"All deaths will be made public" in institutions, in the city or in Ephad, assured this Wednesday evening Professor Jérôme Salomon, Director General of Health, during his traditional update on the coronavirus.
What to do when you do not know the number of people actually infected? Are not the 1331 deaths linked to the virus more numerous? Today, doctors only do the test if they have a serious infection. And in Ehpad, after suspicion of symptoms and request from Center 15, only the first three cases are tested. Not the others who come afterwards.
How can we measure the situation in these establishments that care for nearly a million residents and beneficiaries? Elderly people who are the most vulnerable to the virus, with an average of 85 years and often several pathologies which make them even more fragile. Recently, in the nursing homes, 7 people died from coronavirus in Haute-Savoie, 16 dead are already to be deplored in Paris in a structure of the 12th century. The previous week, 20 elderly people had died from Covid-19 in the Vosges and 13 in Haute-Marne…
"We won't really know until after the crisis"
It is therefore impossible to know precisely the fatality rate linked to Covid-19, that is to say the number of deaths compared to the number of infected people, since massive tests have not been carried out ... In fact, the point made each evening by the Ministry of Health is probably not exhaustive. The epidemic is deadly but how many deaths do they slip through the cracks?
“An application is under development allowing daily monitoring of mortality, as soon as an Ehpad or another medico-social establishment has reported at least one case suspected of being infected with SARS-CoV-2 which occurred in the 'establishment', announces Public Health France. The public establishment, attached to the Ministry of Health, specifies: "In the coming days, the addition of deaths occurring in the hospital and those occurring in an Ehpad will provide daily estimates of mortality covering the two main places of death related to Covid-19. Those occurring at home or in other institutions representing a small part of the mortality linked to Covid-19 ”.
“We will not really know until after the crisis, after the study of excess mortality, as was the case for the heat wave or for the flu. So see you in six months, says Pascal Champvert, president of the Association of Directors of the Service for the Elderly (AD-PA). We know how to count the number of dead but not the number of sick. However, I do not believe that the figures given are very far from the reality ”.
Coronavirus suspected
"Besides, I do not understand the rumor which says that we would not count the dead in Ehpad. It's wrong ! A doctor comes to make a death certificate. And if the person was not tested and had symptoms, it is noted: suspected coronavirus. It is also a safe bet that some people were counted as having had it when it was not the case, "adds Champvert.
The declaration of death established by a doctor is effectively the subject of a certificate, containing two parts: a first with the administrative data of the deceased person which is intended for INSEE (transmitted by the municipalities). A second section, anonymous this time, contains the medical causes of death. It is then sent to the Regional Health Agency (ARS), then sent to CépiDc (Center for epidemiology of medical causes of death) of Inserm.
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Regarding the elderly cared for at home, are tests still carried out in the event of suspicion? "It is extremely variable according to the territories ...", concludes the president of AD-PA.