Coronavirus: Can We Manage a Health Crisis Without Quantified Objectives?

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Emmanuel Macron does not want to set health criteria for the reopening of schools

EPIDEMIC: Emmanuel Macron and the government no longer give quantified targets after the announcement of new measures, which is not without problems

  • Since the 5,000 cases per day and the 3,000 people in resuscitation, caps set during the second confinement, no quantified objective concerning the coronavirus pandemic has been given by the government.
  • Tuesday, Emmanuel Macron added vagueness around health indicators by revealing that the reopening of schools would be decided independently of the figures of the epidemic.
  • Is this visual navigation dangerous?

Tuesday, Emmanuel Macron told the  Parisian: “I did not condition the reopening of kindergartens and schools, then colleges and high schools, to health indicators. “When the third confinement was announced last week, already, the head of state had not given any quantified target to be reached in order to lift the restrictive measures against the coronavirus. And this unlike the second confinement, between October and December 2020, where the limits of 5,000 cases per day and 3,000 people in intensive care had been given by the president.

An objective that had not been achieved moreover. Admittedly, France had returned below the bar of 3,000 patients in intensive care, but it had not approached 5,000 cases per day. The second confinement was however lifted on December 15, probably to “save” Christmas and the economy of gift purchases, while France was running around 10,000 cases per day.

Vaccination as an exception

Since this failure, quantified objectives, there are no more. Incidence levels (and corresponding alert levels) do not result in automatic measurement. No numbers are required to make or reverse a decision. Mortality or hospital saturation are only commented on in terms of increase or decrease, never as levels not to be exceeded. Only vaccination keeps fixed and indicated objectives: 10 million people vaccinated in mid-April, 20 million in mid-May, and 30 million at the end of June. Can this health policy, without precise limits, ultimately be effective?

“We need goals because the measurements are gradual, so they have to be used in specific situations. It is important to define these situations in a clear and objectifiable way – with figures, therefore – and the corresponding measures ”, pleads Hélène Rossinot, a doctor specializing in Public Health. Fixing the exit from confinement to such and such a result, the reopening of non-essential places to another, is to justify why we take such and such a decision. It is currently difficult to know whether a measure is working or not, as it is not given any clearly identifiable goal, apart from the very vague “decrease the circulation of the virus”.

What to jump the researcher in epidemiology Michaël Rochoy: “We sail by sight. We do not know what justifies such action, why the closure of schools was decided last week and not before, nor what will have to be presented as a result to get out of the third confinement. ”

Heading or not heading?

This is perhaps one of the main effects of the absence of quantified objectives in the government strategy: the absence of visibility. Example with the interminable curfew implemented in the country for months, and which no one can say what will allow it to be lifted. Michaël Rochoy: “Without a goal to achieve, you don’t know where you are going or when it will end, and there is this feeling of an endless day. A goal is also a finish line. “Hélène Rossinot wonders about the support of the population:” Without a goal, there is less motivation and less understanding of the measures. ”

Certain figures certainly deserve to be questioned. “We can question the incidence or the number of cases per day, set targets in terms of mortality or resuscitation, that can be understood,” resumes Michaël Rochoy. But we cannot compose without health indicators ”. Especially since France has many tools in this area. And the epidemiology researcher wondered: “What is the point of testing so many people so as not to then use them as a point of reference?” ”

Breaking free from sanitary

This visual navigation seems to echo an increasingly marked separation between Emmanuel Macron and the scientific community. Tackling the Scientific Council, criticism of caregivers, a reminder that not everything can be dictated by health… Michaël Rochoy says ironically: “We feel a desire to emancipate ourselves from science, but compose without health data in a… health crisis may not be the idea of ​​the century. ”

Hélène Rossinot recalls: “Of course there are other factors to take into account, but it is ridiculous to oppose health and economy or social in such a crisis. The economy, as well as the mental health of the French, will be better when we are out of the crisis. It remains to be seen when.

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