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HEALTH

ANALYSIS: Is France right to keep its schools open during the pandemic?

As France considers once again tightening its Covid-19 restrictions, the country's schools have reopened after the holidays - contrary to the policy in several other European countries. So how much virus spread is there in schools in France?

ANALYSIS: Is France right to keep its schools open during the pandemic?
Pupils in French schools have worn face masks since schools reopened in September. Photo AFP

January 4th marked the return to school in France after a Christmas break where families across the country got together for the first time in a long time, following weeks of lockdown.

The period of holiday socialising will likely cause a future spike in Covid-19 numbers, scientists have warned.

But despite pushing back the dates of reopening not only restaurants, bars, but also cinemas, theatres and other cultural establishments, President Emmanuel Macron’s government decided against keeping children at home.

“The situation has shown that there was no particular infection in schools,” said Education Minister Jean-Michel Blanquer on December 20th.

 

Since schools reopened in September, the government has reiterated the message that keeping children in school was safe, both for the children themselves and their families. 

Other European countries – albeit ones that are currently in a worse Covid situation than France – have decided otherwise. The UK, Ireland, Germany, Italy, Austria and the Netherlands all have delayed returning children to the classroom.

So is France different, and – if yes – why is that?

1. What we know about children and Covid-19

“Children can be infected and infect others, so reopening schools means increasing the risk of infection,” Pascal Crépey, an epidemiologist at the Ecole des Hautes Etudes en Santé Publique, told The Local.

“What we know is that children are much less likely to be symptomatic. And when you are less symptomatic, you are less likely to be contagious.”

While research seems somewhat divided on this point, it is the opinion of France’s state health council, Haut Conseil de la Santé, that children are neither prone to become seriously ill from Covid-19, nor are they likely to infect adults.

The Council's stance is based on scientific findings that that young children have lower viral loads. This does not mean they are not contagious when they carry Covid-19, but it means they unlikely to develop severe forms of the virus. 

Scientists in the UK recently published a report that backed this up. It said up to 70 percent of children infected with Covid-19 could be asymptomatic, which means they could have the virus without showing any symptoms.

Professor Martin Hibberd of the London School of Hygiene and Tropical Medicine told the Guardian that the proportion of asymptomatic Covid-19 cases was “probably more like 50 percent for those in secondary school while for boys and girls in primary school, around 70 percent may not be displaying symptoms even though they have picked up the virus”. 

Hibberd agreed that this could mean that children were also less likely to pass the virus on to others.

“It's a real possibility but we cannot yet be sure,” he said.

2. What we learnt from the second wave of Covid-19

Among the evidence that backs this up are the differences in the first and second waves of Covid-19 infections in France. During the first wave of the virus, the country kept schools closed throughout spring, only returning small groups of pupils back to class in June. Attendance was not mandatory, and anxious parents could continue to homeschool their children.

In September the government changed its strategy and reopened all schools with compulsory attendance. Too many children had fallen behind during the first lockdown, Macron said during a speech in which he stressed the crucial importance of education in reducing social inequality in France.

“It was kind of working,” Crépey, who has studied the impact of lockdown, said about the government's strategy to reopen schools. “We did not see a massive number of clusters in schools and it did not seem to impact the lockdown itself.”

In fact, the less rigid lockdown this autumn had roughly the same effect as the strict lockdown in spring in terms of bringing cases down to manageable numbers.

The below graph shows how the number of Covid patients in hospital fell sharply once both lockdowns were introduced. Hospital numbers is a more accurate comparison than case numbers, since testing has ramped up hugely between the first and second waves.

 

While schools reopened bars, cafés, restaurants, gyms and cultural spaces like cinemas and museums all remain closed and – until December 15th – people were only permitted to leave home for essential reasons.

But France did not simply reopen schools without restrictions. The government put strict health rules in place, with teachers and children over 11 years old having to wear protective face masks in school at all times (this was later changed to all children aged six and over). 

READ ALSO: What you need to know about France's Covid-19 health rules in schools

 

Later, universities closed and high schools introduced partial home schooling due to increased levels of viral spread in France.

3. What we know about Covid-19 clusters in schools in France

In his interview just before Christmas, Blanquer said “less than 0.2 percent of primary, secondary and high schools” had closed since the beginning of the school year on September 1st, which he called “a fine victory of education”.

Dozens of schools and hundreds of individual classes closed in France shortly following term start in September after they reported to have cases of Covid-19 among their pupils or staff. After the government raised the bar for closing a en entire school or class, the number dropped.

The most recent breakdown of Covid clusters in schools – in a weekly report from Santé Publique France published on November 12th – schools and universities accounted for 1,280 clusters out of 9,055 in total.
 
This was less than nursing homes for elderly (2,006) and private businesses (1,928), but more than health establishments (1,059), families (218) and public and private gatherings (445).
 
However France has 7,200 Ehpad nursing homes and 61,510 schools, according to government data.

In the same report, Santé Publique France said a November spike in Covid-19 cases in the age group 2-14 was “probably linked to the return to school after the school holidays” that autumn.

4. What we don't know

One of the main criticisms regarding Covid-19 transmission in schools is that there is little research breaking down the exact level of spread in educational establishments in France. In order to get that, there would need to be mass testing of pupils at random, in order to reveal the asymptomatic cases.

How big of a role schools play in spreading the virus has been rendered more uncertain by the new strain of Covid-19 virus discovered in the UK – later found to have spread to France and several other European countries – which scientists say is spreading more among younger parts of the population.

In a recent report, scientists at the Centre for Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine warned that a national lockdown imposed in England in November was unlikely to prevent an increase of infections “unless primary schools, secondary schools, and universities are also closed”.

Other scientists too have warned of the risks of reopening schools as Covid-19 rates are on the rise across Europe.

Antoine Flahault, a renowned epidemiologist and director of the Geneva Institute, which monitors Covid-19 in the world, warned European countries against repeating the same mistakes as in January.

“Let's not reopen schools in the beginning of January,” he wrote on Twitter. “Let's vaccinate, vaccinate first. Let's accelerate the vaccination.”

 

But the decision to reopen schools in France was calculated, Crépey said.

“One of the reasons schools are closed in the UK is that they are absolutely not in the same epidemic situation as us. The UK is facing a massive resurgence.”

“For the moment, France can afford to keep schools open, from an epidemic point of view,” he said, adding:

“Of course, if the situation worsens it could become necessary to close schools again.”

 

Member comments

  1. Multiple cases of Covid in nearby schools (SW rural France) and not only were schools not shut down there was almost no contact tracing and parents were told after the fact. Parents face prosecution if they don’t send their kids in despite teachers saying that – particularly for maternelle age children – it is almost impossible to stick to the health protocols. A terrible situation.

  2. I will be forever grateful for France’s sane approach to keeping schools open and putting a high priority on education.

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HEALTH

How serious is the threat from dengue fever in France?

As tiger mosquitoes are now present in over 80 percent of mainland France, health authorities are worried that local transmission of tropical diseases, like dengue fever, will increase.

How serious is the threat from dengue fever in France?

As of January 2024, tiger mosquitoes – known for their ability to carry diseases such as dengue, chikungunya and Zika virus – had been detected in 78 of France’s 96 mainland départements, including the Paris region.

This has left public health authorities concerned about the spread of dengue fever in France, particularly this summer as large crowds are expected amid the Olympic Games.

READ MORE: MAP: Tiger mosquitoes reach northern France

How common is dengue fever in France?

In the first four months of 2024, 1,679 cases of dengue fever were identified in mainland France, a number that is 13 times higher than the same period last year, Le Parisien reported.

Crucially, however, none of these are believed to have been contracted in mainland France – they were all reported among patients who had recently travelled from the tropical regions where dengue fever is common.

The majority of cases were from people who had visited the Caribbean islands of Martinique and Guadeloupe – where the disease is endemic.

These islands are for administrative purposes part of France – so often show up in French health data – but they are roughly 7,000km away from Paris.

So far, there have not been any indigenous cases (autochtone – or people infected on mainland French soil) yet this year.

Local transmission of the disease remains relatively rare. In 2023, nine separate outbreaks of indigenous dengue transmission were identified, one of which occurred in the Paris region. These led to 45 cases of local transmission (in mainland France).

Most were in southern France – in the Provence-Alpes-Côte d’Azur, Occitanie and Auvergne-Rhône-Alpes regions – though one outbreak occurred in the Paris region, according to French public health authorities.

This is less than 2022, which was a notable year with 66 total cases of indigenous dengue fever were recorded. In comparison, between 2010 and 2021, only 48 cases (total) were recorded.

What to expect for 2024

Experts believe that the number of cases in France, including indigenous ones, will grow this year, as tiger mosquitoes now occupy more territory in mainland France.

On top of that, the number of cases has increased significantly in Martinique and Guadeloupe.

“What we see in France is a mirror image of what is happening in the French Caribbean, and more widely in Latin America and the rest of the Caribbean, where dengue fever has been circulating since the start of the year at unprecedented levels”, the head of Santé Publique France, Dr Caroline Semaille, said during a press conference.

The Olympic Games will also bring an influx of tourists from all over the world, and weather conditions are expected to be conducive to mosquitoes – a year with a lot of rainfall, and potentially high temperatures. 

What is dengue fever?

The disease is spread to people from bites by infected mosquitoes.

The most common symptoms are high fever, chills, abdominal, joint and muscle pains, and vomiting. It can also cause a skin rash that resembles measles, according to France’s Institut Pasteur.

Symptoms usually begin three to 14 days (with an average of four to seven) after being bitten.

However people are asymptomatic in 50 to 90 percent of cases (depending on the epidemic), which can make monitoring difficult.

At-risk groups include the immunocompromised, children and the elderly, who are more likely to suffer from severe forms of the disease.

Deaths from the disease are very rare, occurring in around 0.01 percent of all cases, almost all in countries that have poor healthcare systems.

How can I avoid tiger mosquitoes?

Female tiger mosquitoes lay their eggs in water, and they can lay several hundred eggs at once. Therefore try to avoid having any standing water outside your home and be aware of the items that might collect rainwater.

This includes regularly emptying vases, flower pots, as well as watering cans and pots. If you want to collect rainwater, you could cover water butts with mosquito nets or fabric to keep the mosquitoes from getting inside.

READ ALSO 5 plants that (allegedly) repel mosquitoes

You can also keep your gutters clean – this helps to keep the water flowing when it rains, and it avoids any stagnant pools from building up.

To protect yourself, try to wear long, loose and light-coloured clothing, in addition to insect repellent. You might also consider wearing a mosquito net head gear.

The main difference between tiger mosquitoes and other species would be getting a bite during the day, and the fact that tiger mosquitoes are likely to bite several times. You can tell for sure if it was a tiger mosquito by seeing the insect itself. They are also silent.

There is no immediate cause for alarm if you are bitten, in almost all cases the bites are just itchy and annoying. In very rare cases, tropical diseases can be spread by the mosquitoes – seek medical help if you develop a high fever and rash.

READ MORE: How to prevent the spread of tiger mosquitoes in France

What do tiger mosquitoes look like?

They are very small, about 5 mm, and they have a highly contrasting colour, with black and white stripes on their body and legs.

If you believe you have spotted a tiger mosquito, you can report it to public health authorities online.

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