Faced with the rapid spread of the coronavirus and the circulation of its variants, many French people are wondering about screening. What symptoms allow you to take the test? Where and how to get diagnosed? What is the government’s current strategy?

In March, stage 3 provided that only people with severe symptoms and nursing staff working in contact with patients could benefit from a screening test: “I only get tested if I am a fragile or at risk person, if I show signs of seriousness, if I am already hospitalized, if I am a health professional, if I am a fragile person in collective structure (EPHAD, handicap) ”, indicated the government on its site dedicated to the coronavirus.

For people who presented similar symptoms, but did not correspond to any of the categories cited, the general practitioner then made his diagnosis on the clinical signs, without requesting screening. This procedure stems from the government’s desire to limit the number of tests carried out.

Since September 2020, anyone who requests it can be tested, even in the absence of typical symptoms. In addition, the medical prescription is no longer compulsory. The screening test is fully covered by health insurance. Choose a screening center near your home. If the test is negative, you must continue to apply barrier gestures, in addition to wearing your mask, and follow coronavirus advice. If, on the contrary, the test is positive for Covid-19, the person must imperatively wear a surgical mask, confine themselves and contact their doctor. The latter will give him the conduct to follow for the future. The test results are communicated 36 hours later. 

In October, a public becomes a priority to take the Covid-19 tests, to limit the sometimes too long wait, to obtain an appointment and the results. The people who have the priority are the people who present the symptoms, the case-contacts, the nursing staff and similar. Screening tents are set up for them, especially in large cities. In addition, 2 agents are recruited within the Health Insurance and in the Regional Health Agencies. Making an appointment is recommended, even mandatory. It is advisable to fill out a form beforehand, to reduce the queues.

Since December, two Covid-19 screening methods are used in France, the PCR test and the antigen test. The first offers very reliable results while the second gives the conclusions quickly, in 30 minutes. As the holiday season approaches, some people wonder whether to take a test allows you to reunite as a family “safely “. According to the Minister of Health, Olivier Véran, we must avoid “saturate the supply of tests, essential for contact or symptomatic people.In addition, the High Authority of Health published a note on December 12, in which it makes recommendations: 

• in the week preceding the days of December 24, 25, 31 and January 1, symptomatic people may benefit from a screening test (antigen test, if the appearance of the first clinical signs dates back less than 4 days, or a test PCR if the symptoms are older) and must be isolated without waiting for the results;
• asymptomatic people can take a screening test if they have been in contact with individuals positive for Covid-19 or if there is a risk-taking in the days preceding the holiday season. On the other hand, if there is no risk taking or that a self-containment takes place in the week preceding the days of December 24, 25, 31 and January 1, it is then useless to do a virological test. .

In November, the antigen test is deployed in France. Carried out in a pharmacy or in a doctor’s office, this type of test detects the proteins produced by the Sars-Cov-2 virus. People who are asymptomatic and who are not contact cases can be tested for antigen. This is particularly the case for people who work in premises or live in confined spaces, such as students or the elderly in nursing homes. People who show symptoms of Covid-19 are also required to perform this rapid screening test, but must take place within 4 days of the appearance of the first clinical signs. In addition to the pharmacist and the general practitioner, many health professionals are authorized to perform the antigen test, even at home. This is the case for nurses, midwives, physiotherapists and many others. They must undergo training beforehand. If the test is positive, the patient should self-isolate and contact their attending physician. If, on the other hand, it is negative, the person must continue to respect barrier gestures. Antigenic tests are reimbursed by Social Security.

In March, the test, developed at the Institut Pasteur, is of the PCR type, and allows a nasal cell sample to detect the presence or absence of the SARS-CoV-2 virus, which causes the Covid-19 disease. . It is very fast, and the results must be transmitted within 24 hours maximum (the majority are obtained within 4 to 5 hours after the test). It costs 54 € if it is carried out in a city laboratory, and 135 € if it is carried out in a hospital center.

For the moment, there are no self-service tests in France as there may be in other countries affected by the epidemic. Only large hospitals and city laboratories are today authorized to test, and with the exception of the Marseille IHU, which has decided to screen anyone presenting with mild symptoms, the number of tests carried out remains limit.

In September, it was necessary to make an appointment in advance to perform the Covid-19 screening test. Today, screening for Covid-19 is done with or without an appointment. The tests can be performed in hospitals, downtown labs or testing centers. Health insurance can directly contact the person identified as “case-contact“. A rapid serological test (TROD) can be performed at a pharmacy. It should be supplemented by a laboratory test.

• If you recognize yourself in one of the categories that may benefit from the coronavirus test, the first step in getting tested is to contact your doctor, or even call 15 if you have breathing difficulties or the symptoms require you to act urgently.
• If you are not sure that it is necessary to carry out a screening test, the government has set up the site https://www.maladiecoronavirus.fr/ to provide you with answers and guide you in your process.

Emmanuel Macron announced the arrival of new screening methods during the month of November: “antigenic tests“, To relieve laboratory congestion and”drastically reduce delays»To obtain the results. Indeed, the test offers a very quick conclusion, within half an hour, or even within 15 minutes. It can be done in pharmacies. Reading the result is very simple, similar to a pregnancy test: one bar indicates a positive and two bars a negative result. The State would have pre-ordered 5 million, to ensure mass screening in airports, nursing homes or universities. It will cost between 5 and 10 € per unit, excluding tax. To this, it will be necessary to add the distributor’s margin and the remuneration of the professional who will do the test. The Head of State also mentioned the self-tests, to be carried out yourself at home, using a saliva or blood sample (similar to an injection to measure insulin in people with diabetes). 

Since the start of the epidemic, the Minister of Health Olivier Veran has continued to explain that France was following the guidelines of the World Health Organization in terms of screening. But the French strategy is singled out: today, France is one of the countries which least screens its population. Since the passage to stage 3, “9000 tests for the coronavirus are carried out every day”, according to Jérôme Salomon, Director General of Health.

In addition, according to the Minister of Solidarity and Health, Olivier Véran, 2,2 million PCR tests are carried out per week as well as 160 antigenic tests.

The screening strategy in France, at the start of the epidemic, was strongly criticized, given the excellent results that some countries have obtained by practicing mass screening. The champion in the matter, South Korea, has carried out nearly 400 tests (in March) since the start of the epidemic, and was with Germany the country with the lowest case fatality rate (000 dead for 120 cases, or 9037%).

Mass screening … after the first confinement

Today, screening tests are carried out on a massive scale in France, as well as in companies and schools.

The WHO has changed direction since the start of the coronavirus epidemic, and has issued new recommendations. “We have a simple message to all countries: test, test, test people! ” expressed Tedros Adhanom Ghebreyesus, Director General of WHO, on Monday March 16. Olivier Veran quickly responded by explaining that France was now preparing for “ multiply the tests when the confinement is lifted ».

A reaction considered insufficient by many, but which can be explained as much by a government strategy aimed at containing the epidemic as by the current lack of means of hospitals. The raw materials and consumables essential for screening (such as swabs) are starting to run out, and some laboratories and hospitals are already overloaded with the number of current patients.

The hope today lies in the commissioning of new, more efficient tests which are currently under development, or even in the process of being validated by the European Commission. Serology tests, which rely on blood analysis to detect the presence or absence of the virus, are particularly highlighted by the government.