Red, green... and orange - the colours of déconfinement
On 28 April, French PM Edouard Philippe outlined his government’s plans for easing lockdown. As part of the plan, he announced that the process would not be uniform across the national territory, for the very simple reason that the pandemic has not hit all of France in the same way. In order to deliver the promised easing from 11 May, France’s metropolitan (i.e. mainland) and overseas départements would be graded according to certain criteria and colour-coded to indicate the degree to which the lockdown could be relaxed. Initially, Philippe promised two colours, green and red, but by the time the first, provisional map was produced on 30 April, orange had been added (albeit temporarily), a very clear indication of the fluctuating nature of the risks and the possibility that any given department might tip back into the red quite easily.
Figure 1 - Red, orange and green departments - 30 April 2020 - from Le Figaro
To explain, the number attached to each department is the number allocated to it in the (more-or-less) alphabetical ordering used in France. If you have ever written a letter to someone in France, you will know the postcode is five digits - the first two refer to the department, the next 3 the postal area within the department. Thus, 19120 refers to the district of Beaulieu-sur-Dordogne (120), in the south-western corner of the Corrèze (19).
The three criteria driving the classification, as the legend on the map above from Le Figaro indicates are: i) the number of new cases in a department over a seven day period; ii) the pressure on beds available in regional resuscitation (réanimation*) units; iii) the capacity and state of readiness of testing and tracing at the local level.
As expected, the North and East of France are rated red, along with the Ile de France, most of Burgundy and the Franche-Comté. There is not a single green department east of the Dieppe-Marseille line, but the Lot (46) is an unexpected and contested outlier in the southwest, though the bordering departments of Dordogne (24) and Cantal (15) are yellow, as are the nearby Tarn (81) and the Gers (32). I’ll come to the reasons for this in a moment.
A red classification does not mean that the lockdown continues, but indicates that the degree of déconfinement will be severely limited and already the government has announced that middle schools (collèges) will not be allowed to open on the provisional date of 18 May if the depratment is rated red. Public parks and green spaces will also remain closed and while an attestation de déplacement will not be required (see past blogs for details on those), the government hopes that as many people as can work from and/or stay at home will continue to do so. Instead, in all departments, an attestation dérogatoire will be required for people wanting to make long journeys. Social distancing measures must be observed, as well as the wearing of masks in public. It is also hoped that people will use their common sense and limit their travel to essential journeys only. (Though judging by many of the calls to various radio and TV stations with questions about this, common sense, like gel hydroalcoolique, is in short supply.)
Figure 1 above shows the provisional headline situation on 30 April, but both Le Monde and Le Figaro have produced maps, based on statistics from Santé Publique France, that give a more nuanced picture. I’ll stick with the maps from Le Figaro because they are more lisible and it’s easier that way to make comparisons.
Figure 2 - Pressure on resuscitation unit beds - source: Le Figaro
Figure 2 gives a very clear picture of the rate of occupation of beds in resuscitation units. But it also, perhaps counter-intuitively, removes from the red and orange categories west of the Cantal, and also those along the lower Loire valley, which includes the Sarthe (72 - Le Mans), Mayenne (53 - Laval) and Loire-Atlantique (44, whose chef-lieu is the city of Nantes). In some of these one might have thought it was the lack of bed space that put them into the orange or red catgories. In fact not, as Figure 3, which shows the percentage of patients reporting to A&E with symptoms, indicates.
Figure 3 - ‘Viral activity’ by department
This is quite a crude measure, and as the health minister Olivier Véran announced on presenting the map and the criteria to the press, gauging viral activity will also be fed into by numbers being gathered by designated GPs, known as Sentinelles, general practitioners who have taken on the role of coronavirus troubleshooters, and also the number of postive tests in a department. But for now, the figures gathered over the last week are what put Cher (18), Nièvre (56), the Lot (46) and the north Corsican department of Haute-Corse (2B)** into the red, along with the overseas territory of Mayotte (976).
[Since publishing this piece, the figures for the Lot have been contested and public health authorities in the region have admitted they may have overestimated the number of patients reporting symptoms. That is why the map is provisional at this stage.]
The third criterion - the capacity on the ground to test and to trace - remains a very grey area. So too does what exactly the map will mean in terms of how local authorities will respond to easing the lockdown from one commune or department to the next. What, for example, will happen on the border zones between red and green departments or even communes? Nevertheless, local government leaders emerged from talks with the government on 29 April pleased with the degree of freedom and flexibility they have been given to work with. For now, the map is purely provisional and, in due course, the orange departments will turn green or red.
*Just as resuscitation units are known as resus in English, so réanimation becomes réa.
**Since the map appeared and I wrote this piece, it has been claimed that the figures for Haute-Corse are wrong and it should not be classified rouge.