Scientific Council’s four scenarios for the coming months

In a communication published online on Thursday, the Swedish Research Council describes “four possible scenarios” in France in the coming months regarding the Covid-19 epidemic. From an “under control” situation to a “critical” sanitation moment, France 24 explains the various options considered.

The Scientific Council, which is responsible for supporting the public authorities in dealing with the Covid-19 crisis, issued a new statement to the government on June 2, posted Thursday, June 4th. “The purpose of this opinion is to identify the various probable scenarios during containment,” the council said in its preamble.

These “four possible scenarios” aim to “prepare and anticipate the actions to be taken” to avoid further containment.

  • An “under control” epidemic

This scenario, the most optimistic among the four vulnerable, is also what seems to be favored by the public authorities: From May 29, Public Health Agency France confirmed that there were “no signals for” a resumption of the epidemic “from Covid-19. Similarly, the President of the Swedish Research Council, Jean-François Delfraissy, declared on Friday 5 June that the virus was “under control”.

This scenario requires health indicators that “must be stabilized over a sufficiently long period” – at least two months – to confirm that the situation is under control, according to the Council.

Number of emergency visits for Covid-19, new hospital patients, emergency hospital patients, intensive care patients, number of daily PCR tests … These indicators, which have been used for some of them since March last year, must be the “signals from” Control of the spread of the epidemic “which indicates a “low level of circulation” of the virus in France, “with a stable or declining trend, with no problematic clusters,” estimates the Swedish Research Council.

In this scenario, the opinion recommends that two measures be maintained “at their current level”: the application of barrier gestures to the entire French population and the “test-track-isolate” strategy of the health authorities.

  • A local recovery of the “critical cluster” epidemic

This intermediate scenario is “likely in the coming weeks”, estimates the Scientific Council based on “what has been observed in Germany and some Asian countries“the last weeks.

The Council elicits the special vigilance that the public authorities should have towards “critical clusters”, pockets of local pollution with “a very rapid, almost explosive dynamic”. In this scenario, “depending on the risk assessment”, the Board proposes an “early, rapid, massive and targeted response in a geographical area.”

Several levers should then be activated in a “combined” way: barrier gesture reinforcement, a massive “test-track isolate” strategy – “practice of testing cannot be limited to symptomatic cases of populations around the cluster”, the council estimates – a proactive attitude towards the insecure populations, as well as a local containment early enough.

The necessity of this scenario is to “control virus circulation and limit the number of cases exported from the identified critical cluster” to avoid a resumption of the epidemic at national level.

  • A resumption of the “low noise” epidemic

This scenario is possible for “a sufficiently large territory” such as a French region or the whole country, explains the Scientific Council. It would consist of a “diffuse recovery” of the epidemic in this given geographical area, combined with a lack of monitoring of Covid-19 transmission chains.

“This resumption of the epidemic rather reflects a relaxation of the measures to control the virus circulation of the population, which allows for an active resumption of the transmission of the virus and in a diffuse manner,” estimates the Council, for which the progressive resumption of displacements of people from a region to another may “encourage the spread of the virus” in this scenario.

Two indicators can preset this situation: the rapid increase in the number of tests performed per day in the affected geographical area, as well as the significant and observed increase in the number of positive tests over time compared to the number of tests performed.

Well, to avoid a reconfiguration similar to that experienced by France in weeks, in this scenario, the Scientific Council recommends “a change of strategy” with the activation of several measures in a strengthened prevention and protection plan (or all depending on the seriousness of the situation): reinforcing barrier measures; strengthening of “test track insulation”, protection of nursing homes, strengthening the responsiveness of public and private hospital structures …

If these measures had no impact on the epidemic recovery situation, “the issue of generalized containment and the conditions under which it must be reactivated will arise,” the Council estimates.

  • “Critical moment” for the epidemic and reconfiguration

This scenario is the most pessimistic and the result of the failure of the measures described in scenario 3, intended to prevent the spread of the epidemic. In this perspective, “the number of cases continues to increase and we arrive at the” critical moment “when, according to the Scientific Council, the authorities must decide whether they want to establish a second containment to avoid the overflow of intensive care.”

However, the possibility of reconfiguring the entire French population is considered by the Council “neither desirable nor feasible on health, social and economic issues”. But in scenario 4, the authorities have to make decisions to “avoid the abundance” of intensive care, as was the case in Grand Est or in Île-de-France several weeks ago.

The “serious decision” on a new containment should be taken into account, on the one hand, the “health effect” of the Covid-19 epidemic and, on the other, “the impact of a second restriction on French society”, according to the Council.

In this scenario, the authorities should also be aware of the goal pursued in the event of new containment: if it is “just to reduce the mortality associated with the virus, imprisonment will be” permanently or extremely early always preferred, “estimates the Scientific Council. And he specifies: “An alternative goal is to assume a surplus of hospital mortality Covid-19 in connection with the resuscitation services being tense.”

Finally, the Council recalls the “importance of anticipating” “in order to better protect” and to avoid a new critical situation, which “absolutely must be avoided”.

This expectation is based on the plan for improved prevention and protection. In seven parts, this plan makes it possible to prepare measures that the authorities will be able to activate gradually or massively depending on the characteristics of the epidemic in the coming weeks. These measures must be “drafted now”, “with stakeholders, especially territorial measures”, in order to “activate them as quickly as possible” “if necessary”, insists the opinion of the Swedish Research Council.