a screening center dedicated to children

INTERVIEW – The pediatrician Amélie Dupont created this specialized center to reassure both children and parents about the nasopharyngeal sample.

To carry out the nasopharyngeal swab, the swab does not pose any difficulty from 1 year.
To carry out the nasopharyngeal swab, the swab does not pose any difficulty from 1 year. TT NEWS AGENCY/via REUTERS

Pediatrician and Emergency Advisor, the Dr Amélie Dupont has created a pediatric Covid screening center, reserved for children under 15.

LE FIGARO. – Why did you create this Covid screening center specially dedicated to children?

Dr Amélie DUPONT. – We found that in cities, families had difficulty getting children under 10 tested. Many laboratories refused to take the sample because it takes more time with the little ones; we’re planning 20-minute slots here. This was not a problem in the spring because all the Covid suspects were referred to the pediatric emergency room where we took the samples. But during the summer we had feedback from our staff, who needed to do PCR tests, for example, to fly. And the start of the school year approached with the recommendation to screen all children with symptoms, which conditioned their return to school.

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Patients, caregivers, young people, people in precariousness … The pandemic also has a psychological impact

The psychological consequences of the health crisis are worrying. Those suffered by Covid patients to begin with. “At least 20% of them have psychological consequences: chronic anxiety disorder, post-traumatic stress disorder, depressive pathology. The neuro-inflammatory disturbances caused by the virus could be one of the determining factors ”, wrote the Academy of Medicine in a statement.

The consequences on the general population which undergoes its second confinement, then. “In Rennes, compared to the same period in 2019, we welcome twice as many young patients in pediatric emergencies [pour les moins de 16 ans, ndlr] for suicidal attacks, three times more for anxiety disorders with somatization [des douleurs physiques inexpliquées], and four times more for anorexic disorders ”, explains the professor of child psychiatry Sylvie Tordjman to AFP.

Read also Reconfinement and mental health: “There is no shame in consulting”

During his weekly update on Thursday, the Minister of Health insisted on the subject. “The mental health of the French has deteriorated significantly […], with a consequent increase in depressive states observed on all socio-demographic profiles ”, declared Olivier Véran.

According to the CoviPrev study conducted by Public Health France, depressive disorders in the general population would indeed have significantly increased during this second wave, with a prevalence doubling between the end of September (11%) and the beginning of November (21 %). The most significant increases were observed among young people (18-24 year olds and 25-34 year olds), “Inactive” and the “People declaring a very difficult financial situation”, indicates agency data.

If the Academy of Medicine calls for making a distinction between the“Worry, sadness, even disarray” and “Depressive illness”, several populations seem particularly fragile. These are notably “People who are afraid for their jobs, those who have sick or dying close relatives, but also people with risk factors and who are afraid of falling ill”, explained Anne Giersch, researcher at Inserm, to Release.

Caregivers, on the front line in the face of the pandemic, “Are recognized at risk of presenting psychological disorders, in particular anxiety-depressive disorders and a state of post-traumatic stress, which underlines the need to take into account this dimension which could in the long term dissuade vocations”, explains the Academy of Medicine.

From the first wave, the psychology services were organized to come to the support of their colleagues. “Post-traumatic, death or other calls are managed internally. But these are people that we may see call on us in two or three months ”, predicted Eric Henry, president of the association Care for health professionals, last March.

Read also Stress, anger, anxiety… Do not neglect the effects of the epidemic on mental health

Olivier Monod with AFP

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Russians named the most popular measures of protection against influenza and ARVI :: Society :: RBC

Photo: Sergey Karpukhin / TASS

Almost 70% of Russians reported that due to the coronavirus pandemic, they have changed their attitude towards the prevention of influenza and SARS. The most popular methods of protection against seasonal diseases repeat the mandatory measures that were introduced in connection with COVID-19, follows from a survey conducted by VTsIOM (RBC has the materials).

All-Russian poll “VTsIOM-Sputnik” was carried out on September 14, 2020 at the request of the “Boiron” company. The survey involved 1.6 thousand Russians aged 18 and over. The maximum error size with a 95% probability does not exceed 2.5%.

When answering the question of what measures they have begun to use over the past six months in order not to get infected, Russians most often named wearing a mask (52%). 38% reported starting to avoid crowded places. 37% started to observe personal hygiene measures more thoroughly. 18% also stated that they intend to isolate themselves when sick people appear in the environment and to do seasonal vaccinations.

At the same time, 83% of respondents said that over the past six months they have not had flu or SARS.

“In the upcoming epidemic season, the so-called“ seasonal ”ARVI viruses, the influenza virus, and the pandemic SARS-CoV-2 virus will circulate in parallel. What will be its duration, we still do not know for sure, but experts are focused on a “long-term” and large-scale anti-epidemic campaign, ”said the head of the Department of Outpatient and Emergency Pediatrics of the Russian National Research Medical University named after N.I. Pirogova, Doctor of Medical Sciences Boris Blokhin.

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“There is no reason for schools to become reservoirs for viruses”

School, reservoir for viruses: chiseled by seasonal epidemics of influenza and gastroenteritis, the image dies hard. Except with the Sars-CoV-2, the rule suffers exception. According to the researchers, the child is not the main vector of propagation of the epidemic. Subject to compliance with barrier gestures and screening of patients, Professor Michel Tsimaratos, head of the multidisciplinary pediatrics department at the Marseille hospital of Timone (AP-HM), believes that returning to class does not compromise the control of the epidemic. It is even, according to this member of the European Academy of Pediatrics, a public health imperative.

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Is there any danger for the children to go back to school?

I am convinced not. Data from Public Health France attest to this: children contract Covid less easily than adults. Importantly, when they are infected, the vast majority of children report little or no symptoms. In children under 15 years of age, severe forms, such as Kawasaki disease, which we do not yet know very well why they are linked to an infection by Sars-CoV-2, are extremely rare.

But does the risk of contamination exist?

We cannot exclude it. There is now a scientific consensus to say that the risks of transmission of the virus are high in closed places with high human density. It is clear between adults. It is less so among children. According to several American and German studies, the viral load of an infected child is comparable to that of an adult. We can therefore think that their contagious potential is similar. But there is also a noticeable difference: Since they often have few or no symptoms, children might be less likely to project infectious droplets into their surroundings.

Read also In Suèvres, the pupils “have forgotten what school is”

What precautions should I take?

If barrier gestures are respected, starting with hand washing, there is undoubtedly much less risk of transmission from child to child and from child to adult – therefore from student to teacher. Conversely, the risk of a child being infected by a sick adult justifies, from my point of view, the wearing of a mask by teachers and school personnel. In the family context, this implies taking precautions, the contagiousness being maximum two days before and up to eight days after the appearance of the first symptoms. The case of a sick parent should also be considered. It would then be preferable for her children to stay at home for fourteen days. To the parents of my patients, I say: put your children in school. On the other hand, protect yourself by putting on a mask outside the home and washing your hands frequently, especially if there are elderly people or people with co-morbidities around.

Social distancing cannot be ensured in schools, should children be required to wear a mask to limit the circulation of the virus?

Not at any age. In most countries, wearing a mask is recommended from the end of primary school. Before, it’s probably unnecessary. The child would spend his time touching it with his hands, which would make it ineffective! The mask can be recommended when there is a possible concentration of sick people. But a class is not the same as a meeting between people who occasionally meet. In a classroom, if no child has symptoms within a week or two of re-entry, the risk of transmission is probably very low. However, if children go to school by public transport, it is advisable for them to put on a mask from the age of 10 or 11.

In the event of proven contamination of a student or a teacher, do you think it wise to close the establishment?

No. If a child is symptomatic, they should be tested and kept at home for as long as they are contagious. Obviously, if there are several children who declare the Covid at the same time, the question may arise of screening the whole class and placing it in quarantine. But if no one has symptoms, I don’t see the point: the most likely is that the children will immunize themselves gently. Subject to respect for barrier gestures, there is no reason for schools to become reservoirs for viruses. It is undoubtedly easier there than in other places to go up and break the chains of contamination. In my opinion, closing schools poses a much greater risk to children’s health than Covid.

What do you mean ?

We will have to study closely the place that screens and desocialization occupied during confinement. For children, starting with the youngest, socialization is essential. At this stage of their development, they suffer much more from the scarcity of social interactions, from their intellectual and cultural environment, than from Covid. In my opinion, the risks of dependence on screens and certain forms of abuse present a greater health risk for them than that linked to the virus.

Nathalie Raulin

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