A Parisian gymnasium where MSF was active between March and June 2020 during the COVID-19 epidemic. Credit: Agnes Varraine-Leca/MSF
A Parisian gymnasium where MSF was active between March and June 2020 during the COVID-19 epidemic. Credit: Agnes Varraine-Leca/MSF

A study published by Doctors Without Borders revealed that a high percentage of people living in extreme hardship in shelters and workers' hostels in the Paris region had been infected with COVID-19. The medical charity recommends ending accommodation in gymnasiums.

It is an alarming finding: Among the most disadvantaged in the Paris region, more than one person in two was infected with COVID-19 between the beginning of the pandemic in early 2020 and July. The figures are based on a survey and on antibody tests conducted by Doctors Without Borders (MSF) and the epidemiology group Epicentre between June 23 and July 2. Researchers looked at 818 people, 90% of whom were foreigners.

Described as the first of its kind in France and in Europe, the study revealed strong disparities in infection rates between the types of sites at which people had been living: the rate of infection was 50.5% in the ten accommodation centers (hostels, gymnasiums, hotels, etc.) where residents were tested; 27.8% at two food distribution sites and 88.7% in the two migrant workers' residences targeted in the study.

By way of comparison, at the national level, 8% of people had antibodies to the virus as of early October, and about 12% in Paris, according to the French national health agency. "These figures, these proportions, we only find them in India, in the slums of Brazil ... and even there we are at 40, 50%," said Thomas Roederer, epidemiologist at Epicentre.

Corinne Torre, head of the French mission for MSF, discussed the findings with InfoMigrants.

InfoMigrants: What does this study tell us?

Corinne Torre: The figures are clear: the higher the population density, the more difficult it is to apply barrier gestures and the higher the rate of infection. It's really a question of overcrowding. Migrant workers' homes are the places with the highest rate of contamination and that's not surprising: we know that there can be four or five people per room in them. These are also people who continued to work during the confinement [Deliveroo deliverymen, Uber drivers, etc.]. People in shelters may also be older than in other types of accommodation, over 50 years old, and may have significant co-morbidities. We need to raise awareness and make people themselves realize that it is better to isolate.

But there is also a big problem regarding the centers requisitioned for these fragile populations. The shelters, as implemented, have created clusters. In them, people eat meals together, those housed there are not divided into rooms according to their vulnerability factors, distance is not respected ... As for the gymnasiums, we should simply stop using that type of accommodation. However, it still continues today.

IM: Some of these people were therefore contaminated in places where they had been "sheltered" by the authorities. Isn't that paradoxical?

CT: There has been no consistency with respect to the pandemic. Shelter is not enough, we also need to provide medical follow-up, organize social support to ensure that distances are respected, and inform people. We saw gymnasiums with 100 beds where no one was assigned to take care of the people housed there, where only two employees, in charge of security, were present on the premises. That situation is unsuitable, and inevitably a place like that becomes a cluster.

IM: Were these cases of contamination serious?

CT: It's very difficult to know at the moment. We don't have the information to determine how many vulnerable people were hospitalized or even died from the virus. There are simply no data available on that, just as we don't have any figures for squatter and slum populations. More studies are needed.

Moreover, it is important to understand that this is a delicate subject to discuss with the populations concerned. During lockdown, many refused to be tested for fear of being diagnosed positive. They were afraid of being sent to "relief" centers [also called "Covid centers"] and losing their housing (although this would not have been the case). They also feared that they would be stigmatized if they were sick and then rejected by others. Those fears are still present, but at MSF, in order to conduct this study, we took the time, once the lockdown period was over, to clearly explain our approach to the interviewees to convince them to be tested.

IM: The high level of infection comes as no surprise. As early as April, MSF told InfoMigrants that the spread in these collective shelters was "almost inevitable." Do you have the feeling that you are not being heard?

CT: Yes, and that's why we wanted to do this study. We had some fears in April, and now we see the results. We wanted to release the medical data so we can develop a better approach for the future. It would be outrageous if no one took these results into account because if we continue to manage things this way, the pandemic is likely to continue.

 

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