France lockdown: What went wrong and what can Canada learn?

Click to play video: 'WHO warns of ‘alarming’ rise in Europe’s COVID-19 cases'
WHO warns of ‘alarming’ rise in Europe’s COVID-19 cases
WATCH: WHO warns of 'alarming' rise in Europe's COVID-19 cases – Sep 17, 2020

How the coronavirus pandemic unfolded in France, Italy and Spain in the spring was seen as a preview of what was coming in Canada.

Europe was considered about two weeks ahead of North America in terms of cases and deaths and was largely shuttered as the virus spread. Eventually, Canada went into lockdown too, hoping abstinence from socializing would help quell the new disease.

But as France kneels to a second wave and a second lockdown, experts aren’t convinced we can “look over the fence to our neighbours” as a marker of our future anymore — at least not completely, according to Dr. Isaac Bogoch, an infectious disease expert based out of Toronto General Hospital.

“When we start to make direct country-to-country comparisons it oversimplifies the issue,” he said.

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“Yes, Canada is having a second wave. Yes, it’s unfortunate. But it’s not the same as France… There are big-picture lessons we can learn, but we can’t just say, ‘We shouldn’t do what France did.'”

Cases soar to April levels

France has “lost control” of coronavirus, doctors warned this week.

Increasingly, the country has seen consecutive daily cases above 50,000, well exceeding the daily coronavirus case tallies from the spring. On Tuesday, France reported the highest number of deaths related to the disease since April — 523 — bringing the national death toll well above 35,000.

Click to play video: 'Europe has record single-day surge in COVID-19 cases'
Europe has record single-day surge in COVID-19 cases

That loss of control was acknowledged Wednesday when President Emmanuel Macron chose to lock things up once again.

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The measures are tight. People must stay home except to buy essential goods, seek medical attention, or exercise for up to one hour a day. Anyone who leaves their home will now have to carry a document justifying them being outside, which can be checked by police. Unlike the first lockdown, however, schools will stay open.

But what makes this wave different from the first?

France, like many countries, has vastly expanded testing capacities since March, which experts say makes it difficult to compare spring numbers from fall ones. It’s the alarming rise in hospitalizations that paints a clearer picture of the severity of the situation.

In several French cities, hospitals are close to running out of ICU beds.

Critics say France hasn’t learned its lesson from the first wave. The nation’s overall ICU capacity — 6,000 — is roughly the same as in March, according to data reported by the Associated Press.

“When you get to this point, you’re left with fewer and fewer options,” Bogoch said.  “Lockdowns end up being the last.”

What went wrong?

It’s not easy to pinpoint, said University of Waterloo infectious disease specialist Zahid Butt, but “timing” plays a role.

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Butt said France’s response was delayed. Lockdowns are considered a last resort, he said, but there were few other preventative measures that preceded it. A curfew was imposed in select cities considered hot spots for the virus and a handful of “red zones” regions closed bars and restaurants.

But “if you’re seeing this degree of cases, you would have put more restrictions in earlier, so that you don’t have to go into lockdown,” Butt said.

Bogoch agrees.

“It looks like they took a bit of a laissez-faire approach and are paying for it now,” he said. “The error would be not to strike while the iron is hot.”

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That’s not the road Canada has chosen to take so far, Bogoch continued. Governments at all levels have and still are adapting, he said. The phased approach to reopening along with the more recent targeted, regional restrictions have helped prevent us from getting “out of control” to date.

“No one is taking a laissez-faire approach here,” he said. “But we’re not out of the woods yet, that’s for sure.”

Parallels with Canada

What’s happening in France — and why — does share some parallels with the resurgence of the virus in Canada.

The World Health Organization has suggested the increase could be partly due to the relaxation of measures and people simultaneously dropping their guard. Like Canada, young people are driving the second surge in France and much of Europe.

“A lot of this also depends on the public response to the pandemic,” said Butt.

“Pandemic fatigue” or “COVID fatigue” has been plaguing Europe for months. Researchers with the WHO estimate that about half the population of Europe is feeling burnt out from virus upkeep.

Click to play video: 'Coronavirus: WHO acknowledges pandemic fatigue, asks people not to give up'
Coronavirus: WHO acknowledges pandemic fatigue, asks people not to give up

It’s taking a toll on Canadians too. A recent poll found that nearly half of Canadians are getting tired of following public health recommendations and rules related to the virus.

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“One thing is for sure about pandemic fatigue — it’s everywhere,” Butt said. “That can have a really substantial impact on everything.”

Some experts believe the fatigue collided with something uniquely European — August holidays.

In much of Europe (especially Italy and France), cities are partially shut down in July and August, when locals tend to flock to beaches or fly south for sun. When cases diminished in the summer, many nations in Europe partially reopened their borders, mostly to other European countries.

Jeffrey Shaman, a professor of environmental health sciences at Columbia University, told Healthline that the surge is likely, in part, “a function of their August vacations.”

They were “co-mingling and not using face masks,” he said. “That’s what got the virus going again.”

It inevitably led to outbreaks, particularly in the French Riviera.

Canada saw its fair share of parties, gatherings and events leading to clusters of cases over the summer. The warnings about weddings and park parties morphed into warnings about Thanksgiving and Halloween.

Cautionary tale

Still, there are differences, particularly cultural ones, said Raywat Deonandan, an epidemiologist and science communicator based at the University of Ottawa. He said France’s COVID-19 burden isn’t surprising, pointing to distinctly different population densities compared to Canada.

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“More multi-generational dwellings means there is a faster spread from young to old. A greater tendency toward communal activity, like cafes and patios, and more crowded streets and venues also mean greater probability of community transmission,” he said.

But there are trends that will inevitably be seen here, according to Deonandan, though it probably won’t be to the same extent.

Click to play video: 'Coronavirus: Ontario to add nearly 800 additional hospital beds'
Coronavirus: Ontario to add nearly 800 additional hospital beds

Hospitalizations tend to lag behind increased virus cases, but they’re rising in parts of Canada. The impacts of those rising cases have yet to be realized, experts agree.

“By no means have we seen an overwhelming influx of patients with COVID-19 in hospital, but that’s always a possibility,” said Bogoch.

“We have to be prepared for something like that. We know with this virus things can change pretty quickly.”

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Ultimately, there’s no reason we shouldn’t be concerned by what we see in France, Deonandan added.

“By no means is it guaranteed that our future is their present,” he said. “But their reality is a cautionary example of what our future might hold.”

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