As Covid cases soar among France’s children, experts baffled by relaxed school protocol

After lingering offshore a little longer than it did at its neighbours, a fifth wave of Covid-19 struck France in November with a vengeance. The country is seeing an average 32,000 new confirmed cases daily, up from 10,000 just two weeks ago.

The surge led Health Minister Oliver Véran last week to announce an extension of vaccine booster shots to all French adults, under threat of having their health pass, which grants access to restaurants, culture venues and travel, voided. Mask mandates are back for all indoor public spaces, even with a health pass, and some local authorities like Paris now require masking in crowds also outdoors.

“This fifth wave will be without contest stronger and longer than the summer’s fourth wave,” Véran warned during a press conference last Thursday.

Meanwhile, as striking as the surge has been nationwide – despite more than 75 percent of France ‘s population aged 12 and up completely vaccinated – the spread is outsized among the country’s unvaccinated youngest.

The European Medicines Agency did recommend approval of Pfizer-BioNTech’s vaccine for 5-to-11-year-olds last week. But Véran said vaccinating this age group would not begin in France until January at the earliest, pending the advice of France’s own ethics and health authority.

The latter on Tuesday issued a first green light only for a subset of “fragile” 5-to-11-year-olds, or those living with immune-compromised or vulnerable unvaccinated people.

And yet last Thursday, in a dissonant break from Véran’s stark warning moments earlier, from his own podium just steps away, Education Minister Jean-Michel Blanquer, went on to declare a loosening of the Covid-19 protocol in schools: no additional restrictions and no more closing school classes automatically when a Covid-19 infection is detected.

The announcement drew reactions of dismay from health and education professionals.

“The dynamic among children is really pretty catastrophic,” Michaël Rochoy, a general practitioner in northern France, told FRANCE 24. “What is needed are stronger measures, that’s logical. But what has been decided is to lighten the protocol,” the doctor added, a nervous laugh betraying his alarm.

“It’s complete nonsense. It’s truly backwards. Cases are going to continue rising, or rise even faster still,” lamented Rochoy, who is a member of Du Côté de la Science, a collective of scientists that serves as a Covid-19 policy watchdog.

Pediatric infections exploding

On paper, the math is blunt. France’s Covid-19 incidence rate, the number of infections weekly per 100,000 people, has shot past 300 nationwide – six times the country’s alert level of 50, where it lingered in October. But that rate is 650 for children aged 6 to 10, their highest since the start of the pandemic.

It is far worse still in some areas. Ardèche hit 1,508 cases on Saturday after doubling week on week all month. The picturesque southeastern department is one of eight surpassing the symbolic 1,000 benchmark, over which it is considered that more than one percent of 6-to-10-year-olds are infected in a given area. The current rate for Paris is 918 and rising.

But even hard-hit Ardèche will remain at Level 2 on France’s controversial four-level Covid-19 school protocol. That means multiple classes can shed face masks to eat together in school canteens and maskless non-contact sport is allowed indoors – two risky flashpoints that rankle specialist critics. (France’s ill-fated dalliance in October with Level 1, which allowed primary schoolchildren to shed face masks at school altogether, was quickly rolled back in November after cases spiked.)

“One is liable to wonder what use it is having Level 3 or 4 of a protocol if they aren’t even used in Ardèche where the incidence rate is enormous,” Rochoy said. “The maximum alert level had been defined as 400. Three times higher and we don’t use Level 3! It’s a good thing these people don’t run nuclear power plants, frankly,” the doctor quipped.

Tragedies rare

Experts agree that very serious Covid-19 cases in children are rare. Children under the age of 10 represent just 13 of the 119,000 Covid-19 deaths in France since the start of the pandemic, although more than half of those children have died since August; three have died over the past 10 days.

A bill passed last week in France’s lower-house National Assembly, meanwhile, recognised the particular needs of patients, including children, suffering from sometimes debilitating long-haul symptoms after Covid-19 infections.

>> Read more: Young people hit hard by long Covid as Delta variant surges

Children have also proven to spread the virus. New data released last week in The Lancet Regional Health Europe from France’s Institut Pasteur-led ComCor study showed that “in those 40 and older, having children attend daycare centre, kindergarten, primary school or middle school was associated with increased risk of infection”.

It stands to reason, experts say, that French children are driving up the nation’s fifth wave, mathematically and epidemiologically. French Prime Minister Jean Castex became the unfortunate apparent illustration of that reality last week when the double-vaccinated 56-year-old tested positive for Covid-19, shortly after declaring himself a contact case of his 11-year-old daughter.

Those worried about slackening school Covid-19 protocols and community spread point out that school holidays are only three weeks away in France, with many children poised to gather with generations of extended family for Christmas festivities.

Class closures halted

For French parents, epidemiological arithmetic aside, life-sized brainteasers have so far mainly meant booking Covid-19 screening tests and taking time off from work to mind junior. Across the country, nearly 9,000 classes were shuttered over confirmed Covid-19 infections on Friday, more than double the tally a week earlier.

The rule for kindergartens (where children do not wear masks) and primary schools (where they do) has been that schoolchildren in the same class as a child who has tested positive are sent home for seven days to stem the viral spread. With so many classes closing, authorities might have responded by bolstering the school protocols to further limit the infections that were shuttering classes. Instead, Blanquer elected to end the single-case class closure policy from Monday.

Under the new rule coming into effect over the course of this week, a confirmed case immediately sets off a campaign to screen the infected child’s classmates for Covid-19. A lab might visit the school; otherwise parents are tasked with getting their kids screened. Children who present a negative test within 24 hours can return to in-person schooling. Parents are “invited” or “strongly recommended” to have their children tested again seven days later, but there is no obligation to do so. A class will now close only if three classmates from separate families return positive tests within one seven-day period.

A thinly veiled boon to working parents, the new rule applied as cases surge has left many observers livid. Critics have long been frustrated by what they see as a tendency to overinterpret pandemic-mitigating proposals as code for wanting to close schools down. They have slammed Blanquer time and again for downplaying the mitigation science on everything from face masks to carbon dioxide detectors.

Blanquer, for his part, famously blasted critics in the spring, saying, “People have to stop being obsessed by the role that schools play in infections.” Critics this time say Blanquer’s latest policy is at best based on bad science, at worst a wrongheaded ploy for mass immunisation through infection.

Calling the decision “unreasonable”, the SNUipp-FSU union of kindergarten and primary school personnel on Monday “solemnly” asked the minister to restore the practice of closing classes from the first confirmed infection. The union’s open letter reminds Blanquer of their prior “very strong reservations” over slackening the Covid-19 protocol “just as the country enters a blistering fifth wave and the Omicron variant appears”.

Too little, too early?

Guislaine David, secretary-general of the SNUipp-FSU union calling to roll back the change, deems the new policy “very worrying” amid “never before seen” infection levels.

“We’ve seen infections rise by practically 100 percent in a week, so we see the wave is very, very high here. Children are enormously implicated in it. And with this there is a very clear risk of spreading infections outside of schools because of a protocol that is insufficiently protective,” David told FRANCE 24.

A crucial flaw in the new rules, critics say, is a disregard for the virus’s incubation period. Put simply, testing an infected child’s classmates within a day of the first positive test result doesn’t get the job done. That test will reveal the classroom’s “patients zero”, but not the children those initially infected have already gone on to infect themselves.

A sick child who tests positive on Wednesday “might have been contagious Monday, Tuesday and Wednesday morning. The people he contaminated will be (detectably) positive on average four or five days later,” Rochoy explained. “The protocol today says the whole class gets tested on Thursday and the negative ones come back to class. But even the child infected as early as possible, on the Monday, won’t be positive until Friday. So everyone infected by Wednesday’s positive child will test negative.” And back they go to class to start the cycle again.

Union leader David notes that no further testing is required after the initial test and believes parents are unlikely to answer the government’s invitation to have their children, who are often asymptomatic, tested again seven days later. The virus “can get around if children are asymptomatic, through one class, into the other classes,” David said. “Children inevitably rub shoulders at recess, at lunch in the canteen, and keep the epidemic going that way, then infect everyone and of course spread beyond schools.”

Addressing those concerns, the education ministry told FRANCE 24 that “if possible and depending on local conditions, complementary preventative measures could be taken” including outdoor masking, limiting contact of the affected class with others during recess or lunchtime, and “limiting risky indoor activities” like sport and singing.

Those adjustments aren’t certain to satisfy critics. “There is nothing better than closing the class for seven days – except for closing the class for 10 days. We’re sure there’s no mingling (between classmates),” Rochoy said. “Bringing children back on the basis of negative tests conducted prematurely will inevitably lead to more infections. It’s a certainty.”

Trial results not yet public

Officially, the protocol change comes after beta-testing in 10 departments nationally. But the results of those trials – conducted at incomparably lower levels of viral spread, scientists note – have yet to be released even as the policy is deployed nationwide.

It also overwhelmingly relies on parents’ initiative to have any symptomatic children tested as school-based testing remains largely reactive in France, not preventative.

In September, the Scientific Council that advises the French government on Covid-19 matters recommended testing all six million kindergarten and primary schoolchildren weekly to keep tabs on viral spread. But the government declined. The education ministry instead offers to provide 600,000 tests a week for primary schoolchildren, but Blanquer has cited low uptake to explain why far fewer are conducted in practice.

Some parents have expressed satisfaction with the relaxed rule on class closures. “It seems bizarre and surprising to us to send home children who aren’t sick, whether it be for Covid or another illness,” Rodrigo Arenas, a representative of the FCPE federation of parents, told RMC radio.

“It’s better today for the children. We’ve all said to ourselves that the best thing for the children is to have them at school,” he added. “We already test all the kids. Protective measures need to be taken at school, it’s not complicated. We need more teachers. When a kid wasn’t positive and he had to go home before, his parents had to take holidays to mind him,” Arenas explained.

Union leader David, for her part, said that not shuttering classes is “clearly meant to please parents and for the economy. A parent who minds a child at home for seven days isn’t at work. That’s the idea: parents’ work not kids’ protection,” David lamented. “I don’t think parents realise what it can lead to. I think people have yet to grasp the fifth wave. When I took the metro earlier, many still weren’t wearing masks.”

Not all parents are onboard with the new order. In an open letter to lawmakers on Sunday, Écoles et Familles Oubliées (Forgotten Schools and Families) demanded they overturn a change the group said would inevitably accelerate infections of children and, by ricochet, their families, and pressing for urgent new restrictions beyond Level 2 of the Covid-19 school protocol.

FRANCE 24 on Monday asked the education ministry whether the appearance of the Omicron variant of Covid-19 on European soil in the time between Blanquer’s announcement and its implementation could plead for suspending the change.

“The ministry does not change protocols at the last moment and always accords several days to allow schools to prepare,” the education ministry replied. “On this variant, the health ministry will provide advice and take any decisions for the whole population before schools. After that, talks will begin between the ministries of education and health. But with decisions that impact nearly 13 million schoolchildren, time must be taken to weigh them properly.”