On Easter Monday, Emmanuel Macron promised lockdown-fatigued French citizens their liberation from strict quarantine restrictions would start in mid-May. But his scientific adviser has since attached a mighty condition: that the country treble its capacity to test the coronavirus responsible for the world’s worst pandemic since the 1918 Spanish flu.
Jean-François Delfraissy, who chairs the scientific committee advising the government on lockdown exit plans, has assessed that the country needed to perform 500,000 tests per week by May 11 — Mr Macron’s tentative date for loosening the restrictions — to measure the spread of Covid-19 and keep it under control. Currently, the country can test only about 150,000 people a week.
“France failed on testing in February because it didn’t have enough of them . . . We have to set ourselves up for success this time,” Mr Delfraissy told MPs last week.
France’s struggles reflect a global race for testing kits as European countries and the US envisage ways to ease movement restrictions now that Covid 19-related death tolls appear to plateau.
Initial delays getting functioning diagnostic tests in the US and persistent shortages of supplies such as reagents and cotton swabs elsewhere have hampered global testing efforts. Now, the prospect of exiting the lockdowns is making tests more crucial than ever in the absence of a vaccine — at least 18 months away — or effective treatments: only wide testing would help prevent a revival of the outbreak, by quickly identifying and isolating new patients, while allowing a return to some normalcy for the rest of the population.
Not all countries are on an equal footing in this race — and those with less testing capacity will be facing a greater likelihood of a second wave. With about 120,000 tests a week, the UK lags behind France as Europe’s worst performer. Meanwhile, Germany tests about 350,000 people per week, with a capacity of 700,000. Italy and Spain each test about 300,000 patients weekly.
“All the other countries that have done a lockdown are confronted by the same questions about how to exit,” said Carlos Moreno, director of scientific research at La Sorbonne university. “But not all countries are in the same position. The approaches are going to be different based on what the political choices are, and depending on the resources of the health system.”
While insisting France will delay its lockdown exit if testing capacity does not meet his target, Dr Delfraissy said accepting “a certain degree of risk” with the deadly pathogen was unavoidable.
“Either we are following a purely sanitary logic and then we all stay in confinement. But for how long? Until the end of time? It’s not possible,” said the 71-year-old immunologist during parliament hearings last week.
There could be 10,000 to 15,000 new infections per day once schools and non-essential businesses start to reopen, he estimated. Asked whether France would have enough to test people who come into contact with new Covid-19 patients, he said: “For now, I am not able to answer that question, it’s a work in progress.”
He also played down the use of so-called serological tests — which test for antibodies normally present in former Covid 19 patients who therefore might be immune. Those tests — which are cheaper and faster to do than the diagnostic test — were not reliable enough, he said.
Calling the virus “a nasty piece of work” (une vacherie), Dr Delfraissy also acknowledged scientists did not know whether antibodies for Covid-19 actually prevented a person from getting sick again.
Under pressure to explain France’s trouble ramping up testing compared with neighbouring Germany, health minister Olivier Véran said on Sunday that securing adequate supplies and test kits was “complicated for every country in the world”. Like many other European countries, France heavily relies on imports for cotton swabs and testing ingredients — notably from China.
Bruno Lina, a virologist and member of France’s scientific advisory council, said that the government had ordered 20 new high-capacity testing machines capable of diagnosing people with Covid-19 via so-called PCR genetic tests. They will ramp up in the coming weeks, he said.
“If it all goes smoothly, if there are no problems with supplies, and all the platforms work properly, we will theoretically be able to test around 90,000 per day once they are all online,” he added. “We’re on track to reach that goal.”
He admitted that France’s centralised state had been too slow building up testing capacity. In March, the country was unable to expand testing outside hospitals by turning to the country’s 1,500 private laboratories because it had not ordered sufficient supplies, he said.
“That network of labs was not able to be activated because we had not anticipated the orders,” he said.
Co-ordination between laboratories across France was starting to improve and the global fight for supplies was also easing, Dr Lina said. “The pressure is starting to fall . . . even as demand for tests is increasing because more suppliers are coming online.”