MASK WEARING. If the eighth wave of Covid stabilizes at a high level, the National Academy of Medicine recommends wearing a mask in closed places in the face of fear of a strong epidemic of influenza and bronchiolitis.
[Mis à jour le 3 novembre 2022 à 11h04] “When the mask becomes necessary again”: this is the alert launched by the National Academy of Medicine, in a communicated published Wednesday, November 2, 2022. The institution is concerned about contamination that may occur if the mask is not restored in closed places. Despite the stabilization of the eighth wave of Covid, doctors are drawing attention to the high level of contamination, combined with the prospect of an early seasonal flu epidemic and the crisis in pediatric emergencies due to bronchiolitis. For these experts, the viral mixture of a “flu + Covid-19” co-infection appears to be particularly dangerous for people at risk.
The Academy therefore takes the side of wearing a mask, recalling that the obligation to wear this protection, combined with strict respect for barrier gestures, had allowed “a spectacular reduction in the incidence of influenza infections, gastroenteritis and bronchiolitis” during the 2020-2021 season. The organization therefore issues several recommendations, deemed necessary:
- the vaccination booster against Covid and the flu.
- wearing an FFP2 type mask in enclosed public spaces for people at risk (elderly or with comorbidity) or healthcare personnel and their entourage.
- the wearing of a surgical-type mask in health spaces and in closed spaces open to the public, in particular public transport.
- respect barrier gestures such as the use of hydroalcoholic gel.
As the Academy asserted, the eighth wave numbers are stabilizing. During its epidemiological point of Thursday October 27, 2022, Public Health France clarified that the incidence rate, that is to say the number of cases per 100,000 inhabitants, is down 14% in France. For its part, the effective reproduction number R is 0.89, which means that a patient infects less than one person and that the epidemic is declining. New critical care admissions are down 20% from the previous week, although the number of deaths is reported to have increased by 12%. Despite the decrease in the number of cases, “in the context of a circulation of SARS-CoV-2 remaining very active and with the approach of the winter period, compliance with combined measures remains essential”, writes Public Health France.
Thus, in addition to vaccination and isolation in the event of symptoms, SPF recommends wearing a mask in the presence of vulnerable people, in the event of crowding in closed spaces and during large gatherings.
However, public support for mask-wearing appears to be eroding over time. Thus, a study conducted in September 2022 by CoviPrev and published by Public health France early October shows that only 16% of respondents wore a mask in public (compared to 34% in May 2022). At work, 70% of French people said they no longer wear a mask (or do so less often) and 61% do not wear it on public transport, compared to 23% in May. More than half of those surveyed (52%) said they no longer wear the mask out of forgetfulness, but also because of a certain weariness.
At the beginning of October, Brigitte Autran, the president of Covars, also recommended that the French wear the mask again in public transport and in populated places, without however making it compulsory. She had called on the French to be vigilant with the wearing of the preventive mask and had revealed that the return of the compulsory mask was under study. The Minister of Health, François Braun, had also indicated that the mask could again be compulsory in public transport. “I do not forbid myself anything”, he had declared at the microphone of RTLOctober 4, 2022.
Is the mask compulsory on the plane, train, metro and other transport?
In its opinion, the Covars recommends wearing a mask to reduce contamination and notes that “Germany has made wearing a mask compulsory in public transport and is considering extending the list of places of obligation”. In airports, the mask is no longer compulsory as well as in planes, “it nevertheless remains recommended”, indicates Paris airport on its site. The SNCF also ensures that “wearing a mask is strongly recommended in our stations and on our trains”. Transit companies in several cities still suggest wearing a mask. “Let’s keep our good habits”, asks the RATP, in a press release published on July 18, 2022. Lyon public transport also advises wearing it in the metros, buses and trams. In Marseille, the RTM, the metropolitan transport authority, published a post on Thursday July 21 on its Twitter account asking to remain vigilant in the face of the virus. “Wearing a mask is strongly recommended network-wide,” she wrote.
There is no longer a legal framework for wearing a mask. As part of the law putting an end to emergency measures linked to Covid-19, the French can do without this respiratory protection device. On the other hand, wearing a mask remains “highly recommended”, as indicated by the Ministry of Health on Thursday July 28. This recommendation applies particularly to hospitals, stressed the ministry: “The mask remains, for the time being, very strongly recommended within health and medico-social establishments”. The largest hospital group in France, Assistance Publique-Hôpitaux de Paris (AP-HP) went further by declaring that wearing a mask would remain “compulsory” inside “its hospital buildings” for “staff, patients and visitors” in order to protect the most vulnerable.
The law on “monitoring and health security in the fight against Covid-19” was definitively adopted by Parliament on July 26. It includes a substantial reduction in most of the mechanisms for combating the virus: in fact, the text formally repeals, from 1er August, the part of the public health code relating to the state of health emergency as well as the system for managing the health crisis, marking the return to common law. The coercive measures of daily life provided for by these regimes – sanitary pass, obligation to wear a mask, confinement, curfew… – can no longer be restored. However, in the context of parliamentary debates prior to the adoption of this health law, the government reiterated its wish that the mask reflex “become the norm again” in “crowded places and public transport”.
If the return of the compulsory mask is not there, it is therefore still widely recommended by the government which encourages everyone to “continue to be vigilant”. The advice applies above all to “closed spaces”, when there are “a lot of people, especially in transport”, as the Prime Minister has explained on several occasions.. The text of the law also insists on the need to continue to apply barrier gestures to protect the most vulnerable. On the other hand, this new law clearly specifies that the wearing of a mask will not be the subject of a national measure of obligation. The Minister of Health François Braun does not rule out “making it compulsory again in the event that a” new dangerous variant “appears, as he confided to the Parisian July 17, 2022.
The government is therefore relying on the incentive lever, relying on the citizen reflex of wearing a mask. Health Minister François Braun appeals to “everyone’s good citizenship”. Wearing a mask is therefore “recommended” in transport, without obligation, just as in “enclosed places where we are in direct promiscuity”, according to the Minister of Health… As such, transport and shopping centers are included in the list of “enclosed places and large gatherings” where the mask is recommended for “frail people, because of their age or their pathologies” (as indicated by the government website). These recommendations are also a call for caution to avoid an epidemic outbreak during the holidays.
The return of compulsory mask wearing in Europe?
The return of the compulsory mask to our European neighbors is often a harbinger of an extension of the obligation in France. So what about Europe? Although it is not yet compulsory in France, some European countries have taken the plunge. One of our neighbours, Germany, has reinstated the obligation to wear an FFP2 mask from the age of 14 on long-distance trains. These level two masks should also be worn in hospitals and doctor’s offices; a negative test is also requested in these establishments, specifies the site of the German Ministry of the Interior. Now the Länder (the Federated States of Germany) have the possibility of taking strict measures, such as the compulsory wearing of a mask in public transport, currently being studied in France.
In Spain, the autonomous communities have the possibility of setting up a local health pass. At the national level, wearing a mask is compulsory in public transport or hospitals from the age of 6. In Italy, wearing the FFP2 mask remains compulsory on public transport, except by plane. The city of kyiv in Ukraine is also affected by the return of the coronavirus, the local authorities recommended, on October 3, the return of wearing a mask in public places such as in schools and public transport.
A new vaccination campaign
In addition, beyond the recommendations on wearing a mask, new vaccines from Moderna and Pfizer are included in the vaccine strategy. The High Health Authority recommends administering new booster doses for vulnerable people, which began on Monday, October 3, with the marketing of two new vaccines adapted to variants of the Omicron strain. François Braun, Minister of Health and Prevention, clarified the interest of these new vaccines, from the Moderna and Pfizer laboratories, at the microphone of France news. He indicated that this new vaccination campaign was in response to the “resumption of the circulation of the virus”, he added that it was therefore possible to set up as of Monday, October 3 “a new booster dose for the target populations”. .
They all have the distinction of being “bivalent” vaccines. This means that these vaccines are based on the original strain of the COVID-19 virus, but also on the Omicron BA.1, BA.4 or BA.5 variant. These vaccines are given as a priority to people eligible for the second booster dose. According to website data Public health France, the Omicron BA.5 variant is largely predominant with 91% of cases. In a communicated of September 20, 2022, the High Authority for Health wanted to be optimistic: “The clinical efficacy expected for these new bivalent vaccines is at least equivalent or even superior to that of the original monovalent vaccines”.
So who is eligible? Also in the HAS press release, it is indicated that the authority wishes to target three populations of individuals:
- people over 60 years old.
- adults under 60 at risk of a severe form of the disease: comorbidities, pregnant women, immunocompromised people, children and adolescents at high risk
- the entourage of these people, whether people in regular contact such as family or professionals in the health sector.
Other conditions are required to receive these booster doses. People aged at least 80, residents of nursing homes and immunocompromised people must have received their last injection at least three months ago. For the others, a period of six months is to be respected. The High Authority for Health has also maintained its previous recommendations for people under 30 years of age, favoring Pfizer vaccines for this category.