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At the height of its pandemic preparedness, France deployed a veritable arsenal of vaccines, antiviral drugs, and 2.2 billion surgical masks.
That was during the H1N1 flu scare in late 2009. Roselyne Bachelot, the health minister who oversaw the preparations, was right, but a decade earlier. That epidemic quickly faded, after killing “alone” 342 French. Bachelot’s political career was destroyed and politicians were wary of overreacting to health disasters.
More than 26,000 French have died in the Covid-19 pandemic. There are likely to be commissions of inquiry in both the Senate and the National Assembly. Thirty-two lawsuits have already been filed against government officials or “unknown persons” for alleged responsibility in the devastation caused by the pandemic.
France was repeatedly warned that this could happen, investigative journalists Gérard Davet and Fabrice Lhomme wrote in a week-long series in Le Monde about the country’s strategy to deal with a pandemic.
In the wake of the 2003 Sars epidemic, which killed about 800 people in Asia, a report by the Administration’s General Inspection (IGA) warned of the likelihood of a new disease, more deadly than seasonal flu, for which there would be no vaccine. In old videos that circulated during the pandemic, former President George W. Bush and Microsoft founder Bill Gates made similar predictions.
Fifteen years ago, the IGA advised the French government to prepare stock of masks “without delay.” The country must also stock antiviral drugs and pre-positioning machines in textile factories to make the highest quality FFP2 surgical face masks, according to the report.
Philippe Douste-Blazy, a physician, became Minister of Health in 2004. Douste drew up a crisis plan in response to the H5N1 avian influenza epidemic that included closing French borders, restricting movement, banning public gatherings, and encouraging barrier gestures and the use of surgery masks High-quality FFP2 masks were reserved for medical personnel, ordinary masks for the general population.
All of these measures were eventually, if belatedly, taken by the administration of President Emmanuel Macron this year.
Face masks are most effective when carried by a virus. But as a French parliamentary report pointed out in May 2005, putting masks on hand is “a way to reassure the population” that can “help limit the country’s paralysis.”
French official policy since January 2006 has been to encourage the use of masks during a pandemic. Infected people should wear surgical masks to protect their environment. Medical personnel should wear FFP2 masks to avoid contracting the disease. And the general public is instructed to wear a surgical mask or disinfected cloth in public “as a precaution.”
False alarm
In 2009, then-Health Minister Bachelot, a doctor of pharmacology, dramatically increased mask production, placed free kits containing antiviral drugs and masks in pharmacies, and ordered enough vaccines to inoculate 42 million people against the H1N1 virus. Fewer than six million French agreed to be vaccinated, and the virus disappeared on its own.
Bachelot was accused of wasting € 1 billion in public funds for what turned out to be a false alarm. The National Assembly, the Senate and the state auditor conducted investigations into what was considered a wasteful vaccination campaign, the “precautionary principle” went crazy.
“When the shit hit the fan it was so violent,” Bachelot told Le Monde. “I found myself completely alone, without a single follower. . . After what happened to me, politicians said it was more risky to do too much than too little. “
The High Council for Public Health (HCSP) confirmed in 2011 that facial masks were still essential to combat a pandemic. But three documents, from the HCSP itself, Xavier Bertrand, Bachelot’s replacement as health minister, and finally the SGDSN, the defense secretary that coordinates the emergency response to a pandemic, outlined a new doctrine.
The state was no longer responsible for storing FFP2 masks for medical personnel. The task would instead be left to hospitals and nursing homes. But in the wake of the 2008 economic crisis, medical establishments were ordered to control their budgets. Hospitals and nursing homes were unwilling to participate in the time-consuming process of issuing offers to tender large stocks of face masks that they could never use. The acquisition of all the masks was dropped into the proverbial administrative cracks.
The state’s stock of masks evaporated, from 2.2 billion in 2009 to 1.4 billion in 2011 to 714 million in 2017. Successive health ministers now blame each other for the debacle.
Jérôme Salomon was named CEO of Health by Macron in 2018 and has become known for his late-night television update on the pandemic. When Salomon was special adviser to the health minister from 2013 to 2015, he was haunted by the possibility of a pandemic. “We are all going to die,” said a sign in his office.
Salomon wrote a note to Macron in September 2016, shortly after Macron left the government to campaign for the presidency, predicting “a great natural event” that would overwhelm the government’s ability to react, with serious consequences for human life and the economy. Such an event “must be seriously planned and anticipated. France is not ready,” Salomon warned.
Surgical masks
However, the number of surgical masks in France has dropped six times since Macron took office, to just 117 million. About 600 million masks were destroyed because they had expired. Benoît Vallet, who preceded Salomon as director general of health, says he believes many of the masks could have been worn independently.
The Macron administration made the “triple mistake” of destroying millions of masks that could have been used, and of not renewing or increasing stocks, write Davet and Lhomme.
After gaining praise from the WHO in the 2000s as one of the best prepared countries in the world, France has struggled in 2020 with a shortage of intensive care beds, tests and protective equipment. The government’s response often seems slow and erratic.
Contributing factors were the absence of institutional memory, the lack of political courage, and the weakening of the organization that purchased and stored emergency medical supplies.
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