- A cluster having emerged in a slaughterhouse near Orleans makes it possible to judge the effectiveness of the method of tracing of contacts wanted by the government to prevent a reconfinement.
- Doctor Thierry Prazuck, head of the infectious diseases department of the CHR of Orléans, deciphers for 20 minutes the strategy pursued to curb the epidemic focus of Tradival.
From our special correspondent in Orleans
Small feat that warms the heart after a day of dragging our gaiters in front of the Tradival slaughterhouse, in the heart of the cyclone since the discovery of a source of propagation of the Covid-19 epidemic. Succeed in stealing a little time from Thierry Prazuck, the head of the infectious and tropical diseases department at the CHR of Orleans, so that he explains to us how one of the first large clusters is managed post-deconfinement from the room joysticks.
Time to wait, we hear a nurse picking up her phone and trying to paint with difficulty the portrait of an entire family to be screened as soon as possible. The lady called does not understand French very well, and there is no longer anyone from ISM interpreting in the area. The association, which facilitates understanding between non-French-speaking residents and French public services, a vast program, has been solicited specifically in the context of monitoring positive cases of the slaughterhouse, where a large foreign workforce works. . "An example of the difficulties we have to face in this type of case," recognizes Dr. Prazuck.
How did you find out about an outbreak in an abattoir in the region?
The first cases appeared last Wednesday, but in reality the symptoms had started before. Only, as people work in difficult conditions, where it is very cold, they are used to colds or small, common respiratory infections. They don't panic right away. Most of the people I had on the phone had only very moderate symptoms, so they weren't too worried. You have a case, good. Then a second. When you have a third, you start to ask yourself questions and tell yourself that there may be something.
It went back to the ARS. From the moment that grouped cases were noted, it was a question of testing the 82 employees who were directly in contact in the cutting workshop. There, we found 22 more positive cases on Friday, with no hospitalization yet.
How does their care take place?
We received the results on Saturday, immediately called the patients to tell them they were Covid +. The problem is that there are a huge number of foreign workers. They don't all speak French. Fortunately, I have a collaborator at the hospital who speaks Romanian, so she called a lot. Some have no social security coverage, there have been a few false numbers… All of these people, we have been contacted so that they can be sampled on Sunday. Among them, there were at least ten positive cases, in addition to those of the slaughterhouse.
How is the work between the infectious diseases department of the CHR and the Primary Health Insurance Fund (CPAM) divided?
We make an initial investigation within the family circle of positive cases, and we summon them all for a sample at the hospital. Then, we enter the data on the software “Contact covide” of all the close entourage. And once we do this work, the CPAM is supposed to go back up the sector to make a broader investigation, to see how many other people there are to take.
[Contact tracing # covid19] This is the process for identifying people detected positive for # covid19 and contact people, in order to break the chain of contamination. Know everything >>> https://t.co/7fb28xeXaN @ Prefet71 pic.twitter.com/8eTre7XMSu
- CPAM Saône-et-Loire Actu (@ cpam_71) May 19, 2020AJ + 5 of the discovery of the first cases, do you think that the famous “contact-tracing” device, sold as the solution to deconfinement, has worked well?
It must be understood that such a large fireplace, we did not have one, it is quite exceptional. For two months, we worked seven days a week because there were serious cases, but here we moved on to another aspect of the management of the disease.
On the slaughterhouse, I think that going faster than that in operational terms, with the weekend in the middle, I don't see how we could have done it. The tests started on Friday, the sampling center was open all Sunday, it did not stop for a second. Strictly speaking, we could have decided to test the whole company faster. But at first, the strategy set by the ARS was to test in the workshop concerned. We quickly expanded.
In your opinion, is there still a risk of losing control of the outbreak in the coming hours?
Tracing homes is first of all a question of human resources that we must make available to us. For the moment, we don't have enough. I have a secretary and a nurse who worked Saturday and Sunday from 8 am to 7 pm non-stop, when they had worked all week, and they will work all week after. When this shot is going to fall, you will have to be careful not to be too disarmed.
To cope with such a household, people need to be trained. However, the hospital's activity resumes and people who are very efficient, because they arrived at the beginning of the crisis, return to their service. Then, the CPAM must also do its share of the work. It is not all up to us.
That is to say ?
There are approximately 400 people working in the slaughterhouse. You multiply by three or four if you count loved ones, that makes 1,200 potentially positive people. How many of them are going to have to be contained, and under what conditions?
For example, I had a family: they live in four in two rooms and there is for the moment only one which is positive. You can't confine him to a room, it's inhuman. The CPAM must offer them a hotel. I'm not saying they don't, but I don't know.
Information bulletin # COVID19 N ° 72 in @RCValdeLoire
62 people in sick
477 deaths in health care
375 deaths of residents in medical and social care
➡️Systematic tests for sick people and their contacts: https://t.co/ lrLib9U2AJ
❗️Save lives, stay careful❗️ pic.twitter.com/KKpgiUEGVO
More generally, do you worry about the appearance of this outbreak a week after the containment is lifted?
No more than that. The workers who work in the slaughterhouse are not people who have remained confined. We needed them to continue feeding. This episode does not mean that it is the consequence of deconfinement, and it is also too early to measure the effects. On hospitalization, there are a few cases, but they have been there for a long time. The decline remains in place. That said, it's like when there was the first wave: at the start, we had mild cases, and then little by little it went up. We do not know.
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The precious help of the CHR mobile teams
At the Tradival slaughterhouse, they are three nurses who have been continuously tested since last Friday. The last living forces of the mobile team managed by Anne Gravier, who was able to mount up to 17 people in April, when it was necessary to test nearly 3,000 people in the Ehpads of the region, "thanks to the reinforcement of others services, school nurses, and even school students. "
Mobile teams only intervene when outbreaks of more than 15 people appear. Friday, it was therefore Anne Gravier who contacted the company at noon to launch a massive screening. "We give instructions on the choice of place, disinfection before and after, the necessary documents". At 3 p.m., the first employees were tested. “The coordination was excellent on the part of all the players. The ARS, the hospital, the laboratories which gave the results in less than 24 hours, and even the company, which very quickly became aware of the problem. That does not mean that one or two people will not fall between the cracks, but that should not have consequences on the control of this hearth of epidemic.
- Slaughterhouse
- Orleans
- Coronavirus
- Health
- Loiret