definition, interruption of work, declaration on Ameli

[Mise à jour le mardi 24 novembre à 11h37] In order to better limit the spread of Covid-19, Health insurance needs to be able to quickly contact zero Covid-19 patients and contact cases. This is why the tracking device adapts to health trends and now favors SMS contacts, indicates a public service statement of 19 November. The goal: more responsiveness and efficiency. What is the exact definition of a contact case? When to take the test Isolate yourself and for how long? What to do when in contact at work? How does it work for a child “contact case”? Explanations.

By definition, a contact case is a person who has been in contact with a positive case of Covid-19. More precisely, according to Santé Publique France: this is a person who, in the absence of effective protective measures for the duration of the contact (hypophone, glass, surgical mask, FFP2, general public worn by the case or by the contact person):

• He shared the same place of life as the confirmed or probable case;
• I have one direct contact with a case, face to face, within 1 meter, regardless of the duration (e.g. conversation, meal, flirting, hugging, hugging).
• Acts of hygiene or care provided or received;
• Has shared a confined space (office or meeting room, personal vehicle …) for at least 15 minutes with a case or has been face to face with a case during several coughing or sneezing episodes;
• Is a student or teacher in the same school class (kindergarten, primary, secondary, university practice group).

→ Attention, people crossed in the public space of fleeting way they are not considered risky contacts.

From 3 November 2020, health insurance has changed the contact tracking device with the implementation of new communication methods. To reach all “contact cases” and no longer just those who have an Ameli account, the emails that had been sent up to that moment are replaced by SMS. From now on :

• If you are a “contact case”, you will receive an SMS from 38 663 referring, via a clickable link, to a website. You must consult this site where you will find all the useful information on the health measures to be observed and on your rights (interruption of work, free release of masks, etc.).
• If you test positive for the Covid-19 test, you will receive an SMS message referring to a site where you are invited to prepare the list of your contact cases at risk as well as their contact details pending the call from the health insurance.

In his weekly update on Thursday 17 September on the health situation and the strategy to combat the spread of Covid-19 in France, Health Minister Olivier Véran pointed out that “Contact cases of contact cases are not contact cases”.

“Contact cases of contact cases are not contact cases”

“In that case, there is no need to be tested, insists Dr. Anne Goffard. We apply barrier measures and avoid overloading the laboratories by being tested for nothing. “

Health Minister Olivier Véran and the French authorities in general are increasingly using the term “risky case contact”. What is the difference with Public Health France’s definition of a “contact case”? A person known as a “risky contact case” was contacted by health insurance teams who was in “at risk” contact with a person who tested positive for Covid-19. Receives a SMS from health insurance which allows it to be a priority to perform a screening test for Covid-19 infection. He can also benefit from a specific work break issued by health insurance if he cannot telework.

According to government recommendations:

• If I live under the same roof as the person infected with Covid-19 or if signs appear, I am tested as soon as possible, if necessary after a teleconsultation with my doctor. I wear a mask for all my travels and stay at home until the test results.
• If I don’t live under the same roof that the sick person (this is a work colleague, contacts during free time activities, private meetings, etc.), I remain in isolation for 7 days at home after my last contact with him and I have him tested after 7 days. “RT-PCR done too early can be negative while the person is infected” remembers Dr Anne Goffard, a virologist at the Lille University Hospital.

Contact cases are a priority for performing the coronavirus screening test (nasal swab). The doctor’s prescription or the SMS received by the Health Insurance for contact cases recognized as “at risk” speed up obtaining an appointment.

L ‘the isolation must last at least 7 days and stop after the disappearance of the last symptoms and at the earliest 48 hours after the disappearance of the fever. The end of the isolation period must be accompanied, during the next 7 full days, by wearing a surgical mask and by rigorous compliance with barrier and physical distancing measures.

For confirmed asymptomatic cases, the 7 full day isolation will start from the day of the positive sample. If symptoms occur, the isolation period should be extended by 7 days from the date of onset of symptoms.

TO contact person at risk, the period of isolation is 7 full days in case of negative RT-PCR test 7 days after the last contact with the case.

The duration of isolation in the event of Covid-19 infection was reduced from 14 days (fourteen) to 7 days in September. To identify himself, the Minister of Health, Olivier Véran, spoke of the “method three 7” during his press conference on September 17: “Isolation is (for) 7 days after symptoms appear when you are sick. Isolation is (for) 7 days after a positive test when you are asymptomatic. And the isolation is (for) 7 days after the last contact with a sick person after performing a 7-day test. ”

Return to work, accelerated in September, has increased the number of contact cases between co-workers.

If you are a contact case in a company: “To avoid infecting other people themselves, contact persons should remain isolated until the screening test results, even if they show no symptoms. They should not go to their workplace.” explains health insurance on his website.

Work interruption in case of impossibility of teleworking

When a person is recognized by health insurance as a “risky contact case” and cannot telework, a specific interruption of work it is necessary. Starting the October 3 Health insurance is opening a teleservice that allows you to request the interruption of work online (on the website and from your smartphone), without waiting times. After submitting his claim on declare.ameli.fr, the insured can benefit from a Suspension of 7 days from the date the Health Insurance contacted him to invite him to isolate himself and take a test, after a risky contact with a person who tested positive for coronavirus. For policyholders who have already spontaneously isolated themselves before that date, the termination can be retroactive within the limit of 4 days. In the event that the test results are not yet known at the end of the initial detention, the policyholder can request a extension its within the limit of 7 additional days. Before proceeding with the payment of daily allowances, Health insurance will verify that the insured is known as a risky contact case. In case of agreement, he will be sent a certificate of isolation worthy of derogatory work interruption, which can be presented to the employer.

“When a child is positive, he must be isolated for 7 days at home, but the other children in his class can continue to go to school”

Young children are at low risk of severe form and underactive in the SARS-CoV-2 transmission chain. The data show that the risk of transmission exists mainly from adult to adult and from adult to child and rarely from child to child or child to adult. On September 17, the health protocol in force in schools was relaxed: “LWhen a child is positive (…), he must be isolated for 7 days at home, but the other children in her class will normally be able to continue going to school “ Olivier Véran announced. According to this new protocol, it takes three confirmed cases of Covid-19 in one class, and no longer just one, so that the other pupils of this are considered as “risky contact casesThe child carrying the virus will have to isolate himself at home for 7 days but this will no longer prevent his classmates from continuing to go to school. As for the teacher, he will no longer be taken into consideration as a “risky contactIt will continue to ensure the pedagogical follow-up of pupils in person.

According to the recommendations of the High Council of Public Health, the search for contact cases must be carried out in early childhood centers and primary schools when:

• A supervising adult is positive for Covid-19 and has been in close / frequent contact with the child without wearing a mask.
• If 3 children of different siblings are positive for Covid-19 in the same class (this is called a “cluster”).

Covid-19 positive child can go back to school:

• after a 7 day eviction AND stopping the signs if he had symptoms. Wearing a mask for children under 11 is not recommended when returning to school.
• It is not recommended to order an RT-PCR test for SARS-CoV-2 upon return of the baby.

“You have to wear a public mask when you are out or with other people, remember our virologist. If you live with a Covid-19 positive person, that person tries as much as possible to isolate themselves, to wear a surgical mask and to limit contact with family members. Even if it is difficult for parents of young children or with elderly or non-dependent people. “

Thanks to Dr Anne Goffard, virologist at the University Hospital of Lille.

Sources:

Sars-CoV-2 (Covid-19) Infection Case Definition, Public Health France, May 7, 2020.

I have been in risky contact with a person with Covid-19. Public health France. September 15, 2020.