• Two weeks after the entry into force of the delisting of comfort screening, “20 Minutes” takes stock of this measure.

  • What impact has it had on monitoring the Covid-19 epidemic?

  • And how can the spread of the virus be stopped more effectively?

Forget the long queues in front of the Covid-19 screening barnums deployed by many pharmacies.

Since October 15, so-called "comfort" tests are no longer reimbursed for adults who are not fully vaccinated.

Two weeks later, is the screening sufficiently effective?

"It never has been," says Catherine Hill, epidemiologist and biostatistician.

So what are the most reliable indicators for monitoring the epidemic and halting the spread of the virus?

What effects does the de-reimbursement of screening tests for unvaccinated people have on the monitoring of the epidemic?

In terms of numbers, the effect was immediate. Last week, 2.3 million screening tests were carried out, according to figures released Thursday by the Ministry of Health. The Drees reports "a decrease of 675,200 tests, focused on 16-65 years", between October 18 and 24, compared to the previous week (where 2.97 million tests had been carried out). According to this statistical service of the ministry, 460,000 fewer tests were carried out on Thursday, October 21 than on Thursday, 14, where “the anticipation of the end of free access was important”.

“The drop in the number of tests is drastic. For example, in my dispensary, we do about half the number of screening tests, confirms 

20 Minutes

 this Friday Pierre-Olivier Variot, president of the Union of Unions of Community Pharmacists (USPO). For the time being, this has no deleterious effect, but in the event of a fifth wave, it may be necessary to revisit this measure to avoid an extension of the screening times for symptomatic people and their contact cases ”.

But "This delisting does not have much effect in reality, insofar as we tested anyone and anyhow," said Catherine Hill.

The French screening strategy has always been unsuitable: we look for SARS-Cov-2 in symptomatic people, and secondly in their contact cases.

Screening has therefore never taken into account the dynamics of the virus, since it has long been known that asymptomatic carriers, such as infected people who have not yet developed symptoms, transmit it ”.

“These data were confirmed once again in a study published in early 2021 in the

Journal of the American Medical Association

(JAMA), which concludes that 59% of all infections are caused by people without symptoms: 24% by asymptomatic carriers and 35% by presymptomatic carriers, details the epidemiological and biostatistician.

However, the risk of transmission is highest within a window of 4 days before the onset of symptoms and up to 6 days after.

In France, with screenings carried out on average more than 2 days after the first symptoms, we understand better why we have never found all the positive cases before they show symptoms, as did the Chinese, the Koreans or Australians.

We, instead of testing early, massively, and isolating the sick, we let the virus circulate ”.

What are the positive effects of this measure?

"Let us first specify that the only case where screening is no longer supported is when it is only used to obtain the health pass", emphasizes Pierre-Olivier Variot. "At least we will stop spending monstrous money on tests for an ineffective screening policy," adds Catherine Hill. For the year 2021 alone, the cost is estimated at 6.2 billion euros for the State ”.

Thus, "an unvaccinated person always benefits from free screening if they have a medical prescription, if they are declared a contact case or in the event of a contraindication to the vaccine, so we always have data on new contaminations", reminds the pharmacist.

By tightening the purse strings, the state will therefore reduce its spending, but this measure, which targets the wallet of the unvaccinated, also and above all aims to make them change their minds.

"This has allowed people hitherto refractory to finally be vaccinated, assures Pierre-Olivier Variot.

This Friday at midday alone, I have five scheduled vaccinations.

And this is a phenomenon that many brothers and sisters are observing ”.

What are the reliable indicators for monitoring the evolution of the epidemic, and stemming the spread of the virus?

“We can monitor the epidemic from the figures of new hospitalizations and admissions to the intensive care unit of Covid patients, as well as deaths. Figures fairly stable in recent weeks, and in which unvaccinated people are overrepresented, ”says Catherine Hill. A reliable indicator but that we only have, by definition, downstream from contamination, and which therefore does not make it possible to contain the spread of the coronavirus. In this case, "the good indicator is the prevalence of the infection: the proportion of the population tested positive on a given day," continues the epidemiologist. To estimate it correctly, it would be necessary to test representative samples of the population, as has been done in England fourteen times ”.

And as "today, the virus is everywhere, it is necessary to massively and quickly test the population", adds Catherine Hill.

No need to subject the whole of France to a PCR or antigen test, we can, as has been undertaken in Marseille in particular, “measure the quantity of virus in wastewater, this makes it possible to assess the number of contaminated people.

If there is no virus, it's simple, no one is infected.

If any are found, all you have to do is go back up the network to identify the buildings where the virus comes from, test the inhabitants there, and then isolate those who are infected.

Because testing for the sake of testing is useless ”.

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  • Anti-covid vaccine

  • Screening

  • Health pass

  • epidemic

  • Covid 19

  • Coronavirus

  • Health