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Covid-19: “It seems premature to lighten the measures”, says Antoine Flahaut
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Covid-19: “It seems premature to lighten the measures”, says Antoine Flahaut
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Director of the Institute of Global Health at the University of Geneva, epidemiologist Antoine Flahault insists on the importance of vaccination and improving indoor air quality, and believes that the current level of contamination does not encourage relaxation.

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What do you think of the easing of certain restrictions decided by the government, which will follow the introduction of the vaccination pass? Isn’t there a risk of seeing contamination rebound?

A form of agility from public authorities is welcome in this crisis, but that does not mean acting out of time. We cannot lighten as long as the curve rises and as long as the level of contamination remains at a very high level. Agility is conceived when the lull has returned, because then it is time to let everyone benefit from this lull. In France, not so long ago, a lull was defined as a level of daily contamination of less than 5,000 cases per day: this kind of criterion is simple and can be regionalized if necessary. But, currently, we are still far from this situation, and therefore, it seems premature to lighten the measures, even if we all wanted it ardently.

As long as classes and canteens are poorly ventilated, contamination will continue

Can we calmly consider the reduction of the protocol in the school environment?

In schools, as in all closed environments, what should be done is above all to launch a vast program aimed at improving indoor air quality. As long as classes and canteens are poorly ventilated, contamination will persist. Swiss researchers have demonstrated, from a study of 150 classes in 59 primary schools in the canton of Grisons, in November, on the one hand that 60% of them were insufficiently ventilated, and on the other hand that the more efficiently the classrooms were ventilated, the less the coronavirus circulated there. If we want to bring a little serenity to the continuity of children’s education, then it is high time to secure schools against the risk of transmission of the coronavirus. This will also apply to other respiratory viruses, but also to improving school performance and the mental development of children. We have everything to gain from breathing better quality indoor air in our places of work, living, or when travelling. In addition, vaccination campaigns aimed at protecting children against this sneaky virus should be accelerated. Remember that 80% of children hospitalized for covid have no comorbidity and did not know they were at risk of severe complications.

Should we, at the present time, continue to test massively?

French testing capacities have become impressive since more than two million tests have been carried out daily in recent weeks. However, the risks of clogging the system are present and if they lead to making access more difficult or delayed for those who need it most, then it would be appropriate to test less or at least to prioritize the indications of these tests. In addition, we are not sure that the estimates of new daily contaminations are very precise, despite the large number of tests carried out, because many people do not test themselves and probably fall through the cracks. Other sampling methods, less cumbersome and less costly, would seem more appropriate in such a situation.

Should tests be reserved for certain categories of people or certain situations?

It is rather the priority of access to tests that must be reserved for certain people or situations. Immunocompromised people, for example, can benefit from specific treatments recognized as effective, when they are infected with the coronavirus, to prevent serious forms which lead to hospitalization or even death. It is obviously very important that these people have priority access to tests, especially since the treatments in question need to be administered as early as possible, as soon as the infection is identified. Elderly people who have lost their immunity as well. Physicians must also be able to prescribe tests for people whose symptoms concern them or because they have comorbidities that put them at high risk of complications. Finally, nursing staff, nursing home staff and caregivers must also be able to benefit from priorities for being tested in order to reduce the risk of reintroduction of the virus into the establishments in which they work, and in which people are sometimes cared for. very vulnerable. Schools could also be the subject of repeated screening campaigns, for example by carrying out PCR on saliva samples pooled by class.

Is it possible to change the screening strategy in the current state of the pandemic, in the face of Omicron?

It is of course difficult to change the screening strategy in the midst of an epidemic wave, but it seems to me that this should be at the heart of the reflections in the very near future. In particular, a system should be set up for sampling a group of the population which would be regularly tested (for example on saliva samples) and which would provide estimates by department or region, as well as nationally, of a better than current figures. It would also be necessary to take care of school screenings and establish a list of priority patients or situations for PCR tests.

Covid-19: “It seems premature to lighten the measures”, says Antoine Flahaut
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