French mortality rate in May below previous years despite epidemic

PARIS (Reuters) – French mortality rates between May 1 and 18 were six percent lower than for the same period last year and one percent below the rate seen over that period in 2018, despite the coronavirus epidemic, statistics agency INSEE said on Friday.

During the peak of the epidemic between March 1 and April 30, French mortality rates were 26% higher than the year-earlier period and 16% higher than the corresponding period in 2018, provisional data showed.

“Since May 1… we no longer excess mortality compared to the two previous years” the agency said in a statement.

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France's coronavirus death rate, new cases slow

PARIS (Reuters) – The growth rate of new confirmed COVID-19 cases in France slowed slightly on Thursday, with health authorities reporting an additional 318 known infections, an increase of 0.2% over 24 hours.

The rate of increases in reported deaths also slowed a little, with 83 COVID-19 fatalities in the past day, bringing the total to 28,215. That represented a rise of 0.3%.

The number of new cases and deaths increased by 0.3% and 0.4% respectively on Wednesday.

Thursday is a public holiday in France. Nursing homes in particular can be slower to report fatalities and cases on weekends and national holidays.

In the last two weeks of the lockdown, the daily rise in the number of confirmed cases was on average 0.8%.

The indicator is being closely watched by the government to ensure the gradual relaxation of lockdown measures does not trigger a feared second wave of the disease.

Genevieve Chene, head of health authority Sante Publique France (SPF), this week said there were no signs the pandemic was picking up, despite some new infection clusters, after France began emerging cautiously from lockdown on May 11.

But she said another week would be needed for a more complete picture of the impact of easing restrictions.

The number of COVID-19 patients being treated in intensive care units fell to 1,745 from 1,794 a day earlier, Thursday’s numbers showed. In total, 17,583 people were hospitalised with COVID-19, a decrease of 358 over the past 24 hours.

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France resists idea of US getting vaccine first

It would be “unacceptable” for French drug giant Sanofi to give priority to the US market if it develops a Covid-19 vaccine, a French minister has warned.

Deputy Finance Minister Agnès Pannier-Runacher was responding to comments by Sanofi CEO Paul Hudson, who said “the US government has the right to the largest pre-order because it’s invested in taking the risk”.

Many labs worldwide are involved in research to find a Covid-19 vaccine.

Vaccines usually take years to develop.

“For us, it would be unacceptable for there to be privileged access to such and such a country for financial reasons,” Ms Pannier-Runacher told France’s Sud Radio.

Earlier this month the EU chaired a global online summit to boost coronavirus research, and secured pledges of $8bn (£6.5bn) from some 40 countries and donors. The funding is aimed at developing a coronavirus vaccine and treatments for Covid-19.

The UK co-hosted the summit but the US and Russia did not take part.

The EU insisted on Thursday that all countries should get equal access to a vaccine.

“The vaccine against Covid-19 should be a global public good and its access needs to be equitable and universal,” said European Commission spokesman Stefan de Keersmaecker, quoted by AFP news agency.

International collaboration

Sanofi’s Covid-19 vaccine research is partly funded by the US Biomedical Advanced Research and Development Authority (Barda).

But in recent years Sanofi has received tens of millions of euros in tax credits from the French government to help its research.

On Thursday Sanofi’s chief in France, Olivier Bogillot, said “the goal is to have this vaccine available to the US as well as France and Europe at the same time”.

Speaking on French news channel BFMTV, he said that would only be possible “if Europeans work as quickly as the Americans”, and added that the US government had pledged to spend “several hundreds of millions of euros”.

Last month Sanofi also teamed up with Britain’s GlaxoSmithKline (GSK) to work on a vaccine, though trials have not yet started.

Sanofi’s head of vaccine research, John Shiver, says “we are using an existing technology that was designed for influenza, and we’re applying it to the new virus that causes Covid-19 disease”.

Sanofi says GSK “will contribute its adjuvant technology, an ingredient added to enhance the immune response, reduce the amount of vaccine protein required per dose and improve the chances of delivering an effective vaccine that can be manufactured at scale”.

The candidate vaccine is expected to enter clinical trials in the second half of 2020 and to be available by the second half of 2021.

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In France's race for virus masks, old people lost out

PARIS (Reuters) – In late February, as the COVID-19 pandemic was about to hit, French President Emmanuel Macron faced a critical decision. Like most countries, France did not have enough protective face masks.

His response was to intervene. By decree, his government put the state in control of all stocks of masks on French territory. Officials were to distribute them to frontline healthcare workers.

Macron’s far-reaching step was unique among major European states. The decree eventually helped channel protective equipment to those most at risk, such as the elderly and people with underlying chronic health conditions, people in the sector told Reuters.

But for some, including hundreds of France’s retirement homes, it meant that mask deliveries from private suppliers failed to arrive as expected. As a result, homes with low stocks operated for around 10 days without supplies, a Reuters examination found.

COVID-19, the disease caused by the new coronavirus, has triggered a global shortage of protective equipment; some world leaders now face criticism for not doing enough in the face of the epidemic.

The experience in France underscores how, confronted with the deadly new virus and sparse resources with which to tackle it, even governments that have acted forcefully can face limits and unintended consequences to their interventions. 

Thirty minutes’ drive from the centre of Paris, the state-owned Emile Gerard retirement home had placed orders with its usual suppliers for 1,700 protective masks in late February and early March for the 240-bed facility, said interim manager Elsa Nicoise. 

Those orders went unfulfilled. Her two suppliers told Nicoise that the equipment she ordered had been requisitioned by the government, she said. 

With only meagre stocks in reserve, she had to ration masks. “We handed them out parsimoniously,” said Nicoise. Seven residents have died with the virus. At least seven staff have tested positive for COVID-19.

Emile Gerard was one of many homes affected. The requisition decree disrupted supplies of tens of thousands of masks to retirement homes – which in total accommodate around 1 million residents – just as the virus was starting to spread among the vulnerable and elderly. That conclusion is based on interviews with four medical supplies distribution firms whose customers include more than 4,000 medical establishments, two nursing home industry representatives, two nursing home bosses, and a trade union official.

The government never physically requisitioned stocks of masks, but producers and suppliers who wanted to avoid violating the decree stopped shipping them to customers. Most didn’t resume regular deliveries until late March.

Reuters found no evidence of a direct link between the requisition policy and the deaths of any particular nursing home residents. People in the French nursing home sector say their protective equipment supplies are now adequate. 

But Jean-Pierre Riso, head of FNADEPA, an industry group that represents retirement home bosses, believes the supply interruption exposed some residents in nursing homes across France to the virus.

“The absence of protective equipment in the first weeks of March contributed to the spread of the virus in retirement homes,” Riso said. 

The French presidential administration declined to respond to questions about the mask requisition, referring to the health ministry. The ministry, in a statement to Reuters, said its order was aimed at preventing market speculation and directing supplies where they were most needed. It said it never seized supplies or insisted that all masks be supplied exclusively to the state, and whenever it became aware of a shortage, it acted to fix that. 

The ministry said, however, stocks of masks had initially been frozen – it did not say who by – and that nursing homes at the start of the crisis were worried about supplies.

As of May 9, 9,737 people had died in French nursing homes with coronavirus-related illnesses, according to health ministry data. That’s just under 40% of total deaths in the outbreak as measured by the health ministry.

ROOSEVELT

Macron, a 42-year-old former investment banker, became president in 2017 promising to unleash the power of the free market, changed the law to enable companies to ask staff to work longer hours, and tried to remove some pension privileges, prompting strikes and protests.  

But faced by the new disease in late February, he cranked up the levers of the state, which owns and operates about half of France’s 7,400 nursing homes. All receive protective equipment through commercial companies, which also supply hospitals in France’s state-run health service. 

When the outbreak erupted, France’s decade-old strategic stockpile of personal protective equipment (PPE) had gradually diminished and not been replenished. 

The country was supposed to hold one billion surgical masks and 600 million filtering facepiece or FFP2 masks – also known as N95 masks, a tight-fitting design to protect the wearer from infection. But it had zero FFP2 masks and the stock of surgical masks was down to 117 million, Health Minister Olivier Veran told reporters on March 21.

In a global supply squeeze, it was suddenly clear it would not be possible to import enough masks: Macron had reached a “Rooseveltian moment,” an Elysee Palace official told Reuters, in a reference to the U.S. President Franklin D. Roosevelt, who ramped up state intervention during the Great Depression of the 1930s.

SUPPLIES HALT 

In a late February meeting, health ministry officials told representatives of big mask producers – four French manufacturers and several foreign firms – that the state would be requisitioning masks, said Franck Sarfati, director of sales with CAHPP, a firm that procures supplies and services on behalf of 4,000 medical establishments. 

From then, producers became hesitant to provide supplies, Sarfati said. Under a March 3 government decree, all regular shipments stopped, and big producers were to send masks to major hospitals in each region. From there they were to be allocated to the health care workers who needed them.

But according to Sarfati, a second commercial supplier and four executives in the nursing home industry, there was a bottleneck: The centralised state supplies were going as planned to the major hospitals, but not being transferred on to the nursing homes.

With the fresh supplies blocked, the Emile Gerard home was left with a stock of 800 surgical masks and 765 FFP2 masks, said Nicoise. A local school donated another 700 masks. It was not enough. At the rate that the home was using masks now, she said, the FFP2 masks would last for several weeks, but the surgical masks would only last a few days.

Anissa Amini, an employee of the home and a trade union representative, said there were times staff caring for a resident did so without an FFP2 mask – because managers had not provided it – then discovered later the person had COVID-19. 

“That’s how it spreads,” she said. Nicoise declined to comment on this point, saying she needed to know the details of any given case. She said the home had promptly implemented all safety measures and recommendations set out by the government. Emile Gerard’s suppliers did not immediately respond to comment.

“PANIC ON DECK”

Retirement homes across France found themselves unable to source new supplies during this period, suppliers and nursing homes said. 

Robert Kohler, director of the La Roseliere nursing home in Kunheim, eastern France, realised on the evening of March 19 he had only three days’ supply left.  After two days of telephone calls seeking help, some businesses donated masks to the home. 

Mask supplier Le Réseau Cocci said there were delivery disruptions to all the 160 nursing and retirement homes and three hospitals that it supplies. “We had a huge number of calls from hospitals and we weren’t able to give them answers,” said its boss, Ronald Monfrini.

Another supplier, Voussert, had orders for around 200,000 masks on its books for clients including dozens of nursing homes, doctors’ surgeries and clinics, said Laurent Camin, its chairman. With the requisition decree, deliveries came to a halt, affecting 1,000 customers, he said. He did not have a breakdown of how many of those were nursing homes. 

“It was panic on deck,” said Florence Arnaiz-Maumé, head representative of Synerpa, a lobby group for private retirement homes, describing the mood in the first 10 days of March among the 1,800 nursing homes that are members of her organisation. She said that since then the supplies were restored and the requisition had helped.

“NOT A PRIORITY”

In the Emile Gerard home, the first state-provided supplies of masks arrived on March 22, but by then the virus had already spread. Some residents would not survive the pandemic. They included Denise Pham Van, the 99-year-old widow of a World War Two veteran.

At the start of the outbreak, Denise, who suffered from dementia, was physically well, said her daughter, Monique Pham Van. As it progressed, she deteriorated. Visits were barred because of the virus, but on a Skype call, Monique Pham Van said, her mother had looked worryingly thin, and did not speak. 

Within a week, Denise was on a drip and being administered oxygen. She had no fever and was not coughing – two of the symptoms of COVID-19 – and the home made an exception to the ban on visits, allowing her daughter to be at her bedside.

On April 13, Monique, wearing a mask, held her mother’s hand and talked to her as her breathing became more and more shallow. Her mother died a little before 2 a.m. the next day. 

Two days after that, Denise’s family were told she had been one of those infected with COVID-19.

“I think that partly the contamination is due to this absence, this lack of equipment,” said Monique Pham Van. In the race to supply healthcare workers in France with protective gear, nursing homes, she said “were not a priority.” 

Manager Nicoise said it was difficult to make that link, given there is much scientists still don’t understand about the virus. “It’s too early to draw conclusions,” she said. “We’re still really in the thick of it. The time for analysis will come after.”

At least 11 families of nursing home residents have filed legal complaints  that identify a lack of masks and other protective gear among the alleged shortcomings in treatment during the outbreak, according to documents seen by Reuters and Fabien Arakelian, the lawyer representing  the families. He said he was preparing another 10 complaints.

The families have not specified who is the target of their complaints; their lawyer said this approach may trigger an inquiry to establish who was to blame.

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French foreign legion soldier dies after being wounded in Mali

PARIS (Reuters) – A soldier from the French foreign legion died in a military hospital near Paris on Friday after being wounded in an explosion in Mali last week in what the French presidency said was an operation against armed terrorist groups.

France, the former colonial power, has 5,100 troops in Mali and the wider Sahel region, but security has progressively worsened since it intervened in 2013 to stop a jihadist advance to the Malian capital, Bamako.

Brigadier Dmytro Martynyouk, of the 1st foreign cavalry regiment, died after being wounded by the improvised explosive device on April 23, the presidency said, without giving more details.

Thirteen soldiers died in a helicopter crash in Mali last November in France’s worst single loss of troops for more than three decades.

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After surviving COVID-19, French neurosurgeon faces long road to recovery

TAVERNY, France (Reuters) – Georg Dorfmuller had hardly been sick during a career that saw him rise to become a top paediatric neurosurgeon in Paris, but all that changed when he contracted COVID-19.

The 61-year-old head of service at the private Adolphe de Rothschild Hospital Foundation fell ill at the end of March.

He developed early symptoms – fever and headaches – of the virus and believes that hospital staff such as himself were perhaps not as careful as they should have been.

“We were careful with those that were suspected of having COVID, but the others who tested negative and their families, we didn’t take too much notice. I think we got it then because three or four colleagues had it at the same time.”

He is among the roughly 6,000 healthcare workers who have been infected in France. More than 26,000 people have died since March 1, including at least 25 in the healthcare sector.

After reaching a low point in mid-April that led to him being monitored in intensive care for nearly a week, Dorfmuller is now slowly on his way back to full health.

Weakened by the illness, he is now undergoing a rehabilitation programme at the Park Hospital of Taverny on the edge of a forest to the north of Paris.

He has been confined to his room for the last 12 days receiving physiotherapy and care to ensure he does not rush back too quickly to a job that at times can seem him in the operating room for several hours at a time.

“On the one hand, you’ve never been sick, so you want to work because you know not being there sets a bad example, but then there is the other aspect.

“You’ve got more years to work, so take a rest and look after yourself first,” he told Reuters amid a physiotherapy session aimed at restoring his muscle strength and easing his breathing.

The facility, which usually caters for people recovering from cardio and breathing illnesses, was forced to create a specific COVID-19 unit given the number of cases and the long recovery process for survivors.

“It’s been a road that was initially extremely hard and draining,” said Viorel Oltean, a doctor at Taverny who took charge of Dorfmuller.

“Here we have to give back not only the physical capacity but also mental capacity so he can restart the surgical profession.”

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