- Since last week, many voices have been raised asking for more Covid-19 screening tests in France.
- The Minister of Health Olivier Veran announced Saturday evening a change in strategy, towards a multiplication of tests at the end of confinement.
- Since the start of the epidemic, Professor Didier Raoult has advocated the generalization of screening tests in the fight against Covid-19.
- For Bruno Lina, member of the scientific committee in charge of advising the government, the generalization of tests requires a complex organization.
Long lines of three to four hours of waiting. These are daily scenes that can be seen in front of the IHU Méditerranée Infection in Marseille. These dozens of people are waiting for a Covid-19 screening test at the institute led by Professor Didier Raoult, known for his work on chloroquine against the coronavirus.
“In accordance with the Hippocratic Oath that we have taken, we obey our duty as a doctor. We provide our patients with the best care for the diagnosis and treatment of a disease. We respect the rules of the art and the most recently acquired data from medical science. We decided, for all the febrile patients who come to consult us, to practice the tests for the diagnosis of infection with Covid 19 ", explains the IHU by press release.
"Test! Test! Test! "
If so many people are lining up, it is because the IHU acts as an exception in France, where screening tests are reserved for "symptomatic health professionals, symptomatic elderly people, people with severe breathing difficulties or co-morbidities, to hospitalized people, and to new homes and new territories ”, details the Ministry of Health. According to their accounts, 60,000 tests were carried out in France, when the Marseille IHU alone advanced the number of “20,000 to 25,000 tests carried out” by their services to 20 minutes .
"Test! Test! Test! », Here is the recommendation hammered for several days by the World Health Organization (WHO) to European countries. This is also the opinion shared by François Bricaire, infectious disease specialist and former head of the Infectious Diseases Department at La Pitié-Salpêtrière. "Undoubtedly yes, it is necessary to generalize the tests in order to have a better image of the importance of the subjects concerned, a better vision of the number of carriers of the virus. This will be all the more essential when the containment is stopped, in order to identify people who are infected, ”he said at 20 minutes .
"A strategy that is not that of the technological world"
For Professor Didier Raoult, screening tests are essential to the fight against this pandemic. They militate for their multiplication since the beginning of the appearance of the virus in France, even before when he tested all the French returnees from Wuhan.
"How was AIDS mastered? It is neither through vaccines, nor through mathematical models. It's the viral load and the treatment. We watch with the treatment that the viral load decreases and, when it is below a certain threshold, people are no longer contagious, and are no longer sick. It is this model that we are trying to set up. But in this strategy, we test, we detect, we treat, the world is not equal. Those who run the fastest, those who did the most, are the Chinese and South Korea. For a population smaller than ours, look at the number of tests they have done. We took a strategy which is not the same as that of the technological world, it is to test very little ”, he explained in a video posted on YouTube by the IHU.
However, according to him, France has the skills to carry out these tests. "It is trivial PCR [polymerase chain reaction] that everyone can do, the question is organization, not technique, it is not the diagnostic capacity, we have it. It is a strategic choice which is not that of most technological countries, in particular the Koreans who are part, with the Chinese, of those who have mastered the epidemic by screening and treatment. We are capable in this country like anywhere else of doing thousands of tests and testing everyone, ”he argues.
"Think about supply and equipment"
For Bruno Lina, a researcher at Claude Bernard Lyon 1 University at the International Center for Research in Infectious Disease, and member of the scientific committee in charge of advising the government, several factors complicate the generalization of tests.
“It is true that we are able to do more tests, but we lack tools such as reagents. There is a very strong global demand and the suppliers of these reagents have to ramp up. There is also a risk of a shortage of swabs for testing. We already have a fairly large testing capacity, to increase it we must think about supply and equipment. We are able to do generalized tests over three days, but for six weeks it requires a much more complex system. And we must guarantee these screenings to the remote villages of Ariège or Hautes-Alpes. It may seem simple from the outside, but in practice it requires a lot of organization, ”he said at 20 minutes .
During a press briefing on the situation on Saturday, the Minister of Health, Olivier Veran, admitted "to change the doctrine". “The challenge is to be able to increase the testing capacity when we lift the containment. We will have to check, for people for whom there was a doubt, whether or not they presented the disease. "
Several avenues are being explored, such as the introduction of faster screening tests. But speed can sometimes be synonymous with a drop in performance. "The appearance of new tests and the gradual ramp-up of traditional suppliers should gradually facilitate our performance in terms of screening", assures Bruno Lina. The government hopes to be ready in about four weeks, when Professor Raoult calls for a generalization of tests for a month.
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