Marseille prided itself on faring better than its arch-rival Paris during the early months of the coronavirus outbreak, bragging about how local star virologist and hydroxychloroquine guru Didier Raoult had kept the death toll low. Now, after a summer respite, France’s second-largest city is ground zero of a resurgent epidemic, and is resisting orders from the capital about how to keep the virus at bay.

When French health minister Olivier Véran on Wednesday singled out Marseille by ordering the closure of its bars and restaurants for at least two weeks following a spike in Covid-19 infections, outrage among local officials was instant.

“This decision is unilateral, unfit, and unfair! You think you are being courageous but in reality you are losing your nerve,” tweeted Renaud Muselier, the centre-right president of the regional council.

“Nothing about the health situation justifies this move,” said Michèle Rubirola, the recently elected green mayor, who is a physician.

The spat is not just the latest instalment of the perennial rivalry between Paris and the ancient port city that is home to 900,000 residents. It is also a sign President Emmanuel Macron’s government, like many across Europe, is entering a more difficult phase of managing the pandemic: one in which people are more reluctant to comply with harsh restrictions on public life and business activity as winter looms and infections accelerate.

Line chart showing incidence rates of Covid-19 infections per 100,000 inhabitants over the last 7 days in two regions of France plus the whole country

An Elabe survey conducted this month suggested 47 per cent of the French thought the government was not doing enough to fight the virus, while 20 per cent thought it was doing too much. Three-quarters of those surveyed said they opposed another national lockdown.

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When Covid-19 struck Europe in the spring, Marseille was not hit as hard as the Paris region and the east of the country around Strasbourg. But after lockdown restrictions were relaxed and holidaymakers made their way to the beach, locals let their guard down.

As of last week, the city recorded 280 weekly new infections per 100,000 people, compared with the government’s alert threshold of 50 per 100,000. Paris’ so-called incidence stands at 180 weekly new cases per 100,000.

In mid-August when infections climbed in Marseille, they were concentrated among young people enjoying summer parties at the city’s beaches and rooftop bars. They then spread to older residents often at family gatherings such as marriages and baptisms, according to health officials.

Now, even though doctors have a better understanding of how to treat severely ill Covid-19 patients — delaying ventilation has led to fewer critical cases and deaths — the city’s intensive care beds are filling up again.

Health officials are keeping a tight control over hospital capacity. Philippe De Mester, head of the regional health office, holds a daily call with the city’s hospitals to dispatch patients and ensure there are enough beds. “We have to manage this day to day, with extremely tight control,” he said. 

The intensive care unit in the military hospital Laveran in Marseille, France. About 100 beds have been added for critical patients in the past month © Eric Gaillard/Reuters

About 100 hospital beds have been added for critical patients in the past month, taking the total to 562. With 84 per cent of those beds now full with all types of patients, hospitals have started delaying some procedures. However, Mr De Mester said that unlike at the pandemic’s peak in March and April, they want to keep treating people with other serious ailments, from heart disease to cancer. 

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“The situation is worrying . . . it is still getting worse. If we look ahead 15 days from now, we will still have more people in the hospital,” he said.

In a small conference room down the hall from his office, half a dozen contract-tracers speak quietly on the phone through surgical masks and tap data into spreadsheets as they hunt down clusters of infections.

Much hinges on the grunt work of these contract-tracers who work long shifts seven days a week. “We are now tracking clusters in schools, day cares, offices and at family gatherings like marriages and baptisms,” said Christine Ortmans, who leads the 20-strong team. “It’s not easy. It’s intense work and sometimes we get overwhelmed.”

Line chart showing new deaths per million people in two regions of France plus the whole country as a seven-day rolling average

Yet local elected officials are adamant they can still keep the pandemic under control without Paris’s interference. The city has asked for a 10-day delay before the closures of bars and restaurants take effect and has released its own metrics showing an improvement since last week when a first round of restrictions was put in place.

Dr Raoult’s research centre, which has 65 beds, continues to attract hundreds of people a day who line up on its concrete steps to be tested for Covid-19 — the results always come in the same day.

In one of his weekly YouTube videos, the virologist who shot to fame by hailing the antiviral hydroxychloroquine as a cure, claimed the virus was becoming less deadly and insisted the worst of the epidemic was over. In Paris, he is a contentious figure but for Marseille local politicians such as Mr Muselier, also a doctor, his word is akin to religion.

Line chart showing number hospitalised for Covid-19 per million people in two regions of France plus the whole country

The French government has vowed to give more leeway to cities and regions to design their own controls so as not to alienate an exhausted population, insisted Christophe Mirmand, who as prefect for the Marseille region is the highest-ranking government official. The challenge for the central government, however, is that it takes two to three weeks to know whether new restrictions are working, he noted.

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“When we take action, we don’t know if the measures are proportional and effective. So we have to grope in the dark for a bit,” he said. “We will always be criticised by some who say we went too far and others who say we didn’t do enough.”

Via Financial Times