De-reimburse Covid-19 screening tests to push the recalcitrant towards vaccination. This is the government’s bet with this measure which entered into force on Friday, October 15. The executive’s objective is also to lighten the bill for public finances. The cost of tests will indeed soar to 6.2 billion euros this year, after 2.2 billion in 2020.
Even if exceptions will remain possible (medical prescription, case of contact, recent positive test, contraindication to the vaccine), nearly 7 million partially or unvaccinated adults will have to pay between 22 and 44 euros for each screening allowing them to obtain a health pass.
This decision was quickly reflected in the number of tests carried out. After a peak Thursday, October 14, the day before the delisting (806,782 tests carried out against 472,026 the previous week), this figure collapsed on the day the measure came into force. It fell to 371,174 from 675,075 the previous Friday, a decrease of 45%.
Will this trend continue, at the risk of breaking the thermometer of the epidemic, as some health professionals fear? While the number of tests carried out stood at nearly 3.2 million during the week of October 10 to 14, the Minister of Health said he expected around 2 million tests to be carried out each week despite the end of free access. “Which will make France one of the most testing countries in the world”, assured Olivier Véran on franceinfo, Wednesday.
Is this reduction in the number of tests already measured in the number of positive cases identified? After a slight rebound, of around 11% in one week, a plateau seems to be emerging in recent days. As for the national incidence rate, the average of which is close to the alert threshold set at 50 positive cases per 100,000 inhabitants, it stagnated at 48.4 on October 15 (against 48.5 the day before).
If it is too early to interpret this stabilization, public health professor Mahmoud Zureik is concerned with AFP: “We will no longer be able to correctly follow the evolution of the epidemic because the incidence rate will be affected”, he predicts. The Ministry of Health anticipates on the contrary “a modest break” and “punctual” on this key indicator, arguing that “comfort tests” are the fact of “often asymptomatic people who have very low positivity rates”.
Will this population take the step of vaccination? Nothing is less certain if one relies on the results of the 28th CoviPrev barometer, the tool of Public Health France to measure since March 2020, via the BVA pollster, the reaction of the French to the epidemic and to health measures. taken by the authorities. According to The poll conducted between September 28 and October 5, the results of which were released Thursday, only 8% of unvaccinated people questioned said they were ready to change their mind.
The risk is that unvaccinated and asymptomatic people will no longer get tested, undermining the policy of tracing positive cases and chains of contamination, as reported on franceinfo, Tuesday, epidemiologist Pascal Crépey, teacher-researcher at the School of Advanced Studies in Public Health, in Rennes.
“We will not see that they are positive and therefore we will not avoid a number of chains of transmission that could have been avoided if access to the tests were easier.”
Epidemiologist Pascal Crépeyto franceinfo
To anticipate the evolution of the epidemic, two other indicators are monitored: the number of hospitalizations and that of admissions to the intensive care unit. “The escalation of incidences” observed lately and dreaded with the end of free tests “will not necessarily mean a rise of the same type of hospitalizations because France is massively vaccinated”, nuance the specialist. Currently, 74% of the population is fully vaccinated. “Hospitalizations are not going to rise in the same proportions as they were able to do on the winter wave of last year. There is, a priori, little risk that this possible wave will overwhelm our hospital fabric”, continues Pascal Crépey.
It is also because the signals were green that the executive has maintained its turn of the screw on the reimbursement of tests. He now concedes that “the epidemic is starting to gain ground again”, as winter approaches. Twenty-one departments exceed an incidence rate of 50 cases per 100,000 inhabitants, the Bouches-du-Rhône in the lead, with a rate of 109 on October 15. If the government’s testing strategy proves to be unsuccessful in stemming a possible fifth wave, another scenario is under consideration: making the booster dose of the vaccine mandatory to continue to benefit from the health pass.