Covid-19: should we reinstate free screening tests?

Jean-Luc Mélenchon suggested it Wednesday on TF1, arguing that it was a necessity for “the quality of the end of the year celebrations”.

THE QUESTION.For the quality of our end-of-year celebrations, we must reinstate the free test“. Guest of TF1 this Wednesday, the candidate of rebellious France, Jean-Luc Mélenchon, ardently pleaded for the reinstatement of free screening, which has become paying for people who have not been vaccinated since October 15. “We don’t care who is vaccinated or not, what we want to know is who is sick or not“, Argued the member of Bouches-du-Rhône, at a time when a fifth epidemic wave worries the health authorities. An opinion shared by several scientists. “This is something that probably needs to be reconsidered», Said Dominique Costagliola, research director at Inserm, on BFMTV. As well as Professor Gilles Pialoux, guest on the same channel. “It is one more tool to detect earlier, to isolate“, He justified, arguing in particular the increase in symptoms of Covid in winter.

Thursday morning, however, the government dismissed this prospect: “This is not planned today», Assured the spokesperson Gabriel Attal. “There is no reason that the French, with their taxes, fund tests that aim to go to restaurants, which aim to go to concerts, which aim to go to the cinema», Blasted the megaphone of the executive. At a time when we are talking about the possible tightening of measures for the unvaccinated, is free testing a good idea?

CHECKS. The benefits of massive screening are no longer to be proven: vaccine or not, the sooner people know they are contagious, the sooner they isolate themselves, and therefore limit the spread of the virus. “Those who know they are positive do not have the same behavior», Supports Professor Gilles Pialoux. Especially since the winter period is always conducive to an epidemic resurgence, not to mention the meetings around the holidays, a period conducive to gatherings, including fragile people. Last year, the arrival of Christmas had been the occasion of an assiduous campaign by the health authorities to encourage the wearing of masks, to a limited number of guests, to the point of putting “grandpa and grandma in the kitchen”. The week of Christmas, the French had thus stormed the screening laboratories.

SEE ALSO – Covid-19: Jean-Luc Mélenchon calls for the return of free tests

However, the prices now in force for the tests (minimum 43.89 € for a PCR and 22 € for an antigen) are undoubtedly dissuasive. As evidenced by the figures of Health Insurance: despite a rebound last week, screening has experienced, since the end of its free, a general decline of 23%. However, of the 3.4 million antigenic tests carried out between October 15 and November 4, 1.7 million, or about 50%, were reimbursed by Health Insurance. For PCRs, over the same period, the “almost all“Tests were supported, further indicates to the Figaro the Directorate General of Health. In addition to the vaccinated, minors, holders of a medical prescription, and contact cases, are exempt from paying.

If there is a decrease, it is therefore the unvaccinated non-holders of a medical prescription who are the main factor. A finding confirmed by the graph below, where the orange curve represents asymptomatic unvaccinated people.

Evolution of the number of tests carried out between September 20 and November 1, 2021. AMELI

This being the case, is the idea of ​​free tests to limit the outbreak of the epidemic really relevant? This orange curve representing only a tiny part of the population, would the effectiveness of such a measure not be limited?

Promote screening

The main idea behind it is to encourage screening“, Argues for his part Professor Gilles Pialoux. In fact, France is currently a poor student in this area: in its latest bulletin, Santé Publique France revealed that the time between the onset of symptoms and screening is 2.5 days, the longest level ever. An observation that upsets the professor. “Political decisions around Covid-19 are often based on the criterion of the incidence rate. Take the saga of masks at school: in recent weeks, the departments have been removing it or putting it back on depending on the number of cases per 100,000 inhabitants. However, this is calculated on the basis of the screenings!», He recalls. “Since the appearance of the vaccine, the executive has relegated the message of screening to the background and it is a shame. Free tests would be a great way to put them back at the center of the anti-Covid strategy“.

All the scientists contacted by Le Figaro are unanimous: the question is more political than epidemiological. The non-reimbursement, in fact, had been decided above all for its coercive aspect, in order to encourage vaccination. Wouldn’t making them free again risk being counterproductive for the vaccination curve? “Knowing which tests to pay has necessarily an impact on the energy to go to be tested.», Objected for his part Christian Rabaud, infectious disease specialist at the Nancy CHRU. “There should be no hesitation possible, so that no one procrastinates on the pretext that it is necessary to take out the walletHe pleads.

And the epidemiologist to go further. “Christmas or not, epidemiological monitoring requires mass screening. As long as the epidemic was on the decline, the importance of the numbers was relative. Now that the curves are going up, we again need the most precise and reliable data possible.“. For a department, a region, a city or even a school, the incidence rate can thus be worth a return to the wearing of the mask, a curfew or even a confinement. It is therefore without delay, according to the epidemiologist, that free tests must be reinstated. “Even if it means readjusting after Christmas“.

In summary, the vast majority of tests are still free since only non-vaccinated people who do not have a medical prescription have to pay for them. Despite everything, epidemiologists believe that making them free could politically put testing back at the heart of the fight against the pandemic, a necessity as the country experiences a fifth epidemic wave. Being able to measure its progress, as close as possible to reality, is essential.

SEE ALSO – Covid-19: in Germany, new restrictions for the unvaccinated and compulsory vaccination for healthcare workers


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