The issues of city medicine placed at the center of the second wave

A welcomed intention: that announced in a press conference on November 5 by the Minister of Health, Olivier Véran, to place general practitioners at the center 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 was 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 that would allow both a rapid end of the second hospitalization, and better guarantees 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 “JDF” program 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 Pharmacist Unions of Officine (USPO) and Sylvie Ciron, nurse.

A role clarified for every health worker

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 verifies, who takes care in case of positivity with or without symptoms, who ensures the follow-up of patients and how The city medicine is organized with the hospital for the management of severe cases. Essential points during this health crisis which, beyond their impact on the organization of health workers, concern the entire population. It is in fact the correct functioning of this care process that depends on the quality and efficiency of the care provided to patients but also on the control of the evolution of an epidemic. And therefore the program of release from prison experienced less and less by the French.

But listening to the health workers invited to the show, we still don’t see the signs that one might expect from a “prepared” health system, as Olivier Véran regularly assures us, for this second wave. . This is especially true of the famous tests: with the arrival of antigen tests in addition to PCR tests, the question remains of who performs them, when and under what conditions. “It remains complex”, admits, doubtfully, Jacques Battistoni who asks to know “what is the strategy of the government that asks us only to make figures?”. “It is not clear, we still don’t know who the suitable patients are,” adds Sylvie Ciron while nurses are one of the health professions at the forefront of identifying new infections. And Jean-Paul Ortiz to denounce “a false security” with antigen tests that are certain only when the result is positive while a significant percentage of negative results can be false.

Still awaiting trial

If the four health professionals in the city are obviously ready, as many of them already did in the first wave – “is this what the liberals did with the Covid centers set up without waiting for the minister’s instructions …?” Recalls Jean- Paul Ortiz “- are still waiting for the procedures to be applied for a better organization of Covid patient care. 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 ourselves now for the deconfinement … But it’s slow “, worries Jean-Paul Ortiz.

Below is the program on “The Covid-19 strategy outside the hospital”: