INTERVIEW – The pediatrician Amélie Dupont created this specialized center to reassure both children and parents about the nasopharyngeal sample.
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.
You also had a fully
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325 new cases and positive number increases in hospital, +26
A total of 9,431 cases of positive Covid-19 have been ascertained in Sardinia since the beginning of the emergency. In the latest update of the Regional Crisis Unit, 325 new cases are recorded, 220 detected through screening activities and 105 from suspected diagnosis. There are also 13 victims (there are 227 in all), the highest figure recorded so far in the island. In total, 267,615 swabs were performed with an increase of 3,323 tests. 349 patients are currently hospitalized in non-intensive wards (26 more than yesterday’s figure), while the number of patients in intensive care is 39 (-1).
There are 5,667 people in home isolation. The progressive number of positive cases includes 3,099 (+68) patients recovered, plus another 50 clinically recovered.
Of the 9,431 positive cases ascertained overall, 1,885 (+89) were detected in the Metropolitan City of Cagliari, 1,509 (+43) in Southern Sardinia, 846 (+70) in Oristano, 1,211 (+3) in Nuoro, 3,980 (+120) in Sassari.
28 coronavirus positive cases have been discovered with the screening campaign launched and substantially concluded in the three municipalities of the red zone arranged with the order of 15 October signed by the president of the Valle d’Aosta Region. Added to those already known, they bring the total of infected to 72, out of a total population in the three municipalities of 2,558 inhabitants. In Chambave, with nearly 700 swabs performed, 16 positive cases were identified. A figure that, added to the already known infections, reaches 31, out of 908 inhabitants. There are nine positives identified in Verrayes with the screening campaign: together with the already known infected people, the overall figure is 28 out of 1,276 inhabitants. (The results of the molecular swab are still missing for three people discovered today positive for the rapid one and about twenty others to be tested). Three positives were discovered in Saint-Denis which, together with the ten already known, bring the share of infected people out of 374 residents to 13 (there are still a couple of swabs to be performed).
«We are in a strong second wave. ” At the top of the state, the tone has changed, as evidenced by this statement by the Prime Minister. We are far from the astonishment of March in the face of an uncontrolled spread of Sars-CoV-2; but the “Thrills” of July have become groundswell. Today, the proportion of positive cases among all those tested continues to increase at 11.8%, while the weekly incidence at the national level exceeds 165 cases of Covid-19 per 100,000 inhabitants. The priority given to screening symptomatic people should certainly amplify this increase, but the epidemic continues to progress, stimulated in recent days by the onset of cold and shorter days: we spend more time in a closed environment, we ventilate less. .
As in the first wave, the situation varies from one department to another: in Gironde, for example, the signals are encouraging, but in certain metropolises in the maximum alert zone, and more particularly in Paris, Lille and Lyon , the situation is deteriorating sharply. In the capital, one of the most densely populated cities in the world, the rate of positive tests is around 17% and the incidence exceeds 410 cases per 100,000 inhabitants per week.
It explodes in 20-30 year-olds, with more than 645 cases per 100,000 … or 13 times the alert threshold set at 50. “All this was predictable, from July”, deplores Mircea Sofonea, lecturer in epidemiology at the University of Montpellier. However, the current curve is much more flattened than that of spring. We are, according to him, “On figures comparable to those of March 10 in terms of incidence, but the epidemic is progressing 4 to 5 times more slowly thanks to the brakes represented by wearing a mask or tracing”.
In town, GPs see patients flocking: “We have an increase of 20 to 30%, indicates the Dr Jérôme Marty, president of the UFML doctors’ union. Usually when you have a little headache you just wait for it to pass. There, people consult. ”
SEE ALSO – Jean Castex: “We are seeing a rejuvenation in intensive care hospitalizations
The number of serious cases is also increasing and hospitals are inexorably filling up, with patients with profiles similar to those of the first wave. The health authorities thus identified 1,539 Covid patients in intensive care on Monday evening. More than one in five resuscitation beds are already occupied by a coronavirus patient, out of a current capacity of 5,800 beds. And if nothing changes, “We could reach this number in November”, estimates Mircea Sofona.
More than a wave, caregivers also speak of a tide, with once again great disparities: barely 13% of intensive care beds are occupied in the Pays de la Loire and less than 10% in the Grand Est, according to data from the government.fr website. In Ile-de-France, on the other hand, more than 40% of these beds are occupied by Covid patients. Those are “Probably up to 300 people per day in the next few days who will arrive in hospitals” of the region, predicted the director of the Regional Health Agency, Aurélien Rousseau, on BFMTV.
We were stunned, in May, to see that the scaffolding that had taken weeks to erect was so quickly undone.
Djillali Annane, head of the intensive medicine and resuscitation service at Raymond-Poincaré de Garches
At the Raymond-Poincaré hospital in Garches (Hauts-de-Seine), Pr Djillali Annane, head of the intensive medicine and resuscitation service, navigates on sight: “Our 15 beds – including 9 Covid – are full. A bed that becomes available is occupied in less than 24 hours. ” Eric Maury, president of the French Language Resuscitation Society (SRLF), for his part describes a situation “Heterogeneous at the Parisian level: at the Bichat hospital (north), they have been calling for help for 15 days. The south of the capital is for the moment less impacted ”. All deplore the lack of anticipation. “We were stunned, in May, to see that the scaffolding that we had taken weeks to erect was so quickly dismantled”, explains Djillali Annane, who chairs the national union of resuscitators of public hospitals. He points above all to a staff problem in intensive care units where at least two nurses are needed for five patients.
Because, in hospitals, the sacred union has lived. The establishments under stress are deprogramming operations, but after having had to make up for the delay accumulated in recent months, the others continue to operate at full speed for Covid patients or not. There is therefore little room for maneuver. “The health reserve is exhausted, and the reinforcements coming from regions, it is finished”, adds Professor Annane, who points to the fatigue and the fed up of the teams. “Some who helped us in April warned us: they won’t come back. They are traumatized. ”
In theory, however, ensures the DGS, “Operations of the ‘medical evacuation’ type are still part of the range of actions that could be implemented.”
The All Saints holidays, very family, will not help. Mixing of populations, increased risk of intergenerational transmission … The executive wants to count on the responsibility of each one, but the message, Wednesday evening, will have to be strong.
REPORTAGE – Professor Dominique Grandjean’s team trains dogs to detect the smell of Covid-19. A project which, according to the veterinarian, could participate in the strategy of mass screening.
A tenth of a second. This is about the time it takes a dog to detect a smell. Except that, this time, it is neither explosives, nor drugs, but rather Covid-19. At the National Veterinary School of Alfort, in Val-de-Marne, five sniffer dogs from the Yvelines firefighters are in training. A bit of a special training, since they learn to detect positive cases of Covid-19.
One after the other, the canines follow one another, accompanied by a member of the cynotechnical unit of the Yvelines firefighters, in a room equipped with five metal cones. Inside, sweat samples from patients infected with Covid-19 or from negative people have been deposited while others remain empty. Quickly, the dog thrusts its muzzle into the cones and continues on its way until it detects a positive case. In this case, the animal reacts either by sitting up, or by barking or by lying down.
Dogs in addition to PCR tests?
So, could canines
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– In Europe, deaths from colon cancer increased by 11.9%. This is the estimate of the effects of covid-dependent delays in screening programs for the prevention of colorectal cancer made known during the United European Gastroenterology week (UEG Week Virtual 2020) and the result of a study by the University of Bologna .
Colorectal cancer is the second biggest killer in Europe among oncological diseases: there are 375,000 new diagnoses every year in the European Union and 170,000 cancer victims. “The early diagnosis of the tumor – explains the author of the work Luigi Ricciardiello – is crucial because it makes it easier to treat and therefore improves the clinical outcome of the disease”. “It is therefore essential that preventive screening programs continue – adds the expert – helping to prevent further increases in mortality”. Experts used a mathematical model to make predictions about the clinical effects of delays induced by the covid emergency, which negatively impacted all routine health care. A moderate (7-12 months) and a larger (over a year) delay in screening lead to a 3% and 7% increase in late cancer diagnosis, respectively. Based on the 5-year survival rates in case of an advanced diagnosis, the authors calculated a significant increase of 11.9% in deaths for a screening delay of more than 12 months.
“Globally – explains the expert – health systems are facing severe difficulties due to COVID-19. Health authorities – concludes Ricciardiello – must act urgently to reorganize activities during COVID-19, without compromising the diagnosis of other high-impact diseases “.
The prefect of the Rhône, Pascal Mailhos, announces this Monday, September 21, new measures against the spread of the coronavirus, while the health situation is deteriorating in the departement. Until now reserved for Lyon and Villeurbanne, the obligation to wear a mask is now extended to 10 communes of the Rhône of more than 10,000 inhabitants.
As in Nice, Bordeaux and Marseille, large gatherings organized in the Rhône will be limited to 1 000 participants, against 5,000 previously. A similar decision was also taken on Monday in Haute-Garonne. The Lyon fair, which was to be held from October 8 to 12, is canceled. Ehpad visits in the department will now be limited to two per week and per resident.
→ ANALYSIS. Covid-19: Ehpad better prepared but still worried
In Lyon and in all the municipalities of the Rhône, the sale and consumption of alcohol on public roads will be prohibited between 8 p.m. and 6 a.m. Private gatherings of more than 10 people are also discouraged by the authorities. On the other hand, no new restrictions concerning bars and restaurants was taken by the prefect, who recalls the rules within these establishments. The measures will come into force on Tuesday, September 22 at 6 a.m.
In bars and restaurants, the measures must be duly observed: – physical distancing and wearing of #masque for any movement, – 1m between each table, – 10 people maximum per table, – bar service prohibited, – ban on dancing or drinking while standing.
In end of new screening centers will open their doors in Lyon and in several departments of Auvergne-Rhône-Alpes.
► Opening of screening centers in Ile-de-France
The Île-de-France Regional Health Agency (ARS) announced the deployment of 20 screening and diagnostic centers in the Île-de-France region, during the Next 15 days. The aim is to facilitate access to tests and unclog laboratories.
→ EXPLANATION. Covid-19: the difficult prioritization of tests
Open 6 days a week until the end of winter, they will initially be reserved for priority people : those with a medical prescription, official contact cases contacted by the ARS or the Cpam, and nursing staff working at home. It will be possible to come without an appointment, only in the morning between 8 and 2 p.m.
Each center will be able to carry out at least 500 tests RT-PCR daily, and results will be reported within 48 hours, assures the Minister of Health Olivier Véran while the first seven centers opened on Monday. In addition, other establishments of this type should emerge elsewhere in France, where the virus is actively circulating and laboratories are saturated.
► Part of the population of Madrid is re-fining
850,000 inhabitants from the Madrid region must now limit their travel. The people concerned will be able to leave their neighborhood only for reasons of primary necessitylike going to work, going to the doctor, or taking the kids to school. On the other hand, it will be possible to move around freely within this district.
→ REPORT. Covid-19: in Madrid, hospitals on the alert
Likewise, entering these areas, located mainly in the disadvantaged south of the capital, will be prohibited except for in case of first necessity. The parks will be closed and shops, bars and restaurants will have to limit their capacity to 50 %.
However, this is not a return to the severe measures imposed in the spring, said the Spanish authorities. Prime Minister Pedro Sanchez assured Saturday evening « do not consider confinement from the country “, while Spain recorded a pandemic rebound.
► The Taj Mahal reopens to the public
The Taj Mahal reopens on Monday after six months of closure, despite a outbreak of new contaminations and Inde. 5.4 million cases per 1.3 billion inhabitants were counted there, which makes India the second country most affected by the pandemic after the United States.
→ EXPLANATION. In India, the figures of the deaths of the Covid-19 intrigue
But after the national lockdown decreed at the end of March, which deprived tens of millions of people of income, the government continues to gradually lift restrictions. Built in the 17th century, the Taj Mahal is the most visited monument in the country with seven million annual visitors.
A strict protocol applies there for the wearing of the mask and the physical distancing, assure the authorities, while some 200 people were present for the first day of reopening of the building. The number of daily visitors was also capped at 5,000.
Many countries have discontinued their breast cancer screening because of the pandemic of Covid-19. A new study, presented at the 12th European Breast Cancer Congress, suggests that this lack of continuity in screening programs could lead to an increase in the proportion of women dying from breast cancer.
But the study also indicates that the risk could be reduced, how? ensuring that all women who, due to their age, should have been screened during the pandemic do so now, even if they have already exceeded the age limit for screening.
“Screening is about detecting cancer at an early stage, when there is a better chance of treating it successfully. Cancer screening programs have never been interrupted like this, so we don’t know what impact it will have, ‘says Lindy Kregting, University of Rotterdam Medical Center, Netherlands.
The work sought to investigate the long-term impact on breast cancer mortality and to observe which strategies would prove to be the most effective to resume screening programs.
For this they have used a modeling tool called MISCAN-Breast to simulate four different approaches to resuming screening programs after six months of interruption: a sudden restart in which all screenings continue in the same order as planned; a delay in screening, except for women who should receive it for the first time; a postponement in screenings, but temporarily increasing the upper age limit for, and an increase in the ability to fully bring up to date all screenings that had been postponed during the six-month interruption.
The results are based on the Netherlands breast cancer screening program, in which women aged 50 to 75 receive a check-up appointment every two years. Similar screening programs exist in many other European countries, although the frequency and age ranges vary.
Based on the four simulations, the computer model showed what capacity would be required (in number of screening and follow-up tests) and the effects that each strategy would have on breast cancer incidence and mortality.
Researchers have found that the first model, postponement, is the one with the most negative result, with an estimated increase of 2.35 deaths per 100,000 women in the next 10 years. At the opposite extreme, total catch-up proves to be the least negative strategy, with an estimated increase of just 0.13 breast cancer deaths per 100,000 women over the next 10 years. However, the study authors note that this strategy will not be feasible for the majority of national health services.
The other two scenarios, the delay except for the first screening and the increase in the age limit, resulted in an increase in deaths of 1.98 and 1.85 per 100,000 inhabitants, respectively, in the next 10 years. Based on these findings, they suggest that raising the upper age limit to receive the latest screening is the best option for most screening programs.
‘Our study shows that a six-month delay leads to a modest but always significant increase in the number of deaths from breast cancer, although each strategy to resume screening programs has different results. The best way to avoid deaths from breast cancer is to catch up on all the screening tests that could not be done during the pandemic. However, We also realize that most screening programs do not have the extra staff and the necessary equipment for that.», By Lindy Kregting.
A second study, which includes 1,051 women diagnosed with breast cancer from Utrecht (Netherlands), analyzed how Covid-19 has affected their daily lives. 48% of those patients have felt lonely during the pandemic.
“Our study shows that women were less willing to seek medical help during the pandemic and that a high proportion of women suffered from loneliness during confinement. And this suggests that patients need to be reinforced with the idea that they should seek medical help when they need it and also that mental health support must be provided, even if it is provided virtually and not face-to-face, “he says Claudia Bargon, doctor and doctoral student at the Utrecht University Medical Center.
Giuseppe Viale, a professor at the University of Milan and the European Institute of Oncology (Italy), who was not part of the research, has commented on the results of these studies. “All over the world, medical services have had to reorganize to face the challenge of covid-19. It is very important that we understand the impact this has had on the diagnosis, treatment and medical care of breast cancer patients, “he says.
« Aberrant. » The word returns in the mouth of Rémi Gebeile, to describe the congestion of his laboratory, the pace of work, the behavior of certain patients… On August 3, this 36-year-old biologist was assaulted at his place of work, in Lyon . He tells. At the end of the afternoon, a man in his forties goes to his laboratory in the Croix-Rousse district to have his mother screened for the coronavirus.
→ EXPLANATION. Contact case: when should a Covid test be done?
Very quickly, the tone rises: he wants an urgent result. “I told him it took 24 to 48 hours, says Rémi Gebeile. He became very aggressive. I then replied that I refused to take it and that there were other laboratories in the area. He slapped me and left. “
“This summer, I lost 7 kg of stress”
An hour later, the man is back. “He snatched my phone from me, then smashed it to the ground,continues the biologist. He gave me a monstrous slap that knocked me down. He wanted to beat me up. Fortunately, his brother intervened. “
→ READ. Coronavirus: Jean Castex announces the reduction of the duration of isolation to 7 days
A complaint is filed the next day, but Rémi Gebeile does not hide the psychological shock, after months of mobilization. “I give my all for my job. During the summer, I lost 7 kg of stress. It happened to me to have insomnia, to get up in the middle of the night to validate the results on time ”, assures the co-manager of the company Dynabio.
Much of the industry is paralyzed. Since deconfinement, the government has stepped up screening. From 200,000 weekly tests in early June, France has now risen to 900,000, according to the report from Public Health France on September 10. You no longer need a prescription or have symptoms to be screened. The result is growing queues and lengthening wait times for results – up to eight days, far from the 24-hour target.
The staff is’ on the razor wire “, According to Lionel Barrand, president of the union of young medical biologists, who evokes the physical assault of a secretary in a Parisian laboratory: “She took a fist in the face.” Verbal assaults are legion – insults, threats, etc.
“The firsts took place in Paris in laboratories that performed walk-in tests. People couldn’t stand the wait, explains François Blanchecotte, president of the national union of biologists. Today, they come from patients who do not have their results in time for their departure by plane. “
→ READ.Coronavirus: antigenic tests, faster but less reliable than PCR
« We swim in full delirium. The other day, a man said: “I squat here until I have my result” ”, relates Annick, 60-year-old technician at the Croix-Rousse laboratory. Some laboratories even had to hire security guards. “In the queues, patients are ready to fight! “, plague Thierry Bouchet, general manager of Biogroup laboratories.
Overtime and burn-out
At the end of August, the Ministry of Health did issue an instruction asking to prioritize the testing of people with symptoms and their contact cases. But in fact, “When you tell people that they are not a priority, they get angry. And some claim that they have symptoms when they don’t have any ”, summarizes Claude Cohen, president of the National Union of Biological Physicians.
In addition to PCR tests, laboratories must continue their routine activity. “The phone never stops, breathes the secretary of a Parisian suburban laboratory. We can’t answer all the time. Between that and the records of files, we must not make mistakes. It’s sporty! “
“Overtime, shifts, permanent schedule changes… The staff has been on the ball for six months. There have been burnouts, people who no longer hold up ”, alert Lionel Barrand. The three secretaries of Rémi Gebeile’s laboratory resigned during the summer and had to be replaced… not without difficulty.
The State has not granted a “Covid bonus” to staff in private laboratories. “We are trying to calm legitimate inclinations by rewarding everyone with bonuses”, nevertheless indicates Thierry Bouchet. A secretary from a large group, who says she receives 20 € more per month, blows: “We would like a rise in salaries, we do not feel supported enough. ““We are left behind”, Rémi Gebeile slice, between two patients.
INFO THE FIGARO – For four months, two teams of researchers have been developing a screening device with dogs capable of detecting a person positive for the coronavirus thanks to their smell.
By Marie-Liévine Michalik
«Covidog“. A portmanteau that designates a pioneering project: training sniffer dogs to detect Covid-19, in the same way that they already detect drugs or explosives. The experiment received public support from the Academy of Medicine and the Veterinary Academy on Friday, which call for continued work and welcome the first encouraging results.
In France, two teams of veterinary researchers have been working on the project since March. One, led by Professor Dominique Grandjean, is located at the National Veterinary School of Alfort in Val-de-Marne. The other is in Strasbourg, guided by Professor Philippe Choquet, teacher-researcher at the CNRS and at the Strasbourg University Hospital.
6,000 olfactory cells to screen for covid
«The dog will snort the virus activity», Explains Professor Dominique Grandjean. Director of the Animal Husbandry and Sport Medicine Unit at the Alfort National Veterinary School, veterinarian and former firefighter, he is convinced of the effectiveness of his
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