to improve adherence to the use of the mask?

It settled in early September and is calming down. The eighth wave of Covid-19 is gaining momentum, with more contamination and more hospitalizations. This Thursday, 65,537 new cases were registered, up from 51,366 a week earlier. And the total number of hospitalized patients, over 16 thousand, has returned to the levels of mid-August.

But if the figures are correct, respect for barrier gestures is at the level of daisies. Wearing a mask is strongly recommended in transportation, but is largely avoided. How come ? Is it just from fatigue? Or is it the result of a lack of pedagogy on the part of the health authorities? Before we get to 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 mandatory in closed public places”, the percentage of French people wearing a mask in public fell in September to the lowest level since the start of the health crisis. . This is demonstrated by the new edition of Public Health France’s CoviPrev survey on the evolution of behavior during the epidemic, published at the weekend.

The 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%) , against 23%). An abandonment observed even in the presence of elderly or vulnerable people (58%, against 44%), according to the survey, carried out from 12 to 19 September on a representative sample of 2,000 adults. Also according to the survey, some French people would be ready to respect these barrier gestures this winter, if the epidemic were still making a qualitative leap. But “out of forgetfulness”, “fatigue” or a feeling of excessive constriction, they couldn’t even do it.

Why this general “forgetfulness”? “For most people the coronavirus is considered something benign and, after almost three years of the pandemic, there is also a form of trivialization of the virus, we are used to it, even though it has caused more than 30,000 deaths since the beginning of the year, notes Antoine Flahault, epidemiologist and director of the Institute of Global Health in Geneva. Furthermore, the authorities have not based the obligation to wear the mask, nor its lifting, on health indicators and on specific scientific arguments, he continues. This was not related to the incidence rate or precise thresholds on the degree of viral circulation, with the risk of having great difficulty in replenishing it later if necessary. And today we pay the consequences: people don’t see why the masks have been removed or why they should be put back, as this has never been clearly explained to them. “

A “Covid time” to improve pedagogy and membership

So, how to improve the pedagogy and the adhesion of the general public to the mask? “Explaining the situation in a simple, clear and direct way, says Dr. Jérôme Marty, general practitioner and president of the French Union of Free Medicine (UFML). In practice, this could be in the form of a “Covid Weather Forecast”, with a bulletin each day, with colors to illustrate the degree of viral circulation, such as the next day’s weather with temperatures and rain. Except there, when the Covid weather turns orange or red, it would mean you have to put your mask back on. “

A proposal hailed by Antoine Flahault. “The image of time is very eloquent! We understand very well when rain is announced that you need to take an umbrella. The Covid weather would make it possible to manage risk in a more informed and wiser way. »A pedagogy to be integrated with 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 that indicated that certain barrier measures are restored from certain thresholds, it would be clearer for the public,” adds Antoine Flahault.

In the meantime, «we have to hammer the three situations in which we have to take the reflex to wear the mask, adds the epidemiologist. When you have symptoms, you wear it, especially because it limits the transmission of all respiratory viruses, as we could not see in the winter of 2021-2021, where strict compliance with barrier gestures with the use of the mandatory mask has extinguished other epidemics. winter. Then on public transport, always. And when the numbers go up, in closed places that welcome the public and poorly ventilated: meeting rooms, shared offices, classrooms or even teaching rooms, due to lack of investments to improve indoor air quality “. And “remember that we wear masks to protect others, and that if everyone wears it, others protect us in return,” Dr. Marty points out.

“A political responsibility”

But while waiting to arouse the accession of the French, should the mask be made mandatory again? “We are thinking about it, not thinking about it, but calculating what would be the advantages of wearing a mandatory mask compared to wearing a recommended mask”, explained Thursday Professor Brigitte Autran, president of the Committee for the monitoring and anticipation of health risks (Covars ), the body that succeeded the Scientific Council.

A possibility considered by the government. The health ministry “does not prohibit” such a measure, Minister François Braun said Tuesday, however assuring “to trust the French” to take protective measures on their own.

“We are now in a situation where experts are giving the alert, stressing that the simple recommendation is not being followed and that perhaps we should move to a more regulatory phase to finally be able to curb hospitalizations, deaths and Covid for a long time, notes Antoine Flahault . But making the use of the mask mandatory is a political responsibility. And with the end of last August of the state of health emergency under which this obligation was put in place, the government no longer has a legal instrument to do so, the epidemiologist develops. This measure must certainly be submitted to Parliament. “

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