The questions of city medicine placed at the heart of the second wave

An intention welcomed: that announced at a press conference on November 5 by the Minister of Health, Olivier Véran, to place general practitioners at the heart of the care of patients with Covid-19. Quite the opposite of what had happened during the first wave of the epidemic last spring when the hospital had been the central actor of the crisis to the point of being quickly overwhelmed. However, is this change of foot the promise of better management of the health crisis? And above all, is it likely to facilitate greater control of the evolution of the epidemic which would allow both a rapid end of the second confinement and better assurances that it does not lead, a few weeks later, to a third wave?

To provide some answers, Jean-François Lemoine, medical journalist and Nicolas Leblanc, public health doctor of the VYV group, received on November 14 in the program “JDF” on Fréquence Médicale, Dr. Jean-Paul Ortiz, president of the Confederation of French Medical Syndicates (CSMF), Dr Jacques Battistoni, president of MG France, Gille Bonnefond, pharmacist and president of the Union of Unions of Pharmacists of Officine (USPO) and Sylvie Ciron, nurse.

A clarified role for each healthcare professional

The logic of this new place given to city medicine is based on a clarification of the role of each of the health actors: who tests, who takes charge in the event of positivity with or without symptoms, who ensures the follow-up of patients and how city ​​medicine is organized with the hospital to manage serious cases. Essential points during this health crisis which, beyond their impact on the organization of health professionals, concern the entire population. The quality and effectiveness of the care provided to patients, as well as the control of the development of an epidemic, depend on the proper functioning of this care process. And therefore the exit schedule from confinement less and less well experienced by the French.

But listening to the health professionals invited on the show, we do not yet see the signs that we could expect from a “prepared” health system, as yet regularly assures Olivier Véran, for this second wave . This is particularly true for the famous tests: with the arrival of antigenic tests in addition to PCR tests, the question remains as to who performs them, when and under what conditions. “It remains complex”, admits, dubiously, Jacques Battistoni who wonders to know “what is the strategy of the government which asks us only to make figures?”. “It is not clear, we do not yet know who are the eligible patients”, adds Sylvie Ciron while nurses are one of the health professions on the front line for the detection of new infections. And Jean-Paul Ortiz to denounce “a false security” with the antigenic tests which are sure only when the result is positive whereas a significant proportion of negative results can be false.

Still awaiting proceedings

If the four health professionals in town are obviously ready, as many of them already did in the first wave – “this is what the liberals did with the Covid centers set up without waiting for instructions from the minister …? ” recalls Jean-Paul Ortiz “- they are still awaiting the procedures they must apply for a better organized care of Covid patients. Because this is the only condition for the evolution of this epidemic to be approximately controlled: “If we want to avoid a third wave, we must prepare now for deconfinement … But it is slow”, worries Jean-Paul Ortiz.

Find below the program on “The Covid-19 strategy outside the hospital”:


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