Just as it was at the start of the ’yellow vest’ protests that swept France in the second half of 2018, it’s easy to come up with lots of good reasons to distance yourself from the protests against Covid health policies that have reached unprecedented levels for the middle of a French summer (see reports here and here). Medical practitioners, politicians, intellectuals, academics, editorialists etc; entrenched in their own convictions and rightfulness, those who have – or who think they have – knowledge and experience find it easy to scorn the confusion that reigns in those protests, to condemn the ignorance which proliferates there, and to attack the conspiracy theories spreading through them, all of it creating fertile ground for the most odious of far-right ideas, including anti-Semitism.

Yet to give way to this easy option would be to confuse cause and effect. The confusion shown by these protestors cannot mask their initial motivation: a pent-up anger against a government which continually sows mistrust, creates division and fuels disorder. In this crisis, one of many in a presidency which has, since Emmanuel Macron was elected in 2017, provoked spontaneous popular protests of all kinds, there is no simple division between ignorant and barbarian protesters on the one hand and enlightened and civilised rulers on the other.

While we defend the need for vaccinations as collective protection against the spread of the virus (see recent articles by Mediapart here, here and here), using an educational approach which contradicts the views of some demonstrators, we haven’t forgotten that the credibility of the first health protection measures, among them the mandatory wearing of masks, was initially undermined by those in authority themselves, who concealed their own negligence with a government lie (see main story here). This initial error, which has never been acknowledged, still less punished, has in turn completely undermined the credibility of official statements.

If the obedient discipline of the public during the first lockdown - which was widely applauded a year ago - now seems nothing more than a distant memory, that is because the government was not able to use that opportunity to build a democratic health policy, one based on dialogue and sharing information with those most involved: nurses, the sick, people at risk, the most vulnerable groups, the most exposed sectors, the geographical areas most affected and so on. In other words, with society itself.

As loathsome or irresponsible as some of their expressions may be, the protestors’ anger against a health policy that is seen as unjustified because it is regarded as authoritarian is the price being paid by the presidency for its authoritarian handling of the Covid-19 crisis, which has lacked debate, transparency, humility and an educational approach, and which has been shielded by a ’Public Health Defence Council’ that meets in secret at the Élysée.

By firmly turning its back on what has been learned in recent decades about public health policy, in particular since the HIV pandemic responsible for AIDS in the 1980s, the Macron presidency has sown discord rather than created harmony. And without that harmony there can be no standing together united in the face of a health threat. In France that is the main lesson from a year and a half spent fighting against Covid-19: that of a lasting and knee-jerk backwards step, which comes on top of other democratic reverses seen in the recent glut of security legislation (a prevention of terrorism law, a law against separatism, a law on global security).

The tension between collective restrictions and individual freedoms is at the heart of public action against epidemics. This public action is traditionally coercive because the pressing need to fight against the infection is seen as justifying the restriction or suspension of individual rights. Yet this classic view was radically challenged by the “revolution in public health” linked to AIDS, with an awareness of the risks of exclusion and of stigmatisation caused by the handling of the epidemic, as well as new public expectations in socio-political terms in relation to public health.

The “liberal” response back then marked a “break in relation to the previous modes of action when faced with infectious diseases … through the unprecedented attention that was given to people’s rights and autonomy”. This comment was made by the former health minister Claude Évin, who was later director general of the Paris regional health authority and who could in no way be mistaken for a dishevelled utopian (see his full evidence given in 2012 here). This political change, he said, manifested itself through a “refusal to resort to restrictive measures, such as mandatory screening or even, up to the start of the 2000s, the obligation to declare that you were seropositive; and, in contrast, through the paramount role given to individual responsibility, to information and to prevention”.

Report from France’s Scientific Council

It is therefore no coincidence that France’s Covid-19 Scientific Council, which was set up at the start of the pandemic and whose chair Jean-François Delfraissy is an immunologist and himself a specialist in HIV and emerging viruses, quickly sounded the alarm about the “urgent” need for the “inclusion and participation of society in the response to Covid-19”. Regular readers of Mediapart know about this memo, dated April 14^th 2020, which is accessible only on our website (read here how it was revealed by Caroline Coq-Chodorge). For this memo’s demand was not only ignored by the person it was aimed at – the president of the Republic – but was also shamefully censured, so challenging was its explicit appeal to “health democracy” to a collective exercise of power that has now extended itself to the top-down control of our health.

In view of the scale of the protests against a (health) policy that was effectively reduced to (administrative) policing (see our article here on this general trend on the part of the government), where the restrictions were not debated in advance and where public respect for them was not nurtured through an education campaign, it is useful to reread this memo which sets out exactly the route that should have been taken to create this sense of unity and togetherness, in other words mutual assistance. It is even more important when one considers how prophetic this memo was about the risk that a “counter society” could emerge on the internet in the face of the crisis, one which showed how a “section of the population leans towards counter-narratives, distorted truths, rumours and conspiracy theories” which in turn revive “conflict between the people/elites, people at the bottom/people at the top, by associating a section of the medical world and the scientific world with the Parisian elites”.

To avoid this trap, the chair of the Scientific Council, Jean-François Delfraissy, recommended encouraging the “support of the people”, using “social expertise” and backing “local responses”. Shut away in his ivory tower (and surrounded by servile supporters), the self-proclaimed epidemiologist-in-chief Emmanuel Macron did exactly the opposite, majestically ignoring the sensible view that “even in an emergency situation, public support is an important condition for the success of the response ”.

The memo continued: “The trust that citizens have in institutions is based on the supposition that they don’t just operate exclusively with control from on high (elected representatives, civil servants, experts) but can also maintain greater involvement from society.” The prophetic memo went on to state that through its various organisations and associations, this society has a “specific expertise that the authorities don’t have”, particularly in relation to the most vulnerable groups and to the diversity of situations on the ground.

Yet this - unheeded - warning was simply expressing knowledge that had already been widely disseminated, including beyond our borders, by every study that has looked into how to handle large-scale health crises (see the article by Matthieu Suc here). In 2017 a report written for the World Bank emphasised the need for the public to be “made aware early on”, with full transparency and no lies or concealment. Ten years earlier, in 2007, the Centre d’Analyse Stratégique, part of the French prime minister’s office, highlighted how among the “challenges posed by emerging infectious diseases” one was the danger of a “confusion of messages”. It said: “Denial and a lack of transparency are no longer possible, or at least have become more risky for the authorities.”

Moreover, the recommendation made by the chair of the Scientific Council simply passed on a demand that had already been made in March 2020 by the government ethical advisory body the Comité Consultatif National d’Ethique (CCNE), which recommended “transparent and responsible communication based more on social structure”. While organised collective action to protect public health is one of the state’s core missions, the CCNE believed that the “consultative method is a guarantee not just of the suitability of the policy decision to which it will have contributed (by relying on scientific expertise), but also of the confidence that it will elicit among civil society”. It went on: “Moreover, this decision, which concerns the whole of society and potentially its fundamental values, should be informed in advance by the expression of citizens’ opinions.”

Lack of coherence at leadership level

Yet the setting up of such an independent body to take into account the views of citizens in this way – a move recommended by both the CCNE and the Scientific Council - was never countenanced by Emmanuel Macron and those around him. Even though, as the country went from lockdown to lockdown and from testing to vaccinations, it would have ensured the development of a health response that was both understood and accepted. This “unprecedented step in our democracy”, added the CCNE, “would contribute to encouraging trust in and ownership of the public authorities’ actions by the whole of society”. What is clear, said the CCNE, is that “the coherence of a

It is something of an understatement to say that there has been a lack of coherence at leadership level over the last year and a half. One year after the huge lie that hid the shortage of masks, Emmanuel Macron himself took the decision not to introduce a new lockdown in February 2021, against the advice of scientists, epidemiologists, and doctors (see the Scientific Council’s advice on January 29^th here). The perspicuity that his sycophants attributed to him at the time came at a terrible human cost, estimated at 14,000 deaths (see our article here), while it failed to prevent a third lockdown in the end, even if this was, alas, too late.

But to this unenviable league table where irresponsibility seems to come top, we can also add the insufficient prioritisation given to at-risk groups over vaccines, as well as the discriminatory targeting of working class areas during the lockdowns. There is also the very recent example of no longer requiring people to wear masks in the places where they need to show Covid health passes; this approach favours surveillance over prevention. In other words, it means abandoning a bird in the hand (protective and safety measures) for two birds in the bush (administrative and police coercion).

In its recent opinions the Scientific Council has continued to call for an approach which can be best summed as “go towards”. Contrary to the impatient and disdainful urgings loudly and variously pronounced by Emmanuel Macron, whose claimed omniscience reminds one of the nervous pacing up and down of the doctors that feature in the plays of Molière, these two words describe a health policy that is empathetic and which takes care to educate and be understood.

The Scientific Council has pointed out that the “most socially disadvantaged groups and those furthest removed from the healthcare system and/or on low incomes” have paid the highest price during the first three waves of the Covid-19 epidemic. So in its opinion issued on July 6^th 2021 the Council called for an intensification of the “’go towards’ vaccination strategy”. It said of this strategy: “It can be carried out in partnership with different local groups and associations and should seek to explain without judging or imposing.” The vaccine, the council stated, should be “explained and offered while avoiding any form of stigmatisation”.

In summary, this is the exact opposite of the presidency’s non-educating approach, which both regards having a vaccine as a categorical imperative and stigmatises those who are reluctant to have one in a discriminatory way; going so far as to effectively blackmail people over their employment (see the article by Romaric Godin here). There is no doubt that whereas one should be “going towards” the public, this president prefers to “go against”. In the same way, the political movement that the president set up using his own initials - ’En Marche!’ meaning ’Forwards’ - has over the last four years of power come rather more to resemble ’En Force’. In other words, it has adopted a permanent policy of forcing things through with no dialogue or listening to others, no sharing of information or consultation, and remained indifferent to the diversity of expectations and opinions despite Macron’s low initial electoral legitimacy; just 18% of the registered electorate voted for him in the first round of the presidential election in 2017, something which did not indicate blind support for his future actions.

If there is one lesson from this presidency, it concerns the great urgency that surrounds the issue of democracy. At a time of global challenges, both health and climatic (see Mikaël Correïa’s article on the latest report from the IPCC here), which put the future of humanity at risk with little distinction between classes, people or nations, we have no other protection than our capacity to invent together responses that are united and lasting. If they are wrong about many other issues, the demonstrators protesting against a health policy that has come down simply to restrictions being imposed from on high without debate are not wrong in highlighting this vital issue.

Edwy Plenel