A curfew with uncertain effects

Despite the Quebec experience of last winter’s curfew, it is still difficult to say that this liberticidal rule is bending the contaminations curve.

Does the return to the curfew box mean that the measure is effective? “Solid evidence, to my knowledge, there is none”, indicates Hélène Carabin, professor of epidemiology of infectious diseases at the University of Montreal. Its effect on public health remains uncertain, especially given the number of measures in place.

“We are not in a situation where we can test that in a randomized study,” explains the specialist. It is impossible to compare two towns or villages which operate under the same rules, except for a curfew. When we have a curfew, we also have other measures at the same time. So isolating the effect of the different factors of public health measures is very difficult. “

Then, each restriction can add up into a “severity index”, an indicator developed by the University of Oxford to assess the intensity of stringency by health authorities. “The higher this index, the more we tend to see the transmission rate decrease. So the more public health measures there are, the more the number of new cases will tend to decrease. It is quite clear, this association. “

This is the argument used by the Prime Minister, François Legault, to defend his decision. “We have indications that it is useful. And currently, the situation is so serious that we cannot afford not to put everything we can add in our toolbox, ”he pleaded at a press conference.

Conflicting studies

Several international studies, of France and from Jordan in particular, stipulate that the curfew slows down contact and, therefore, contamination.

A compilation of published studies in the scientific journal Nature Human Behavior compared the effectiveness of 6,000 health measures implemented in 79 countries. This analysis ranks the curfew as the fifth most effective means to lower the rate of transmission, after banning gatherings, closing schools, closing borders and public access to protective equipment.

On the contrary, a study carried out by two Quebec researchers last spring came to the conclusion that the “curfew effect” on the drop in cases “seems doubtful”. The infection curve does decrease after the measure was introduced, but “the curfew does not seem to have caused an acceleration in the downward trend in cases, which is a sign of its ineffectiveness”.

According to data provided by the government, “we see that social contacts at home were really stable,” explains one of the study’s authors, Julien Simard, postdoctoral researcher in social work. “The vast majority of outbreaks (93%) took place in institutional settings, such as schools, at work, in daycares. Curfew is like slashing water. It comes to act where there are not really outbreaks. “

“When we generally assess the effectiveness of a measure or a drug, we also compare the acceptability of side effects,” continues her colleague Emma Jean, doctoral student in sociology at the University of Montreal. What we suspected at the time was that there was a disproportionate impact on marginalized people.These restrictive measures had an effect on mental health, on domestic violence. It’s hard to put a figure on it, but that’s what the workers in the field are saying. These are also consequences that must be taken into account. “

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