Mediapart today publishes the results of an investigation which reveals the mismanagement at the highest levels of the French state over the key issue of protective masks. These errors, which have occurred from January right to the current day, amount to a state lie and have led France to an unthinkable situation: a shortage of masks for healthcare workers on the front line in the battle against Covid-19 coronavirus crisis, and for the public in general.
- At the end of January and start of February the Ministry of Health, though aware of the state's low stocks, only ordered a small number of masks, despite internal warnings. This equipment then took several weeks to arrive.
- After this first fiasco, at the start of March the French state created an inter-ministerial unit dedicated to buying masks. But once again the outcome was catastrophic: during the first three weeks of March this unit only obtained 40 million masks, enough for just one week at current rates of use. In particular the unit missed several opportunities to obtain rapid deliveries of supplies.
- The government hid this shortage for nearly two months and adapted its health advice on wearing masks according to the level of stocks. At the end of February the country's top health official recommended wearing a mask for anyone in contact with a person with the virus. A month later the government's spokesperson said it was pointless.
- Some companies in “non-essential” sectors of the economy continued to use masks for economic reasons. An example is the aircraft manufacturer Airbus who seem to have received favourable treatment. At the same time some nursing staff have continued to work without protective masks because of insufficient supplies.
- The government is now trying to replenish the stocks, accompanied by a completely new strategy in which they are having to prepare for the end of the lockdown “when we know [the public] will need to be massively equipped”, as the junior economy minister Agnès Pannier-Runacher admitted in a meeting of which Mediapart has obtained a recording.
Below Mediapart sets out the different stages of this unfolding tragedy.
♦ ACT I (end of January 2020). A lie about a shortage
“The big mistake in the US and Europe, in my opinion, is that people aren’t wearing masks,” George Gao, director-general of the Chinese Centre for Disease Control and Prevention (CDC), told Science magazine on March 27th. The virus is transmitted by droplets and close contact, and droplets play a “very important role” said the Chinese official who was on the front line in the battle against Covid-19. “You’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or pre-symptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others,” said Gao.
The problem was that in mid-January, when the epidemic started in China, stocks of masks were almost non-existent in France.
Mediapart understands that at this time there were fewer than 80 million 'surgical' masks in France plus a further 80 million which had been ordered but not delivered, and zero stocks of the more protective 'FFP2' masks.
Surgical masks are the basic masks against projecting the virus, designed for the public and with a period of usefulness limited to four hours. They do not protect those who wear them but stop the wearer from infecting others.
The second type, plus the top of the range FFP3 masks, are protective respirator masks to be used by nursing staff. Only the FFP2 and FFP3 masks protect the wearer. During a pandemic they should be given to all staff who are the most exposed to the virus: hospital nurses and doctors, GPs, firefighters, ambulance staff and so on. Yet France had no stocks of these.
That decision was made not by the current government but its predecessor. In 2013 the then-minister of health, Marisol Touraine, had in fact decided to get rid of the state's strategic stocks and to transfer responsibility for them to employers, whether public or private, who from then on had the task of “establishing mask stocks to protect their staff”.
Rather than being transparent about this shortage – which was not of their doing – and explaining that the few stocks that were available would be reserved for nurses, prime minister Édouard Philippe and his government chose not to inform the French public. And they used false health arguments to hide the inadequate stocks. First the government explained that the masks were useless for the general public, then that they were not effective because French people did not know how to wear them before, belatedly, the government has switched to trying to “massively” equip the public in order to get ready for the end of the current lockdown.
♦ ACT II (end of January, early February). A slow and inadequate reaction
By the end of January some in the team around Jérôme Salomon, the country's director general of health and the top public servant on health issues, were already getting worried, Mediapart understands. But politicians did not dare admit to the public that there was a risk of a shortage of masks and preferred to say initially that the masks were useless – until such time as the orders arrived.
On January 24th, a few hours before the confirmation of three European – French – cases of Covid-19, the health minister at the time, Agnès Buzyn, sought to reassure people as she left that day's scheduled meeting of ministers: “The risks of the spread of the virus in the population [editor's note, French population] are very small.”
The French public took no notice. From mid-January “many people rushed into the chemists, into DIY stores to buy masks, online, everywhere. It quickly emptied stocks,” said the commercial director for the West Mediterranean area for American manufacturer 3M, one of the world leaders in making masks, in a confidential internal meeting. The emptying of supplies was hastened by the fact that “many masks stocked in France went to China or elsewhere”. The commercial shortage was so acute that from the end of January 3M “stopped supplying” French chemists and “prioritised” the hospitals, the commercial director said.
Health minister Agnès Buzyn's comments were also completely out of step with the reality experienced at that very moment by the Ministry of Health's own crisis unit which was studying a plan of action of the different stages of the epidemic. The 25-strong unit, which is made up of staff from the ministry's monitoring centre CORRUSS and its health security monitoring directorate, was worried about the low stocks of masks. “We started to get worried and we got ready for battle to buy them in massive numbers at the end of January,” one member of this crisis unit told Mediapart, on condition of remaining anonymous.
On January 24th the Direction de Générale de la Santé (DGS), the body that oversees health policy in France and which is headed by Jérôme Salomon, asked the public health agency Santé Publique France (SPF), which is under the authority of the ministry, to carry out an inventory of medical supplies. On January 30th the DGS then asked the public health agency to buy “as soon as possible” 1.1 million FFP2 masks only, according to a document seen by Mediapart:
On February 7th the DGS made a new request for the public health agency. This time it was to buy 28.4 million FFP2 masks via an “accelerated purchase procedure” by contacting just the three main French producers. No new orders were made for surgical masks. Moreover, the DGS ordered supplies of 810,000 surgical masks with short expiry dates (March 31st or August 31st 2020) to be sent to China.
Two weeks after the first DGS purchase request, the results were catastrophic. By February 12th, out of the 28.4 million FFP2 masks asked for, the SPF had received just 500,000 and had ordered another 250,000 which had not yet arrived. As for the planned 160 million surgical masks, there was still a shortfall of 30 million masks which had been ordered but not delivered.
Inside the Ministry of Health concern was growing as officials worried about the problems of supplies and the slowness of Santé Publique France to react. At an internal meeting on February 11th it was acknowledged that the goal of achieving 28.4 million FFP2 masks was in jeopardy. That did not stop the new health minister – by now Olivier Véran had replaced Agnès Buzyn who had become President Emmanuel Macron's preferred candidate to be mayor of Paris in the March local elections – to declare several times on France Inter radio on February 18th that “France is ready” faced with the “risk of a pandemic”.
How can this fiasco be explained? The Ministry of Health insists that it came up against a very competitive market – limited supplies, growing demand across the world, rising prices – in particular against Asian countries who already have their usual supply chains. But the government had clearly committed several errors: making very low-volume orders that were too late and too scattergun – each ministry ordered for itself, reducing the buying power in negotiations. Finally, the executive had used public contract procedures that are ill-suited to an emergency. This includes those operating at European Union level.