“You can’t test an entire school at 7:00 PM because there is a positive case in all the classes.” Posted Sunday, January 9 on Instagram and “liked” more than 200,000 times in one day, the cry from the heart of a pharmacy assistant from Toulouse has obviously hit the nail on the head. And illustrates the immense pressure that the explosion of Covid-19 contamination is placing on the professionals responsible for screening. For the first time, Thursday, the bar of two million PCR and antigenic tests in one day was crossed in France. The various screening locations are saturated, as observed by France 3 Bretagne in Rennes on Monday.
70 families came to have children tested without symptoms. Top strategy
Pharmacy not yet open. Already 20 behind us. #TestCovid #it’s raining #Brittany #government #AntigenTest #rennes #tripledose @jmblanquer @olivierveran pic.twitter.com/4oDvOia4Nl– Benoît Thibaut (@BenTybo) January 10, 2022
Hundreds of people wait to have their children tested in the center of #screening from the Triangle to #Rennes which just opened a few minutes ago. 500 #tests should be done per day, there are already more than 500 people waiting in the hall of the Triangle pic.twitter.com/IcEBWvEPk0
– sylvaine salliou (@sylvainesalliou) January 10, 2022
The government has seized on the subject. Sunday, his spokesperson, Gabriel Attal, detailed a series of measures in order to screen even more. On Monday, Jean Castex invited himself to the 20 hours newspaper of France 2 to recognize the difficulties and announce an adjustment of the test protocol for students in contact cases. But the Prime Minister also expressed his attachment to massive screening: “Breaking the thermometer would do no good.” Faced with this dilemma, franceinfo lists the avenues that could help prevent overheating.
Change the National Education protocol
Omicron and the end of year celebrations fueled the rush for tests, but the protocol in force in the National Education since the start of the school year is also singled out. “What embolishes us most currently in pharmacies is the screening of young people, schoolchildren”, lamented the president of the Federation of Pharmaceutical Unions of France, Philippe Besset, Monday on franceinfo.
Initially, each case reported in a class required students to present three negative tests (the same day, then two and four days later) to return to class, the first to be a PCR or an antigen (with the exception of non -vaccinated 12 years and over, placed in isolation). Very time-consuming for parents, this rule was quickly criticized by the Federation of Parents’ Councils (FCPE), which finally called for a strike on January 13.
Relaxing this protocol is one of the levers for reducing the number of tests, and the government has already announced adjustments. Since Friday, the detection of a new positive case no longer requires students to start from zero the cycle of three tests. And on Monday, Jean Castex announced that the first test could also be a self-test. For parents who have managed to get hold of it, there is no longer any need for a visit to a pharmacy or a center. The government, however, excludes giving up this trio of tests: “Schools are intended to remain open, and only a fairly intensive screening allows us to do so”, hammered Olivier Véran, the Minister of Health, Monday, in the Senate.
The protocol is “tenable, otherwise that would mean asking kids not to go to school anymore”, estimated Monday Gilles Bonnefond, spokesperson for the Union of trade unions of dispensing pharmacists, contacted by franceinfo. But the effectiveness of the relief announced by the Prime Minister will depend on the accessibility of the self-tests. On France 2, he promised that 11 million tests would be delivered to pharmacies and that they would be accessible free of charge to the parents concerned, without detailing by what modalities. As the return to class is now based only on honor certificates, some parents could be tempted to avoid pharmacies entirely and not to test their child. This would reduce the queues, but would complicate the health situation even more.
Define priority audiences
Some specialists are calling for a broader overhaul of the testing strategy. Gilles Bonnefond is pleased that the instruction is no longer to carry out a confirmatory PCR test after a positive antigen test (which was used to identify the variant). And reminds that no test is necessary at the end of the isolation period for the vaccinated, unless they have symptoms: “Some employers asked for it to come back to work, when it was not the rule”, he laments.
On Friday, the general directorate of health also issued a prioritization instruction. But it concerns practically all cases: priority is given to symptomatic people, contact cases, people who have made a positive self-test, those with a prescription and those who have to perform compulsory tests on return from countries at risk. Then, in a second step, comes the turn of those who have to take a test to go abroad. In addition, the instructions above all call for people to be tested last to obtain a health pass valid for 24 hours. “But we have very little of it, it is no longer an issue”, assures Gilles Bonnefond.
Lionel Barrand, president of the union of medical biologists, called Monday on RTL for another change of instruction which “would save us time” : make disappear “the test we do on D5 in the person positive “which, in his eyes, “no use”, because it does not provide certain information on the risk of being contagious. The epidemiologist Antoine Flahault, quoted by the Yahoo site, even wants to question the principle of “get tested in the slightest doubt” : “If, for example, you are in good health, and you have mild symptoms, there is no need to go overcrowding the laboratories, a self-test and compliance with barrier procedures is sufficient.” But there is no indication that the authorities are ready for such changes.
Open more screening centers
Gabriel Attal’s flagship announcement on Sunday was the desire to create “several hundred” screening centers backed by vaccination centers. During the lulls of the vaccination schedule, professionals could perform tests, imagined the government spokesperson. “We need another place, other staff, which we do not have to date”, reacted Monday on France 2 a department head of a hospital where a vaccination center has been installed, in Aulnay-sous-Bois (Seine-Saint-Denis). Gilles Bonnefond, representative of pharmacists, was also skeptical: “The centers are vaccinating with a vengeance, I am not sure if they have any hollows. And they should be supplied with tests in a very short time.”
Enabling pharmacies to strengthen themselves
The problem is not so much the number of tests to be carried out as the lack of manpower to do them, proclaims Gilles Bonnefond. The spokesperson for the Union of Community Pharmacists Unions is basing many hopes on another government announcement: the possibility of making temporary recruitments more easily for screening. He hopes he can “pay them at a fixed rate, without administrative procedures or employment contracts, as in vaccination centers”, with the possibility of using them only in the busiest times, Monday, Friday and Saturday. He also estimates that this would allow the roughly 4,000 pharmacies that do not offer tests “to open time slots”. He hopes the measure will quickly materialize.
More dubious, Philippe Besset, president of the Federation of Pharmaceutical Unions of France, recalled Monday on franceinfo that “all the caregivers are busy, nurses, doctors also”, and that healthy students are “already mobilized”. On Sunday, a decree authorized all graduates or master’s students in molecular biology to perform tests.
Hold on while waiting for the wave to pass
No one is suggesting, of course, to give up testing. But many professionals point out that the test overload should be temporary. “What we are being told is that the peak of the Omicron wave will arrive, and the contaminations will quickly come down”, recalls Gilles Bonnefond. This is notably the scenario observed in South Africa. On BFMTV Monday, the epidemiologist and member of the Scientific Council Arnaud Fontanet estimated that the peak would arrive “around mid-January”. “We will see in the coming days if we reach a peak in contamination then a drop or a plateau”, commented Olivier Véran in the Senate. A finding that reminds us that the testing crisis is perhaps only temporary. But also that the measures intended to mitigate it will have to be swift to have an effect.