“We will contact you in the context of the fight against the Covid 19 epidemic.” Here is the SMS sent by Medicare to people who tested positive for Covid-19. Msometimes the call never comes. After receiving this message, many people to have waited for the phone call, without success. And for good reason : the incidence rate has exploded since mid-December and the departments responsible for contact case tracing struggle to keep up.
“We just got this text and that’s it”, confirm Elwenn and Matéo, both 24 years old. The couple, who reside in Tours (Indre-et-Loire), tested positive on December 22, after performing a PCR test. They took care of warning their relatives, hoping to then be put in contact with Medicare. Not vaccinated against the virus, they would have liked to obtain information on the steps to be taken. “We were waiting for this call to learn more about the conditions for issuing the certificate of reinstatement, says Matéo. We finally found the answers on Google. “
The treatment protocol (except in exceptional circumstances) provides that patients who test positive receive, before the telephone conversation with Medicare, this SMS to prepare for the interview and provide the names of the identified contact cases. Then, one of the telephone advisers trained in “contact tracing” is responsible for calling the patient to present the procedure and define with him the list of his contact cases. A procedure that constitutes the very essence of the government’s strategy “isolation, tracing, contact tracing, sequencing, screening”, reaffirmed by the Minister of Health, Olivier Véran on December 16, facing the variant Omicron.
But, with the recent explosion of contaminations (the 230,000 contaminated mark was crossed on December 31), the “contact tracing” teams find themselves overwhelmed. “We’re completely drowned, we can’t call everyone anymore”, confides Benjamin Sablier, staff representative and CGT delegate for Health Insurance in Bouches-du-Rhône, who regrets “increasingly complicated working conditions”. LThe difficulties are also accumulating on the side of the pthe inbound call form, which represents nearly 10% of Medicare “contact tracing” staff. The trade unionist identifies a dropout rate of only 5 to 8% in the Bouches-du-Rhône and a average waiting time for a caller estimated between 2 and 3 hours, “figures rather similar to national data”.
The workforce had yet been strong to face this fifth wave, with even a little anticipation. “Following the epidemic rebound at the end of October, we have significantly increased resources”, argues Medicare, contacted by franceinfo.
“Since the beginning of December, 6,000 people have been assigned to this tracing mission – a doubling of the workforce”
Health insuranceto franceinfo
But some reinforcements, planned before the explosion of contaminations and mainly recruited via temporary contracts, are slow to arrive. “The last batch is due on January 15th, when we have urgent needs now”, regrets the trade unionist.
Since March and the third wave of the epidemic in France, Medicare has been prioritizing phone calls to people who tested positive. Contact cases, on the other hand, receive an SMS with a link to a website containing useful information, but no longer talk to the call center agents. Despite this modification of the protocol, the overload of work for the agents remains evident and can have effects on the quality of the interventions. The mission of deliverance derogatory work stoppages has become more complex with the rapid increase in positive cases. The stops have been multiplied by seven in recent weeks, Franceinfo learned at the end of December. “We were not already afloat before the health crisis, we will not be able to manage all the files on time”, alert the representative of the CGT.
Jonathan *, 30, witnessed this. This employee in a communications company tested positive on November 23 with an antigen test carried out in a pharmacy. He was indeed called by Medicare the next day, but the difficulties appeared when he was issued his sick leave: “I explained to my interlocutor that I had never had one in my life, that I did not know the procedures. She replied that I will receive the document in a fortnight.” A period considered too long by the young worker. “My employer told me that if the stop didn’t happen, my absence would be turned into paid time off or unpaid time off. So I tried to call the help number, but couldn’t get someone. ‘one end of the line, I felt a little abandoned “, he laments.
Health Insurance, responsible for making contact with everyone, regularly updates its criteria for prioritizing calls. “At the beginning, we had to treat as a priority the positive cases with the Omicron variant, but the distinction no longer exists since the end of December, we take the cards as they go”, explains Stéphanie *, responsible for doing “contact tracing” for health insurance in Auvergne-Rhône-Alpes. And the agent added: “Since the holidays, when we arrive in the morning, we deal with cases going back to the previous half-day, we no longer call those who test positive on D-1 or D-2.” People who only provide information to landlines, especially the elderly, are also prioritized in calls because they will not be able to receive SMS.
Medicare is not the only institution to have to review its mode of operation in the face of the explosion of cases. Regional health agencies are also involved in “contact tracing” to investigate positive cases qualified as “complex” which can be the source of major sources of contamination. “There is a strong tension in the services, we should not believe that it is ‘business as usual'”, we confirm on the side of the ARS of Ile-de-France, while the region is particularly affected by the wave of contamination with the Omicron variant.
“Such an impact is unheard of. To cope, we had to set up a prioritization in the processing of reports, explains Cécile Somarriba, director of surveillance and health security of the ARS Ile-de-France. We base ourselves on two criteria: the population concerned, with priority given, for example, to the investigation of cases in nursing homes and in all fragile communities. The second criterion is the number of confirmed cases at the time of the start of the health investigation. We deal with the most risky situations first. “
And while the situation could still become tense in the coming days with an epidemic peak expected in mid-January, the relevance of this painstaking work is questioned, according to some experts.
“The ‘test, trace, isolate’ policy works well when you have less than 10,000 cases per day.”
Philippe Amouyel, epidemiologistto franceinfo
For this doctor at the Lille University Hospital, “200,000 positive people daily is unmanageable. During the second wave of 50,000 cases, the teams were already overwhelmed”. According to him, even a recruitment effort would not be enough: “We need time to find them, to train them, while it is now that things are exploding. And then, we will not be able to mobilize a large population for this work.”
Government announcements concerning the easing of isolation criteria should not, however, relieve the agents in charge of “contact tracing”. “These new rules, it will waste a little time at the beginning since I have become a kind of automaton by repeating the same thing with each call. We will be groping a little the first days, but it will quickly become routine again. “, predicted Stéphanie *.
* The first names have been changed.