Tempers fray over France’s vaccine strategy

France’s vaccination campaign, which has been heavily criticised for its slow progress, is beginning to reduce Covid-19 infections, hospitalisations and deaths among people over 80. But with cases rising among younger adults, the government must decide whether more restrictions are needed to contain the spread of the virus. 

President Emmanuel Macron tried to sound optimistic on Monday when he was asked by a young man in the Paris suburb of Stains whether the government could make life easier by having the 6pm-6am nationwide coronavirus curfew start an hour later each night. “We have to hold on for a few more weeks, four to six weeks,” Macron said. 

A few hours later, Macron’s health minister Olivier Véran had to spell out the bad news: the target date was a minimum, and people should not count on any relaxation soon because “the curfew and the current restrictions will be in place for at least the next four to six weeks”. 

Since the New Year, France has teetered on the brink of imposing lockdown measures as demanded by many doctors and epidemiologists, and as adopted in Germany and the UK, but so far rejected by Macron. He hopes that vaccinations and existing controls — including the continued closure of restaurants and bars — will be enough to protect hospitals from an unmanageable surge of new Covid-19 patients. 

Gendarmes try to disperse Parisians along the River Seine last week. President Emmanuel Macron is wary of imposing another nationwide lockdown on a weary population © Thomas Coex/AFP /Getty

More than 85,000 of France’s 67m people have been killed by the pandemic in the past year, but Macron is wary of imposing another nationwide lockdown on a weary population. There has been a fierce debate in recent weeks over the merits of his determination to keep schools open unlike elsewhere in Europe, but at the same time many French flout the current rules by holding secret parties or ignoring the curfew. Nor does the president want to inflict further damage on the economy.

“It’s a risky bet but remains similar to strategies seen elsewhere in Europe,” said Antoine Flahault, director of the Institute of Global Health at the University of Geneva. “Basically leaders wait till the situation is extreme to respond with tough measures — as in the UK or Portugal around Christmas.”

Chart showing a clear vaccine effect in France: cases, hospital patients and deaths are now falling in older groups while climbing among younger ones

Flahault recommends a “zero Covid” strategy of complete suppression, not least because of the rapid spread in Europe of new variants of the virus. These variants are more infectious than the early forms of the virus and in some cases will sap the effectiveness of the vaccines slowly being rolled out across the continent. 

“The situation is very tense because it can escape from control at any moment with an exponential rise in the infection curve,” he said, noting that new cases in France had risen from an already high plateau of about 11,000 per day in December to 20,000 now, which made it impractical to trace contacts or contain clusters. In the UK, which has a similar-sized population, the latest data show nearly 6,400 new cases per day.

After two nationwide lockdowns in the spring and autumn of last year, the French government has so far this year adopted a piecemeal approach to dealing with steadily rising infections. It has imposed weekend-only lockdowns on Dunkirk in the north and Nice in the south and placed 20 départements, including the whole of the Paris region, under increased surveillance.

Chart showing that in France’s autumn wave we saw the opposite pattern: rates among older groups fell more slowly, emphasising how the pattern we’re seeing now is almost certainly driven by vaccines

If Macron’s lockdown decisions have had mixed reviews — some in France say they are too strict and others insist they are not strict enough — his handling of the other anti-Covid weapon at his disposal, vaccination, has been roundly condemned on all sides. 

That is partly because the EU as a whole has been slower than the UK and the US in producing and procuring vaccines, which has left Macron and Clément Beaune, his Europe minister, on the defensive as they sing the praises of the EU’s joint procurement policy. 

“The message here is, ‘We have to show that the EU works and is benefiting us,” said Georgina Wright of the Institut Montaigne think-tank in Paris. 

Yet even when compared with its EU neighbours, the country’s vaccination programme has fallen short. “This is the biggest problem for France,” said Wright. “It’s shocking and it really is a French problem.” 

France has struggled to accelerate its vaccination campaign since it began in late December, but still aims to have offered a jab to all adults who want one by the end of summer. 

The country has administered 6.7 vaccine doses per 100 people in its population as of February 28, according to Our World in Data, putting it at the back of the pack in the EU and far behind global pacesetters such as the UK with 31, the US on 23 and Israel on 95. In Europe, Denmark had managed 10.8, Spain 8.2, Germany 7.6, and Italy 7.2.

Health officials in France insisted one reason for the slow rollout is that they initially focused narrowly on the elderly living in care homes and the otherwise vulnerable. They also believed they had to move carefully given the exceptionally high levels of scepticism about vaccines among the French.

Another more embarrassing reason is France’s failure to make the most of the AstraZeneca vaccine deliveries that began arriving a month ago and will increase significantly in March and April. Macron himself said wrongly at the end of January that all the indications were that AstraZeneca was “almost ineffective” for the over-65s, when in fact there was simply insufficient data at the time. 

This week the government reversed its decision not to use AstraZeneca for the over-65s, and the pace of vaccination is expected to pick up. Still, as of Monday, France had used only 24 per cent of the 1.1m Oxford/AstraZeneca doses it had received, according to health ministry data.

In contrast, France had used about 90 per cent of the 4.2m doses of the BioNTech/Pfizer vaccine it has received to date. 

“France managed the first part of the pandemic better than the UK, but the second part, since we’ve had vaccines, has been much better managed in the UK than in France,” said Nicolas Bouzou, economist at consultancy Asterès. “They added errors on top of errors on vaccination.” 

The question now is whether the French vaccination programme can be accelerated in time to avert the need for harsh new lockdown measures. 

“The bet that the infections will fall with current restrictions is not totally impossible so political leaders may pin their hopes on it,” said Flahault. “But if the infections surge then these countries will have lost valuable time.”

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