Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-15T21:27:39.806Z Has data issue: false hasContentIssue false

France's response to the Covid-19 pandemic: between a rock and a hard place

Published online by Cambridge University Press:  05 March 2021

Zeynep Or*
Affiliation:
Institute for Research and Information in Health Economics (IRDES), Paris, France
Coralie Gandré
Affiliation:
Institute for Research and Information in Health Economics (IRDES), Paris, France
Isabelle Durand Zaleski
Affiliation:
AP-HP Santé Publique Hôpital Henri Mondor, Paris, France
Monika Steffen
Affiliation:
PACTE, University Grenoble-Alps, Grenoble, France
*
*Corresponding author. Email: or@irdes.fr

Abstract

France is one of the European countries hardest hit by the Covid-19 pandemic. The pandemic brought into light structural weaknesses of the health system, including its governance and decision-making process, but also provoked changes that helped to improve its resilience. We analyse the French experience of Covid-19 in 2020 by critically reviewing major policy measures implemented during the first two waves of the pandemic. France has struggled to find the right balance between the rock of economic and social damage caused by containment measures and the hard alternative of a rapidly spreading pandemic. The response to the first wave, including a full lock-down, was an emergency response that revealed the low level of preparedness for pandemics and the overly hospital-centred provision of health care in France. During the second wave, this response evolved into a more level strategy trying to reconcile health needs in a broader perspective integrating socio-economic considerations, but without fully managing to put in place an effective health strategy. We conclude that to achieve the right balance, France will have to strengthen health system capacity and improve the cooperation between actors at central and local levels with greater participatory decision-making that takes into account local-level realities and the diversity of needs.

Type
Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

AP-HP (2020) ‘Assistance Publique–Hôpitaux de Paris’ response to the COVID-19 pandemic’. The Lancet 395, 17601761, Parisian hospitals group.CrossRefGoogle Scholar
Bergeron, H, Borraz, O, Castel, P and Dedieu, F (2020) Covid-19 : Une crise organisationnelle. Sciences Po Les Presses, Paris.CrossRefGoogle Scholar
Borowczyk, J and Ciotti, E (2020) Information report on the impact, management and consequences in all its dimensions of the Coronavirus-Covid 19 epidemic. ‘Rapport d'information déposé par la mission d'information relative à l'impact, la gestion et les conséquences dans toutes ses dimensions de l’épidémie de Coronavirus-Covid 19’. National Assembly. No. 1399.Google Scholar
Bounie, D, Camara, Y, Fize, E, Galbraith, J, Landais, C, Lavest, C, Pazem, T and Savatier, B (2020) Dynamiques de consommation dans la crise: les enseignements en temps réel des données bancaires, Focus, Conseil d'analyse économique, N°049-2020, October 2020.Google Scholar
Brun, S and Simon, P (2020) L'invisibilité des minorités dans les chiffres du Coronavirus: le détour par la Seine-Saint-Denis, in Dossier « Inégalités ethno-raciales et pandémie de coronavirus », De facto, Available at https://www.icmigrations.cnrs.fr/2020/05/15/defacto-019-05/ [21 January 2021].Google Scholar
Cette, G and Cohen, E (2020) Le plan de relance n'est ni de gauche ni de droite, Telos. Available at https://www.telos-eu.com/fr/economie/le-plan-de-relance-nest-ni-de-gauche-ni-de-droite.html [28 November 2020].Google Scholar
Courtejoie, N and Dubost, C-L (2020) Parcours hospitalier des patients atteints de la Covid-19 lors de la première vague de l’épidémie. Les dossiers de la Drees, No.67, 139. Available at, https://drees.solidarites-sante.gouv.fr/publications/les-dossiers-de-la-drees/parcours-hospitalier-des-patients-atteints-de-la-covid-19 [February 2021].Google Scholar
Dubost, C-L, Pollak, P and Rey, S (2020) Les inégalités sociales face à l’épidémie de Covid-19. Les Dossiers de la DREES, No. 62,. Available at https://drees.solidarites-sante.gouv.fr/IMG/pdf/dd62.pdf [27 January 2021].Google Scholar
Ehkirch, V (2020) Covid-19: comment les cliniques privées aident les hôpitaux durant la seconde vague? L'express. Available at https://www.lexpress.fr/actualite/societe/sante/covid-19-comment-les-cliniques-privees-ont-aide-les-hopitaux-durant-la-seconde-vague_2138611.html [27 January 2021].Google Scholar
French Academy of Medicine (2020) Pandémie de Covid-19: mesures barrières renforcées pendant le confinement et en phase de sortie de confinement. Available at http://www.academie-medecine.fr/communique-de-lacademie-pandemie-de-covid-19-mesures-barrieres-renforcees-pendant-le-confinement-et-en-phase-de-sortie-de-confinement/ [21 October 2020].Google Scholar
French government (2020) Projet de loi de finances rectificative pour 2020. Available at https://www.vie-publique.fr/loi/277070-lfr-4-loi-de-finances-rectificative-2020-4e-budget-rectificatif [27 November 2020].Google Scholar
French Ministry of Health (2020a) Interview of M. Olivier Véran, the Minister of Health, to France Info, on 29 April 2020, about the measures after the end of lock-down from 11 May 2020 onwards. Available at https://www.vie-publique.fr/discours/274295-olovier-veran-29042020-deconfinement-epidemie-covid [27 January 2021].Google Scholar
French Ministry of Health (2020b) Structures des urgences: éviter l'engorgement des services et empêcher la contamination croisée au sein des services. Available at https://solidarites-sante.gouv.fr/IMG/pdf/recommandations_pour_les_services_d_urgence.pdf [21 November 2020].Google Scholar
French Ministry of Health (2020c) Télé-santé dans les hôpitaux et établissements de santé. Available at https://solidarites-sante.gouv.fr/IMG/pdf/19_telesante_hopitaux_etablissements_sante.pdf [21 November 2020].Google Scholar
French Ministry of Health (2020d) Statistique annuelle des établissements de santé (SAE), base statistique. Available at https://www.sae-diffusion.sante.gouv.fr/sae-diffusion/recherche.htm [27 January 2021].Google Scholar
French Ministry of Health (2020e) Ségur de la santé: les conclusions. Available at https://solidarites-sante.gouv.fr/systeme-de-sante-et-medico-social/segur-de-la-sante-les-conclusions/ [25 October 2020].Google Scholar
French Ministry of Health (2020f) Interview de M. Olivier Véran, ministre des solidarités et de la santé, à France Inter le 29 octobre 2020, sur la mise en place du 2ème confinement. Available at https://www.vie-publique.fr/discours/277100-olivier-veran [27 January 2021].Google Scholar
French Public Health Agency (2020a) Coronavirus: chiffres clés et évolution de la Covid-19 en France et dans le Monde. Available at https://www.santepubliquefrance.fr/dossiers/coronavirus-covid-19/coronavirus-chiffres-cles-et-evolution-de-la-covid-19-en-france-et-dans-le-monde#block-266151 [21 November 2020].Google Scholar
French State Council (2020) Conseil d'État, 17 avril 2020, Port d'un masque de protection, commune de de Sceaux. Available at https://www.conseil-etat.fr/ressources/decisions-contentieuses/dernieres-decisions-importantes/conseil-d-etat-17-avril-2020-port-d-un-masque-de-protection-commune-de-de-sceaux [27 January 2021].Google Scholar
Gandré, C, Coldefy, M and Rochereau, T (2020) Inequalities in the risk of onset of psychological distress during the lockdown linked to Covid-19 outbreak. First results of the Coclico survey conducted between 3 and 14 April 2020. Issues in Health Economics, 18, No. 255.Google Scholar
Gay, R and Steffen, M (2020) Une gestion étatique centralisée et désordonnée: France. Chronique internationale de l'IRES (Special issue: Les mobilisations sanitaires des Etats et de l'Union européenne face à la première vague de Covid-19) 3, 122138, No. 171.CrossRefGoogle Scholar
INED (2020) La démographie des décès par Covid-19. National institute for demographic studies. Available at https://dc-covid.site.ined.fr/fr/donnees/france/ [21 January 2021].Google Scholar
INSEE (2020) Conjoncture française. Emploi – chômage. National institute of statistics and economic studies. Available at https://www.insee.fr/fr/statistiques/4653872?sommaire=4473296 [21 January 2021].Google Scholar
Milon, A, Deroche, C, Jomier, B and Vermeillet, S (2020) Report for the president of the Senat, Commission of inquiry on public policies against major pandemics in light of the health crisis of Covid-19 and its management [‘Commission d'enquête pour l'évaluation des politiques publiques face aux grandes pandémies à la lumière de la crise sanitaire de la covid-19 et de sa gestion’], Sénat, No. 199, Tome 1.Google Scholar
Pittet, D, Boone, L, Moulin, AM, Briet, R and Parneix, P (2020) Report for the President of the Republic, Independent mission on the evaluation of the management of Covid-19 crisis [‘Mission indépendante nationale sur l’évaluation de la gestion de la crise Covid-19 et sur l'anticipation des risques pandémiques’]. Preliminary report.Google Scholar
Racapé, A (2020) Covid-19 : en Côte-d'Or, la coopération s'accélère entre les hôpitaux privés et publics, France Bleu. Available at https://www.francebleu.fr/infos/sante-sciences/covid-19-en-cote-d-or-la-cooperation-s-accelere-entre-les-hopitaux-prives-et-publics-1606117620 [27 January 2021].Google Scholar
Rouquet, A (2020) Covid-19 : « De toute évidence, la stratégie vaccinale française se fracasse contre le mur du réel, Le Monde. Available at https://www.lemonde.fr/idees/article/2021/01/06/vaccins-le-gouvernement-a-essaye-de-cacher-une-faillite-logistique-par-une-communication-maladroite_6065314_3232.html [27 January 2021].Google Scholar
SHI (2020a) Croissance record du recours à la téléconsultation en mars. Social health insurance fund. Available at https://www.ameli.fr/fileadmin/user_upload/documents/20200331-CP_Teleconsultations_Covid_19.pdf [21 November 2020].Google Scholar
SHI (2020b) Téléconsultation et Covid-19: croissance spectaculaire et évolution des usages, Social health insurance fund. Available at https://www.ameli.fr/medecin/actualites/teleconsultation-et-covid-19-croissance-spectaculaire-et-evolution-des-usages [25 November 2020].Google Scholar
SHI (2020c) Dépistage de la Covid-19 : déploiement des tests antigéniques. Social health insurance fund. Available at https://www.ameli.fr/pharmacien/actualites/depistage-de-la-covid-19-deploiement-des-tests-antigeniques [21 January 2021].Google Scholar