La Croix: Have we ever known this type of epidemic in the past?
Patrick Zylberman : There have been many cases. In Asia, the last epidemic dates from 2003 with SARS (severe acute respiratory syndrome). There had been 774 deaths worldwide and more than 8,000 cases, almost 95% of which were in China. Containment measures were then taken.
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In Europe, the last great collective confinement was in Yugoslavia in 1972 during an epidemic of smallpox brought back by pilgrims from Mecca. About ten million people have been confined and held militarily. Historically, containment dates from the Renaissance, in the Italian cities of the XIVe and XVe centuries, to prevent the plague, in particular.
However, confinement today is no longer envisaged to prevent contamination. For the dam to be effective, with regard to respiratory diseases which are highly contagious, conditions of confinement would be necessary such that they would be absolutely unlivable and impractical. They would lead to the opposite of the desired goal, that is to say that instead of blocking the spread of evil, people would flee by all means, including the most violent, and would spread evil .
In the case of SARS in 2003, were the containment measures effective?
P.Z. : In Asia, people are fairly respectful of the authorities’ instructions. For example, in Singapore, which is a small state with a strong focus on hygiene and coercion, there were only 0.03% breaches of the containment guidelines. It’s not much. The 26 offenders were also punished by the courts.
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This example from Asia in 2003 is not necessarily generalizable. At home, I suppose we would have a slightly larger proportion of offenders. But I imagine that, driven by anxiety, people would tend to lock themselves in at home quite spontaneously.
Since when have the effects of containment measures been studied and compared?
P.Z. : It took a while to realize that containment considered a barrier to an epidemic is ineffective. We noticed this with cholera in the XIXe century and then we needed time to admit that it was not the absolute weapon.
Confinement is very unpopular for the people who suffer it and very popular for the others, that reassures. It’s a little bit like locking the epidemic in a place of sacrifice that would allow everyone outside that place to be protected. Obviously this is not the case because there are perverse effects and it is sometimes a factor in the spread of evil.
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Has containment never been proven?
P.Z. : The only example of containment that has worked dates from the Spanish flu crisis in 1918, but under special conditions since it was on an island. This happened in Eastern Samoa, which was under American administration. It was impossible to get in or out, and the population was protected. Western Samoa, which was under New Zealand administration, did not benefit from the containment measure: the mortality was absolutely frightening, of the order of 22 or 23%.
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