A resident puts on a face mask as a French riot police officer informs her of the mandatory face mask requirement in Marseille. Photo / AP
Faced with an increase in infections, especially among young adults, French health officials are expanding mask rules and warning against complacence.
As the two women sat in deck chairs enjoying the last rays of sunshine near the Canal de l'Ourcq in Paris on Sunday evening, nearby loudspeakers jolted them witha reminder that they were in a new mask-mandatory zone.
"You've got your mask?" Safiya Zenag, unmasked, asked her friend, who replied: "No, I didn't bring it. I hate wearing it."
Faced with a recent resurgence of coronavirus cases, officials have made mask wearing mandatory in widening areas of Paris and other cities across the country, pleading with the French not to let down their guard and jeopardise the hard-won gains made against the virus during a two-month lockdown this spring.
The signs of a new wave of infection emerged over the summer as people began resuming much of their pre-coronavirus lives, traveling across France and socialising in cafes, restaurants and parks. Many, especially the young, have visibly relaxed their vigilance and have not followed rules on mask wearing or social distancing.
In recent days, France has recorded about 3,000 new infections every day, roughly double the figure at the beginning of the month, and the authorities are investigating an increasing number of clusters.
But 30 per cent of the new infections are in young adults, ages 15 to 44, according to a recent report. Since they are less likely to develop serious forms of the illness, deaths and the number of patients in intensive care remain at a fraction of what they were at the height of the pandemic. Still, officials are not taking any chances.
"The indicators are bad, the signals are worrying and the situation is deteriorating," Jérôme Salomon, the French health ministry director, told the radio station France Inter last week. "The fate of the epidemic is in our hands."
Salomon warned that the virus would continue to circulate and that people would have to adjust their behavior. "We have to live with it,'' he said.
France suffered 30,400 deaths from the virus — one of the world's worst tolls — and experienced an economically devastating lockdown from mid-March to mid-May. Thanks to the lockdown, however, France succeeded in stopping the spread of the virus and lifted most restrictions at the start of summer.
Philippe Juvin, the head of the emergency department at the Georges Pompidou European Hospital in Paris, said he was not surprised by the rise in cases.
"You lock down people during two months, putting a stop to infections," he said. "Once people are again allowed to go outside, it is not surprising that infection quickly resumes."
The course of the pandemic in Europe has followed a somewhat similar trend, with Spain also reporting new local clusters. But important disparities exist among countries. In the past week, as France reported 20,000 new cases, Italy reported 7,000, and Britain, 3,000, according to data collected by The New York Times.
Mircea Sofonea, an epidemiologist at the French University of Montpellier, said today's situation had "nothing to do in terms of imminent health risk" with the situation that preceded the European lockdowns because the number of hospitalised coronavirus patients and deaths remains very low.
In France, the daily number of deaths has hovered around 15 in the past week. By contrast, at the height of the epidemic in March and April, hundreds died every day in France, with the toll sometimes rising into four digits.
In April, intensive care units were at 140 per cent capacity; only 7 per cent were occupied about 10 days ago.
Sofonea said all European countries were expecting a rebound of the epidemic in the fall, when people who have been away on vacation come back to work and when social interaction resumes.
The French authorities fear that the rising number of infections in young people, many of whom are asymptomatic, may contribute to the spread of the virus to older, more vulnerable people.
"Young people felt a little more invincible," said Olivier George, a 36-year-old baker. "That's probably what made them the most affected group."
Across the continent, crowds of young people are flocking to illegal parties organised in outdoor areas, regardless of the risk of infection.
While the number of new cases in France has been rising steadily, it is difficult to draw comparisons with earlier stages in the epidemic.
The number of tests being carried out across France has increased to about 600,000 a week — or about six times the numbers performed during the height of the epidemic. At that time, France suffered from severe shortages of test kits, making it impossible for many suspected of having Covid-19 to get tested.
Raphaëlle Escande, 23, a business school student, said she fell ill in March with symptoms of the disease, including the loss of smell, a sore throat and fever. "That lasted three weeks,'' she said. "I stayed home because you couldn't get tested.''
France's scientific council, a government body that advises President Emmanuel Macron on the coronavirus crisis, said in a report in late July that "the balance is fragile, and we can change course at any time to a less-controlled scenario."
The council warned that a second wave was "highly possible" in the fall, given the current trend.
The sharp rise in cases has led the government to declare Paris and the region of Marseille as high-risk zones, effectively granting the local authorities power to impose new measures aimed at containing the spread of the disease.
In Paris, mask wearing had been limited to public transportation and indoor establishments, as it was in the rest of the country. But the requirement was extended to crowded outdoor areas about a week ago, and further expanded across many more swathes of the city over the weekend.
Prime Minister Jean Castex warned last week that the country had been going "the wrong way" for the past few weeks, and said he wanted "to extend as far as possible the obligation to wear masks in public spaces."
The government's reliance on face masks as a main weapon in its fight against the virus amounts to an about-face in its strategy. Early in the epidemic, faced with severe shortages of masks, the government said they were useless against the virus — contradicting its own long-standing public health policies.
"I didn't find them coherent at all,'' said Laura Castel, 31, a high school teacher. "In the beginning, it was, 'Don't wear masks, they're not necessary.' But that's because we just didn't have masks, in my opinion.''
Now that France has more than sufficient supplies of masks, Castel said, the government was "singing a new tune.''
Perhaps because of the government's contradictory messages on masks, people were slow to start wearing them in newly mask-mandatory zones in Paris. Along stretches of the Seine over the weekend, only about half of pedestrians had their faces covered.
The police will be enforcing the measures — which will be in place for at least a month — with a fine of 135 euros ($245).
In addition to masks and tests, France now has other tools that were unavailable at the start of the epidemic, including contact-tracing teams and a contact-tracing smartphone application — though neither have been fully tested yet.
As the French learn how to live with the virus, health officials have adapted by quickly moving to extinguish local outbreaks and tightening restrictions as needed. The goal is to prevent local clusters from spiralling out of control and pushing France again into a national lockdown.
Anthony Rasoloarimanana, 40, a travel agent who was walking under the elevated metro tracks of Boulevard de la Chapelle in northern Paris, a new mask-mandatory zone, said he was worried that the recent period of resurgence was similar to the one just before the lockdown in March.
"Have the sacrifices we've made over several months been for nothing?" he said of the lockdown. "That would be terrible."