- The 953 residents and 854 staff of ten Ehpad in the department were tested serologically last week.
- According to the results, the rate of residents who have been in contact with the disease varies from 0% to 76%, and that of staff from 2% to 62%.
- The limits of serological tests, underlined by the High Authority for Health, lead us to turn to other, biological tests.
Since the start of the coronavirus epidemic, 547 people have died in nursing homes and 639 in hospitals in the Haut-Rhin, according to an assessment made Monday. Last week, the departmental council launched a screening operation in ten establishments for dependent elderly people, aimed at adapting the health response.
What did the results reveal, made public on Tuesday? Of 953 residents tested, 296 (31%) had antibodies showing that they had been in contact with the disease, as were 221 (26%) of the 854 staff members tested. Behind these figures, there are "a variety of situations," says Christian Fischer, director of autonomy at the Haut-Rhin departmental council.
Up to three-quarters of residents tested positive
In one of the nursing homes, 76% of the residents tested positive, and in another 62% of the staff, when, on the contrary, one establishment presents no positive case among the residents and another "only" 2% among the staff. Of the ten establishments studied, four have more than 50% of residents with a positive serological test, three have 10% to 36% of residents in this case and three others, 3% maximum.
"As the department is very struck, the experts did not expect this heterogeneity," notes Brigitte Klinkert, the president (DVD) of the Haut-Rhin departmental council. They rather expected to see the Covid present in all Ehpad. This is not the case today. "
The "mapping" of the disease
Other teaching, "there is a strong correspondence between the clinic, that is to say the consultations of the doctors, and the cartography revealed by the tests", specifies Christian Fischer.
“Thanks to these tests, residents who had not previously been ill were found to be positive. That allowed the Ehpad in question to have a greater attention towards them, to see if, in the days to come, they did not develop symptoms ”, underlines Brigitte Klinkert.
A method contested by the High Authority for Health
However, the president of the departmental council recognized this Tuesday the limits of this study to define "an operational strategy" against the disease. The High Authority for Health said last Thursday - three days after the start of the samples - that the serological tests lacked reliability.
"Failure to perform a test can have serious consequences for people who believe they are falsely immunized", explains the Regional Health Agency (ARS) du Grand-Est, for whom "recourse to these serological tests is not not recommended ”.
Adapting the rules for the Haut-Rhin
"This is a fundamental and new element for us, which we did not have on April 14 when the serological tests were launched," says Brigitte Klinkert. And which explains the decision not to generalize these serological tests in the Ehpad of Haut-Rhin. On the contrary, the departmental council intends to "subscribe to the national doctrine which favors PCR tests", or biological tests, from a sample from the nasal cavities.
While these tests, with a view to prevention, were reserved for establishments presenting new cases of Covid-19, the departmental council announces that it has "obtained an adaptation" for the Haut-Rhin, where all the establishments are potentially already affected. "We will have the possibility of carrying out these PCR tests as soon as there is a new suspicion among staff and residents", in establishments which have not experienced a new case in the previous two weeks, announces Brigitte Klinkert. In practice, if a new case is found, all staff will be tested.
Up to 500 tests per day in departmental labs
The president of the departmental council counts on the cooperation of the laboratories of the two Alsatian departments to carry out PCR tests, after having obtained the green light from the prefecture. These structures could eventually carry out “400 to 500 tests per day” for a total of 12,000 tests across Alsace.
The screening strategy "will intensify in the coming weeks" in the Grand-Est, announced ARS on Monday.
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