how, in the face of a deadly heat wave, a government on vacation “lost its footing”

2023-08-02 04:01:22

The summer 2003 heat wave, during which 15,000 people died in France, was marked by the absence, mistakes and denials of political power and the authorities.

Monday, August 11, 2003. France is experiencing an unprecedented heat wave when Jean-François Mattei speaks at TF1’s “20 Heures”, duplex from his vacation home in the Var. The Minister of Health is in the garden, wears a black polo shirt and makes reassuring remarks. At the time, the figures for the heat wave, which will ultimately be the cause of excess mortality of nearly 15,000 deaths according to Inserm (PDF), are still vague. “I hear estimates, 50 here, 300 there”explains that evening Jean-François Mattei, who has no idea of ​​the extent of the damage but assures that there is no reason to worry.

The reality, however, is dramatic. While temperatures have exceeded 36°C since August 4 in Paris, and the mercury has locally reached 44°C in the Gard, emergency physician Patrick Pelloux talks to the media regarding a “hecatomb” in the hospital. Two days before Mattei’s interview, The Parisian alert on its side on an unprecedented episode of strong heat and title “Fourteen deaths of the heat wave”.

“It all started with a discussion at the coffee machine, remembers journalist Charles de Saint Sauveur, who covered the health crisis for The Parisian. A colleague who lived near Saint-Antoine Hospital says she heard ambulances all night. And there, it clicks.” His colleague calls the firefighters and the doctors, who confirm that a crisis is brewing. The emergency services are overwhelmed, the first victims die but the authorities are strangely absent.

The Raffarin government, which is emerging from a long series of demonstrations once morest the pension reform, is on vacation. President Jacques Chirac flew to Canada, François Fillon, Minister of Social Affairs, Labor and Solidarity, for Tuscany and the administrations are idling. “At the time, the holidays were a kind of truce for confectioners and we understood that ministers cut”, explains Charles de Saint Sauveur. For its part, the Paris police headquarters passed keep silent regarding the magnitude of the ongoing disaster.

“The instruction from the police headquarters was not to broadcast an alarmist message and not to give the dead.”

Jacques Kerdoncuff, press officer for the Paris fire brigade (BSPP) during the 2003 crisis

during the parliamentary commission of inquiry

“The firefighters were the first to see that we were tipping over, but the information was not passed on to the Ministry of Health”, rewinds epidemiologist William Dab, then adviser to Jean-François Mattei at the ministry. He went on vacation abroad on August 9, 2003, two days before the minister’s catastrophic intervention on TF1. “At that time, the general directorate of health (DGS) alert on a heat episode, but there is no mention of a health risk, he explains. We screwed up, we weren’t ready, and it took the vase to start overflowing and the funeral services to start to saturate for the DGS to realize that something major was going on.”

“Three days of major failure”

William Dab will later recognize, before the parliamentary commission of inquiry, “an under-representation of risk”. “There was a form of duel between the politicians who wanted to pretend that nothing was happening and the doctors in the field who said there was a problem”, ahead for his part Patrick Pelloux.

The government’s wake-up call comes amid the crisis. Patrick Pelloux, then president of the Association of Emergency Physicians of France, took advantage of a France 3 report on the heat wave to discuss the catastrophic situation in his hospital and challenge the authorities. The Prime Minister, Jean-Pierre Raffarin, immediately telephones his Minister of Health and asks him to intervene. Jean-François Mattei’s teams then set up a duplex at TF1’s “20 Hours”, the consequences of which will ultimately be disastrous. The geneticist will agree on a “error” on the substance as on the form at the microphone of the podcast “Mechanics of politics” on France Culture, in February 2022. “The denial lasted for a weekend, analyzes the journalist Charles Saint Sauveur. There were three days of major failure, where basically the state lost its footing.”

On August 12, the day following the minister spoke, the tone changed within the executive. Jean-François Mattei offers his resignation to the Prime Minister, who refuses it, then returns urgently to Paris. “I see the reality of the situation which escaped me”, recalled a posteriori Jean-François Mattei. The minister is then forced to play the fireman on duty. He occupies the ground in hospitals, in Paris and in the regions, and multiplies the interviews, without ever giving figures.

Meanwhile, Jean-Pierre Raffarin triggers the white plan in hospitals and convenes a crisis unit. The media then evoke overwhelmed hospitals, a lack of places in funeral homes and elderly people who die alone at home. On August 13, the first figures provided by the funeral directors reported 3,000 dead – in reality there were already nearly 12,000. And the first heads began to fall.

Discredited by his duplex in a polo shirt, Jean-François Mattei is asked to keep a low profile. THE government spokesman, Jean-François Copé, recovers the crisis communication – President Chirac will not speak until August 21, when he returns from vacation – while the director of the DGS, Lucien Abenhaïm, resigns following being disavowed by his Minister of Health in the media. The doctor, who will be replaced by William Dab at the DGS, leaves in silence, before settling his accounts in a book in the fall of 2003. Professor Abenhaïm denounces the errors of communication and assessment of the Minister of Health in crisis management. And opens the post-heat wave period, which will end before the parliamentary commission of inquiry.

The parliamentary commission of inquiry instructs the government

After several months of hearings, the National Assembly’s commission of inquiry delivers its conclusions. Claude Evin, former Minister (PS) of Health and chairman of the commission, writes that “politics was dramatically absent”. “There has been a deficiency in the political management of this crisis”, judge the deputies, who conclude that there are significant shortcomings in the functioning of the Ministry of Health but spare Jean-François Mattei. On the other hand, the management of the summer crisis by the government concentrates most of the criticism. Nicolas Sarkozy and François Fillon, respectively at the time Ministers of the Interior and of Social Affairs, Labor and Solidarity, admit not having been “at height”.

“There was a leak of responsibility”, launched twenty years later Jacques Kerdoncuff, for whom the memory of the crisis he had “very bad life” is still alive. “There weren’t many challenges, everyone was trying to defend their piece of fat”believes for his part Marc Payet, who covered the crisis for The Parisian. And to add: “Basically, the 2003 heat wave is not the Mattei affair, who was in the wrong place at the wrong time. It is the first major climate crisis, it is the harbinger and premonitory of what is happening twenty years later.”

Has France learned the lessons of this fiasco? “Yes and no. After the heat wave, Prime Minister Raffarin understood that France was not armed in public health“, adds William Dab, charged by the government with learning the lessons of the health crisis in 2003 and proposing concrete measures. Among them, the implementation of the heat wave plan, meteorological vigilance but also a toll-free number, still in force today. “But look at the number of deaths last year, we had another heat wave with a high excess mortality [un excès de plus de 10 000 décès selon Santé publique France], and this shows that we are not in a logic of continuous improvement.”

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