"If we don't have tracing, we don't have deconfinement". The sentence, signed Olivier Véran, Minister of Health, reaffirms the government's desire to trace people infected with the Covid-19 virus and their entourage.
If the idea of the StopCovid application has been ruled out for the date of May 11, a file called "Contact Covid" must be deployed as of Monday, May 11 across the territory under the responsibility of general practitioners, then the 'Health Insurance. A collection of data that worries many players. We take stock.
What is the "Contact Covid" file?
Parliament is expected to adopt the new health emergency bill this weekend to extend it until July. This includes, in its article 6, the collection of "data relating to people affected by this virus and to people who have been in contact with them can be shared". To set up this data collection, the government relies on a specific file: "Contact Covid".
On the website of the Ministry of Health and that of Health Insurance, its deployment is specified. Made available to doctors, laboratories and pharmacists, this file “will be the tool […] for: identifying and contacting, for each positive person detected, all of their close contacts in order to encourage them to comply with strict guidelines for 'isolation'.
Concretely, a doctor who practices himself or receives a positive Covid-19 test must record the patient's file (name, date of birth, contact) within 24 hours of the test result. Finally, "with the patient's agreement", as Health Insurance specifies on its site, the health professional can write down the contact details of the people in the family, "friendly, professional" environment of the patient, "in contact closer with him up to two days before the onset of signs of the disease. "
In addition, this file will also be accessible to departmental health insurance platforms as well as to regional health agencies (ARS) and to Public Health France. The departmental platforms, also called "health brigades", will be made up of medical and administrative staff from the Health Insurance. They will be responsible for "completing" the data collection started by the doctor, but may also order tests and issue work stoppages.
Is there an obligation to complete this file?
"For the moment, no," says Jean-Paul Hamon, president of the Federation of Doctors of France. But we think the law will make Covid-19 a reportable disease. ” Covid-19 would therefore join, at least temporarily, diseases like cholera or tuberculosis. In this case, the doctor will have the obligation to declare a patient sick.
But on the patient side, "to avoid any debate on medical confidentiality, we ask that the transmission of other data be based on voluntary work", asks Jean-Paul Hamon. A point on which he joined the Academy of Medicine or the Senate.
Will doctors be paid for this data?
Health Insurance informs that specific pricing measures will be put in place "to support and recognize the commitment of self-employed doctors". Thus, an increase invoice of € 30 at the consultation rate can be set up in the event of a positive test at Covid-19. The total cost of a consultation could therefore cost a patient € 55 (€ 25, standard price, + the € 30 mark-up). "This is not an overcharging, warns Jean-Paul Hamon. It is the recognition of a long consultation as some complex consultations are already ”. The patient will have to pay this amount except in the case of third party payment. But it will be reimbursed by Health Insurance.
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Another point questioned the population: the remuneration of data. Doctors were encouraged by Health Insurance to trace patients “beyond the nearby cell”. By registering these other contact cases, they would have received additional remuneration ranging from 2 to 4 euros depending on the data entered.
But an amendment, tabled by four LREM deputies, was adopted on May 6 so that "data collection" cannot "give rise to remuneration".
What do doctors think?
The debate agitates the medical community between public health mission and attack on professional ethics. As of May 5, the National Academy of Medicine published an opinion "favorable" to the temporary establishment of this data system under several conditions, requesting in particular that any infected person can oppose the transmission of data as well as "broad communication on the implementation of the system". For its part, the Order of Physicians requests that the nature of this data be "strictly limited" to the fight against the pandemic.
Among the unions, several opinions are opposed. “We pass on data that is far more sensitive to health insurance all year round and everything is going well. She has never betrayed medical confidentiality, ”says Jean-Paul Hamon. Conversely, for Jacques Battistoni, president of the MG France union, the file could "constitute a very dangerous precedent for the health control of populations" and refuse "this practice of unworthy filing which undermines professional ethics".
What precautions will be taken?
The Director of Health Insurance, who will therefore collect this data via his site Amélie.pro, tries to reassure. "Health Insurance, in its daily relationships with doctors, already handles a lot of health data today," says Nicolas Revel. “The non-nursing staff who will have access (to this data) are collaborators whose mission it is already. No sensitive medical data is intended to be shared beyond, "he said in an interview with Les Echos.
The data collected should only be kept for a maximum of one year from the publication of the law. "We will be particularly attentive to the duration of data storage and their relevance," warned Marie-Laure Denis, president of the Cnil, an organization which will have to approve the decree detailing this system.
Finally, the Senate, during the first review of the law, approved this article 6 under conditions: the creation of a control body or even individual right to oppose registration in the file. Two last safeguards to try to reassure the most skeptical.