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How France Lost the Weapons to Fight a Pandemic How France Lost the Weapons to Fight a Pandemic
(3 days later)
PARIS — When President Emmanuel Macron repeatedly declared “war” on the coronavirus in March, he solemnly promised that France would support “front-line” health workers with “the means, the protection.”PARIS — When President Emmanuel Macron repeatedly declared “war” on the coronavirus in March, he solemnly promised that France would support “front-line” health workers with “the means, the protection.”
The reality was that France was nearly defenseless.The reality was that France was nearly defenseless.
The government’s flip-flopping policies on past pandemics had left a once formidable national stockpile of face masks nearly depleted. Officials had also outsourced the manufacturing capacity to replenish that stockpile to suppliers overseas, despite warnings since the early 2000s about the rising risks of global pandemics.The government’s flip-flopping policies on past pandemics had left a once formidable national stockpile of face masks nearly depleted. Officials had also outsourced the manufacturing capacity to replenish that stockpile to suppliers overseas, despite warnings since the early 2000s about the rising risks of global pandemics.
That has left France — unlike Germany, its rival for European leadership — dependent on foreign factories and painfully unable to ramp up domestic production of face masks, test kits, ventilators and even the thermometers and over-the-counter fever-reducing medicines to soothe the sick.That has left France — unlike Germany, its rival for European leadership — dependent on foreign factories and painfully unable to ramp up domestic production of face masks, test kits, ventilators and even the thermometers and over-the-counter fever-reducing medicines to soothe the sick.
Today, as it has begun loosening one of the world’s strictest lockdowns, France has become a case study in how some countries are now reconsidering their dependence on global supply chains built during the past two decades on the mantra of low costs and quick delivery. Even now, France has no guarantees that it can secure enough supplies in the coming weeks to protect against a potential second wave of the virus.Today, as it has begun loosening one of the world’s strictest lockdowns, France has become a case study in how some countries are now reconsidering their dependence on global supply chains built during the past two decades on the mantra of low costs and quick delivery. Even now, France has no guarantees that it can secure enough supplies in the coming weeks to protect against a potential second wave of the virus.
“In times of crisis, we can no longer switch from one production zone to another to get our essential products,” Louis Gautier, the former director of the General Secretariat for Defense and National Security, a powerful inter-ministerial unit inside the prime minister’s office that coordinates the response to large-scale crises, said in an interview. “The issue of strategic stocks and secure supplies has to be reconsidered. A new model has to be invented.”“In times of crisis, we can no longer switch from one production zone to another to get our essential products,” Louis Gautier, the former director of the General Secretariat for Defense and National Security, a powerful inter-ministerial unit inside the prime minister’s office that coordinates the response to large-scale crises, said in an interview. “The issue of strategic stocks and secure supplies has to be reconsidered. A new model has to be invented.”
France had long identified masks as indispensable in a pandemic, yet the government had mostly stopped stockpiling them during the past decade, mainly for budgetary reasons. Domestic production collapsed at the same time the country’s pharmaceutical industry was also moving overseas.France had long identified masks as indispensable in a pandemic, yet the government had mostly stopped stockpiling them during the past decade, mainly for budgetary reasons. Domestic production collapsed at the same time the country’s pharmaceutical industry was also moving overseas.
France had decided “that it was no longer necessary to keep massive stocks in the country, considering that production plants were able to be operational very quickly, especially in China,” the health minister, Olivier Véran, said in Parliament in March.France had decided “that it was no longer necessary to keep massive stocks in the country, considering that production plants were able to be operational very quickly, especially in China,” the health minister, Olivier Véran, said in Parliament in March.
But the scope and speed of the coronavirus defied that logic. Still reeling from its own outbreak, China, the world’s leading maker of masks, was overwhelmed with orders. India, a top exporter of medication, temporarily banned exports for fear of shortages.But the scope and speed of the coronavirus defied that logic. Still reeling from its own outbreak, China, the world’s leading maker of masks, was overwhelmed with orders. India, a top exporter of medication, temporarily banned exports for fear of shortages.
As the globalized supply chain broke down, French health officials lost critical time as the national government — as well as cities, towns and even wards — scrambled to buy supplies directly from China and elsewhere. The government organized highly publicized airlifts of masks from China, betraying both its desperation and its dependence.As the globalized supply chain broke down, French health officials lost critical time as the national government — as well as cities, towns and even wards — scrambled to buy supplies directly from China and elsewhere. The government organized highly publicized airlifts of masks from China, betraying both its desperation and its dependence.
France has suffered more than 27,000 deaths and one of the world’s highest fatality rates, 60 percent greater than in the United States.France has suffered more than 27,000 deaths and one of the world’s highest fatality rates, 60 percent greater than in the United States.
“We will have to rebuild France’s agricultural, health, industrial and technological independence,” Mr. Macron said in a recent address.“We will have to rebuild France’s agricultural, health, industrial and technological independence,” Mr. Macron said in a recent address.
To many critics, France’s defenselessness in face of the virus was the logical conclusion of the hollowing out of France’s manufacturing base — a transformation that has deepened inequality and fueled violent protests, like the Yellow Vest movement.To many critics, France’s defenselessness in face of the virus was the logical conclusion of the hollowing out of France’s manufacturing base — a transformation that has deepened inequality and fueled violent protests, like the Yellow Vest movement.
In the early 2000s, Germany had a slight edge over France in manufacturing and exporting PCR test kits — the most widely used today to detect the virus — and oxygen therapy equipment, according to United Nations data. But by 2018, Germany had a $1.4 billion trade surplus for PCR test kits, whereas France had a deficit of $89 million.In the early 2000s, Germany had a slight edge over France in manufacturing and exporting PCR test kits — the most widely used today to detect the virus — and oxygen therapy equipment, according to United Nations data. But by 2018, Germany had a $1.4 billion trade surplus for PCR test kits, whereas France had a deficit of $89 million.
While Germany was able to mobilize its industry quickly to fight the pandemic, France was paralyzed. It couldn’t carry out large-scale testing because it lacked cotton swabs and reagents, low-value but crucial elements that had been outsourced to Asia.While Germany was able to mobilize its industry quickly to fight the pandemic, France was paralyzed. It couldn’t carry out large-scale testing because it lacked cotton swabs and reagents, low-value but crucial elements that had been outsourced to Asia.
“France has deindustrialized too much since the 2000s; it’s paying for it today,” said Philippe Aghion, an economist who teaches at Harvard and Collège de France.“France has deindustrialized too much since the 2000s; it’s paying for it today,” said Philippe Aghion, an economist who teaches at Harvard and Collège de France.
In a still unpublished study, Mr. Aghion and economists at the Free University of Brussels found that over all, countries with the capacity to manufacture test kits and related instruments, like Germany and Austria, had so far suffered fewer deaths during the pandemic.In a still unpublished study, Mr. Aghion and economists at the Free University of Brussels found that over all, countries with the capacity to manufacture test kits and related instruments, like Germany and Austria, had so far suffered fewer deaths during the pandemic.
In France, shortages have affected even basic goods. Drugstores ran out of thermometers. Supplies of paracetamol — a common pain reliever sold as Tylenol in the United States — became so dangerously low that the authorities restricted its sale.In France, shortages have affected even basic goods. Drugstores ran out of thermometers. Supplies of paracetamol — a common pain reliever sold as Tylenol in the United States — became so dangerously low that the authorities restricted its sale.
The last European factory producing the medication was in France, near the city of Lyon, but it closed in 2008, according to France’s National Academy of Pharmacy. The association has long warned of a growing dependence on foreign drugmakers, noting that 60 to 80 percent of active pharmaceutical ingredients in Europe are imported — compared with 20 percent three decades ago.The last European factory producing the medication was in France, near the city of Lyon, but it closed in 2008, according to France’s National Academy of Pharmacy. The association has long warned of a growing dependence on foreign drugmakers, noting that 60 to 80 percent of active pharmaceutical ingredients in Europe are imported — compared with 20 percent three decades ago.
“Nothing has been done at the government level to stop this,” said Marie-Christine Belleville, a member of the academy.“Nothing has been done at the government level to stop this,” said Marie-Christine Belleville, a member of the academy.
Warnings, in fact, had been issued for years.Warnings, in fact, had been issued for years.
In the aftermath of the SARS pandemic in Asia in 2003, French officials analyzed the risks in a series of reports and built up a national stockpile of masks and other protective equipment manufactured by domestic suppliers — in keeping with a Gaullist tradition of maintaining a strong domestic defense industry that also exports Rafale fighter jets, submarines, minesweepers and frigates to the world.In the aftermath of the SARS pandemic in Asia in 2003, French officials analyzed the risks in a series of reports and built up a national stockpile of masks and other protective equipment manufactured by domestic suppliers — in keeping with a Gaullist tradition of maintaining a strong domestic defense industry that also exports Rafale fighter jets, submarines, minesweepers and frigates to the world.
In 2006, a government pandemic plan recommended a series of measures, including creating stockpiles of masks. A year earlier, France’s Health Ministry signed a five-year contract to buy 180 million masks a year that Bacou-Dalloz, then the biggest mask maker in France, would produce at a factory in Plaintel, about 280 miles from Paris.In 2006, a government pandemic plan recommended a series of measures, including creating stockpiles of masks. A year earlier, France’s Health Ministry signed a five-year contract to buy 180 million masks a year that Bacou-Dalloz, then the biggest mask maker in France, would produce at a factory in Plaintel, about 280 miles from Paris.
Details from the contract, a copy of which was obtained by The New York Times, reveal the government’s strategic thinking at the time. Securing a domestic supplier would help France avoid being “exclusively dependent on importations that would be disrupted in the context of a pandemic.”Details from the contract, a copy of which was obtained by The New York Times, reveal the government’s strategic thinking at the time. Securing a domestic supplier would help France avoid being “exclusively dependent on importations that would be disrupted in the context of a pandemic.”
The contract would ensure the government’s “renewal of its stockpile of masks” as older stocks reached their expiration dates. And during a pandemic, the government could requisition the plant’s production.The contract would ensure the government’s “renewal of its stockpile of masks” as older stocks reached their expiration dates. And during a pandemic, the government could requisition the plant’s production.
The government order “monopolized the Plaintel factory’s entire production capacity,” said Jean-Jacques Fuan, a former director of the plant.The government order “monopolized the Plaintel factory’s entire production capacity,” said Jean-Jacques Fuan, a former director of the plant.
By 2008, the government issued a white paper that for the first time cited pandemics as a potential national threat, ranking it fourth behind terrorism, cyberwarfare and a ballistic missile attack.By 2008, the government issued a white paper that for the first time cited pandemics as a potential national threat, ranking it fourth behind terrorism, cyberwarfare and a ballistic missile attack.
“In the next 15 years, the arrival of a pandemic is possible,” the paper warned. It could be highly contagious and lethal, it said, and could come and go in waves for weeks or months.“In the next 15 years, the arrival of a pandemic is possible,” the paper warned. It could be highly contagious and lethal, it said, and could come and go in waves for weeks or months.
But soon afterward, many politicians began criticizing the policy of stockpiling masks and medication as wasteful. About 383 million euros spent in 2009 on acquiring 44 million vaccinations against the H1N1 flu caused a political scandal after less than 9 percent of French people were vaccinated.But soon afterward, many politicians began criticizing the policy of stockpiling masks and medication as wasteful. About 383 million euros spent in 2009 on acquiring 44 million vaccinations against the H1N1 flu caused a political scandal after less than 9 percent of French people were vaccinated.
Updated June 5, 2020Updated June 5, 2020
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
In 2013, the General Secretariat for Defense and National Security issued new pandemic directives emphasizing “overall savings” and reducing the importance of maintaining a stockpile. Surgical masks would be stocked, but not the more sophisticated FFP2 masks that, the report noted, cost 10 times as much.In 2013, the General Secretariat for Defense and National Security issued new pandemic directives emphasizing “overall savings” and reducing the importance of maintaining a stockpile. Surgical masks would be stocked, but not the more sophisticated FFP2 masks that, the report noted, cost 10 times as much.
The directives also transferred the responsibility — and costs — for securing and stockpiling masks to public and private employers. This contributed to the severe shortages that France has suffered in recent months, as government officials became less engaged on the issue.The directives also transferred the responsibility — and costs — for securing and stockpiling masks to public and private employers. This contributed to the severe shortages that France has suffered in recent months, as government officials became less engaged on the issue.
Mr. Gautier, the former director of the general secretariat, said that the new directives had been intended to improve the distribution of masks by requiring employers, like hospitals, to stock them and to make them legally responsible for the protection of their employees.Mr. Gautier, the former director of the general secretariat, said that the new directives had been intended to improve the distribution of masks by requiring employers, like hospitals, to stock them and to make them legally responsible for the protection of their employees.
But he acknowledged that “it would have been logical to transfer the credits and not only the costs to the employers. We should have also put in place measures of control to ensure that the reforms had been applied correctly.”But he acknowledged that “it would have been logical to transfer the credits and not only the costs to the employers. We should have also put in place measures of control to ensure that the reforms had been applied correctly.”
But the new policy also undermined France’s capacity to produce masks. Employers, now charged with procuring masks, naturally sought cheaper suppliers abroad.But the new policy also undermined France’s capacity to produce masks. Employers, now charged with procuring masks, naturally sought cheaper suppliers abroad.
And to save costs, the government placed large orders that only Chinese factories were able to satisfy, said Francis Delattre, a former senator whose 2015 report warned of the depletion of masks.And to save costs, the government placed large orders that only Chinese factories were able to satisfy, said Francis Delattre, a former senator whose 2015 report warned of the depletion of masks.
“Small French factories were losing orders,” Mr. Delattre said. “It was very dangerous to entrust only one or two Chinese conglomerates with the health protection of the country.”“Small French factories were losing orders,” Mr. Delattre said. “It was very dangerous to entrust only one or two Chinese conglomerates with the health protection of the country.”
And without its single government customer, the factory in Plaintel, which had once been running 24 hours a day, saw its business shrivel and eventually closed in 2018, Mr. Fuan said.And without its single government customer, the factory in Plaintel, which had once been running 24 hours a day, saw its business shrivel and eventually closed in 2018, Mr. Fuan said.
As expired masks were disposed of, France’s national stockpile shrank from 1.7 billion in 2009 to 150 million in March.As expired masks were disposed of, France’s national stockpile shrank from 1.7 billion in 2009 to 150 million in March.
And as the “invisible enemy” began rampaging throughout France, the country that made some of the world’s most sophisticated military hardware in the world was unable to produce enough face masks.And as the “invisible enemy” began rampaging throughout France, the country that made some of the world’s most sophisticated military hardware in the world was unable to produce enough face masks.
“This crisis must lead us to consider health care as a strategic sector that should draw on a lot of what we do in defense,” said Arnaud Danjean, a European lawmaker.“This crisis must lead us to consider health care as a strategic sector that should draw on a lot of what we do in defense,” said Arnaud Danjean, a European lawmaker.
“We weren’t armed for this,” he added.“We weren’t armed for this,” he added.