France weighs forcing patients infected with coronavirus to isolate themselves


                Alors que la France cherche à alléger son verrouillage de Covid-19 et à endiguer la propagation du virus, le président français Emmanuel Macron a proposé cette semaine d'obliger les personnes infectées à s'isoler des autres.  Son premier ministre Jean Castex a emboîté le pas et a promis bientôt un projet de loi sur la question.  Déjà, cependant, la perspective de forcer les gens à s'aligner sur le coronavirus a été accueillie avec scepticisme - et a soulevé de nombreuses questions - même du côté de Macron de l'allée politique.

                                    <p>Détaillant sa feuille de route pour mettre fin au deuxième verrouillage de la France lors d'un discours télévisé mardi, Macron a déclaré qu'il souhaitait que "le gouvernement et le Parlement prévoient des conditions pour assurer l'isolement des personnes contaminées, y compris de manière plus contraignante".  Le président s'est également engagé à soutenir les personnes touchées "sur le plan matériel, sanitaire et psychologique".

How was Macron’s proposal received? In short: isolation, of course. Forced confinement, maybe not.

Castex, for his part, declared that the intention is not to “control in order to control” but “to have a constraint better respected” and which will be supported “by reinforced human and medical resources” so that “this isolation is better accepted and therefore more effective ”. The prime minister did not say what the new measures would look like.

Sanctions and questions

While France waits to learn more, the question marks are multiplying. How does the government plan to adopt such new coercive measures? What will be the penalty in the event of non-compliance? How will the state support people infected with the coronavirus “materially and psychologically”? These are all considerations that Macron wants to open for debate.

One thing is for sure, lawmakers are already thinking about the possible details and fixing the issues.

Gérard Larcher, the conservative president of the Senate, suggested that they exercise caution given that the issue is nothing less than encroaching on “fundamental freedom”. The veteran senator appeared to ignore Macron’s call for lawmakers across all parties to simply debate the issue on the floor and hold it up for a vote, saying the issue “deserves a top-down debate, which only one bill can bring ”.

“A parliamentary debate is not enough. The real debate in Parliament is when there is a bill and it is not enough for us to debate and vote, ”Larcher said Thursday on radio Europe 1.“ If there must be coercion, we must respect a certain number of conditions: respect for doctor-patient confidentiality, support for people, what are the clauses of this isolation. ”

The leader of the Socialist minority in the National Assembly of the lower house, for her part, said she did not think isolating people was a good idea. “If we have coercive measures, the French will no longer be tested,” Valérie Rabault told Sud Radio. “It’s a lot riskier as a strategy than having an incentive strategy. ”

The far right is also not happy with the idea. Marine Le Pen, leader of the national rally, questioned the logistics of a plan that makes isolation mandatory. “There comes a time when you have to face the reality: are we going to send police to people who test positive to see if people are really at home? she asked on Sud Radio on Wednesday, suggesting that the government “stop making decisions that it cannot put into practice”.

Le Pen’s second-in-command, National Rally vice-president Jordan Bardella, also questioned how feasible the measures would be and said he preferred “to convince rather than coerce”. The legislator of the European Parliament said he was “irritated” by the “permanent infantilization” of the French by the government.

<div class="m-em-image">
French police officers check a driving authorization form in Place de la Concorde in central Paris on November 13, 2020, during the second Covid-19 lockout in France. © Anne-Christine Poujoulat, AFP
    </div>Des doutes persistent également dans les rangs de la majorité centriste de Macron.  L'ancien ministre de l'Intérieur Christophe Castaner, qui est désormais le leader de la majorité à la chambre basse du parti La République en marche de Macron, est resté prudent, affirmant qu'il soutenait l'obligation de forcer les personnes infectées à s'isoler, mais uniquement si la confidentialité médecin-patient est respectée.

“I am in favor if we manage to guarantee… medical confidentiality, which is the domain of the public health insurance. The follow-up must be done in this context, ”Castaner said on LCI television on Wednesday.

“If, on the other hand, it is a file where you or I, if we have Covid-19 … we find ourselves in a file widely disseminated, including to the internal security forces, to the police, to the gendarmerie for checks in the street, I’m against, ”said Castaner, who oversaw law enforcement as interior minister for almost two years until July.

Last Friday, meeting caregivers in a hospital in Brittany, Castex himself showed skepticism about the notion of compulsory isolation. “I am sure there are people who, if you tell them ‘you have an obligation to isolate yourself’, they will not be tested,” the prime minister told health workers.

Healthcare providers divided

Indeed, politicians are not the only ones to express reservations about the obligation to comply. Healthcare providers in France are also not sure it would work.

“The value of compulsory isolation is limited,” said Dr Jean-Paul Harmon, general practitioner in the Paris region and honorary president of the French Federation of Physicians (FMF), to the information site 20 Minutes . “I am not really convinced that additional law, which is coercive, is necessary. People are contagious even before they have symptoms, so they infect those around them before being tested. [and] therefore before they are subjected to possible mandatory isolation. »

Macron’s nascent proposal goes hand in hand with the appeal made by a healthcare collective. The France Assos Santé group represents 85 associations of health care users and pleads for the government to impose coercive measures against coronaviruses. The collective wants stricter isolation with “a complete restriction of movements and visits” for those who test positive and cases of contact in their entourage. The goal, they say, is simple: to avoid a third lockdown.

Coercive isolation elsewhere in Europe

Legally speaking, “a law which forces a patient to isolate himself is conceivable in principle as long as it is limited in its scope since the objective of public health takes precedence over everything else”, Jean-Philippe Derosier, professor of public law at the University of Lille, told FRANCE 24. “But it’s a safe bet that coercion, in these circumstances, is less well suited than effective public education would be. Similar measures applied in other countries have not necessarily proved effective. ”

Mandatory isolation rules reinforced by sanctions have already been put in place by France’s neighbors in Europe, including Switzerland, Great Britain and Belgium.

In Italy, infected people who violate their quarantine restrictions can face three to 18 months’ imprisonment and fines ranging from € 500 to € 5,000. The rules are even stricter in Spain; there, first-time offenders are liable to a fine of € 3,000, while a person who repeatedly violates isolation rules is liable to a fine of up to € 600,000.

Greece has the most severe punishment; anyone infected who violates the Covid-19 quarantine rules – without infecting anyone else – faces five years in prison. This penalty can be up to 10 years if the offender has infected at least one other person while breaking the rules and up to 15 years if this contamination causes death. If the Quarantine Breaker infects multiple people who die, the sentence can be life imprisonment.

Other countries have gone further in terms of the means put in place to monitor the isolation of patients infected with the coronavirus. South Korea has turned to technologies like smartphone data tracking to enforce quarantine rules and has gone so far as to require that an infected person who violated isolation rules be equipped an electronic monitoring device.

France is not there yet. But the attempt to isolate people without coercive measures during the first spring lockdown had clearly limited impact; the hotels and other establishments requisitioned for this purpose were largely empty. Questions also remain about how to reach out to the social bonds of those infected, considered so important during this difficult time, especially in terms of the mental health of the most vulnerable in society. All are elements that French legislators will have to take into account in the days to come.

This article has been adapted and translated from the original in French.



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