It is a decision that the government had taken to encourage the French to be vaccinated against Covid-19. Since October 15, so-called “comfort” tests are no longer reimbursed for unvaccinated people, unless they have a medical prescription or if they are identified as contact cases. Screening charged around 22 euros for an antigen test and 44 euros for a PCR.
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But faced with the arrival in France of the fifth wave of the epidemic, several specialists are calling for a return to free testing for all. “We dropped the screening and it’s a mistake “, thus estimated Wednesday, November 17 Gilles Pialoux, head of the infectious diseases department of the Tenon hospital in Paris, on BFMTV. The idea was also invited into the political arena, while the presidential candidate Jean-Luc Mélenchon pleaded on TF1 for the return to reimbursement of tests. Franceinfo takes stock of the various arguments put forward.
1Testing more would allow us to better understand the rebound of the epidemic
It is above all the health situation that is put forward to defend the return to reimbursement of screening tests. Like the‘Germany, which has restored their free access to an outbreak of contamination cases. “In a period of epidemic rebound (…), we must be able to ensure that infected people, whatever their vaccination status, are detected as quickly as possible”, defends epidemiologist Pascal Crépey in the columns of L’Obs.
However, a month after the end of their free service, the number of tests fell. While 440,000 samples were taken each day around October 10, 300,000 screenings were performed daily at the end of October. A decrease that risks blurring the monitoring of the epidemic, argue several specialists. “There is probably an underestimation of the number of cases in France”, explains for example Mahmoud Zureik, professor of epidemiology and public health, to L’Express (subscribers article).
“This poses a problem if we are led to take measures based on a certain traffic threshold, because in this case we need reliable indicators”, he continues.
Pascal Crépey argues that massive screening is crucial “lat the start of an epidemic phase “, when “there are also more people infected, so more contact cases “. For his part, Gilles Pialoux adds that as winter approaches, screening is essential to differentiate Covid-19 infections from those due to seasonal viruses. “There are going to be people who are going to have a lot of symptoms that look like a Covid benign and will not be tested “, breathes the head of the infectious diseases department at Tenon hospital.
2With paid tests, the time between the onset of symptoms and screening lengthens
In addition, the end of free tests seems to have widened the gap between the appearance of the first symptoms and the date of the sample. This period is now 2.5 days, “ie the highest average value observed in 2021”, French public health point in its latest newsletter on tracing activities.
“This augmentation [du délai] could be explained by the necessary visit to a prescribing doctor prior to the test for unvaccinated people “, SPF advance. Pascal Crépey also evokes those who “decide to wait, to see if the symptoms persist before paying to be tested” Where “asymptomatic people, who could have been tested if it had always been free, but who will not do so because it pays off”.
“To reduce these delays, we should ensure that people can go and get detected easily, and therefore free of charge.”Pascal Crépey, epidemiologist
However, it is important that this period remains “as short as possible” to limit the spread of the virus and ensure rapid isolation of positive cases and contact cases, adds Public Health France.
“Not having quick access to the tests could be detrimental, because if you have symptoms or if you are in contact and you have to go through a medical prescription to be able to do this test, this delays the diagnosis, the treatment, and all this also leads to the spread of the virus “, abstract Mahmoud Zureik. “It is one more tool to detect earlier, to isolate, abounds Gilles Pialoux. Someone who knows they are positive does not have the same behavior, it is human. He isolates himself, he takes action. “
3Paid tests do not seem to have convinced those reluctant to vaccination
At last, “Using the test de-reimbursement made political sense to force the unvaccinated a little more to become vaccinated”, exhibits Pascal Crepey to the Parisian. But the goal is still far from having been achieved. Number of first-time injections have not seen a rebound since the end of free tests. About 17,000 first doses of vaccine are now administered daily, a far cry from the 350,000 injections made in early August, at the height of the campaign.
However, there is no question for the government to change its strategy. “A large majority of French people have access to tests, which remain covered by Social Security for people who are vaccinated, who are contact cases of positive cases and for people who have a medical prescription, which is still enough large“, pleaded the government spokesman, Gabriel Attal, Tuesday, on France Inter. And to decide on Thursday morning on the LCI set : “It is not planned today” to return to free testing.