Paris (AFP)

In a few weeks, the Covid-19 pandemic gave a boost across the world to the development of telemedicine, medicine practiced remotely using new technologies.

Such a leap forward would have taken years to happen in normal times. The confinement of half of humanity and the fear of transmitting the SARS-CoV-2 virus has boosted medical consultations by video application and mobile phone.

The most radical changes have concerned general medicine, where caregivers often had to deal with shortages of protective equipment themselves.

"General medicine has undergone significant changes in the way doctors and teams have treated patients during the epidemic. The speed with which these changes have been achieved has been remarkable," Martin Marshall told AFP. , President of the Royal College of General Practitioners, the British body of general practitioners.

As the epidemic progressed, national rules were adapted or relaxed in many countries to allow for widespread remote consultations.

In France, while teleconsultation, reimbursed by Social Security since the end of 2018, struggled to take off, the coronavirus epidemic gave it a huge boost: the weekly number of teleconsultations increased from 10,000 acts per week in early March to nearly one million in mid-May, after peaking at 1.1 million in the second week of April.

According to Health Insurance, the pace has not weakened after the end of confinement, teleconsultation making it possible to partially reduce the waiting times in medical offices, stretched due to hygiene measures and accumulated delays during the confinement.

In the United States restrictions on access to teleconsultations have been lifted as well as certain data protection rules.

According to Layla McCay of the NHS Confederation, an organization linked to the British public health system, the major part of the 1.2 million daily consultations for basic care was carried out remotely during confinement in the United Kingdom and this change is intervened "in the space of a few weeks" only.

- "A desaster" -

This revolution did not happen without a few hiccups. "My first video consultation session was a disaster. Workers saw a hole, the microphone broke down, a colleague burst into the room," recalls Camille Gajria, doctor and teacher at Imperial College London (remarks reported by the British Medical Journal, BMJ).

Teleconsultation can be effective but we must be attentive to "cognitive biases", to misinterpretations which can easily result from a video consultation, she underlines.

The coronavirus crisis has given new impetus to telemedicine also in India which has only 8.6 health professionals per 10,000 inhabitants (WHO figure of 2018) and where doctors are concentrated in cities while 70% of the population lives in the countryside.

Ayush Mishra, founder of the telemedicine company Tattvan, explains that the epidemic convinced the government to relax the rules that governed teleconsultations.

The entrepreneur, who lost a leg in a motorcycle accident for lack of appropriate and rapid care, hopes to be able to quickly multiply his teleconsultation centers across the country, today numbering 18.

Ayush Mishra would like to extend access to health care to the greatest number of Indians who live far from large urban centers. "You have to be able to offer this access, it's a fundamental right," he told AFP.

Even if the devices connected to the internet (thermometers, blood pressure monitors, etc.) facilitate remote consultations, many gestures can only continue to be performed in the patient's physical presence and the most complex consultations can never be done remotely , emphasizes Martin Marshall.

But the fold of telemedicine has been taken, says Layla McCay. "Our members tell us in return that their culture has fundamentally changed. Doctors who before were perhaps reluctant to digitize are now realizing the benefits they can derive from it. We will no longer be able to backtrack" .

© 2020 AFP