Since its publication Thursday evening, the first map of France of deconfinement does not stop causing annoyance among some local elected officials. The controversy crystallized in three departments classified as "red", Haute-Corse, Lot and Cher. However, this would be due to errors in the reporting of information. "It is incomprehensible, and it is quite simply common sense", points out the deputy of the Lot Aurélien Pradié. The Directorate General of Health recognizes the phenomenon with the Parisian and ensures that "the correction will occur in the coming days". Explanations.
To fully understand, it is necessary to recall in which case a department is classified in red. In fact, two cards were revealed, each with three color scales (green, orange and red). The first, which concerns “circulation of the virus”, is calculated from the rate of emergency visits for suspected Covid-19 relative to the total number of passages. The second relates to the level of tension in resuscitation. If a department is in red in only one of these two criteria, it is in red in the end.
Cher, Lot and Haute-Corse owe their red color to the first criterion. In these three departments, the rate of emergency visits for suspected Covid-19 is greater than 10%. The Directorate General of Health was unable to tell us whether it related to the past 24 hours or the past week. However, we observe in the Public Health France database that the eight departments in red (with one exception) are those with the highest weekly rate of emergency visits over the last full week, that going from 19 to April 26. It can therefore be assumed that a weekly average has been taken into account.
Except that in the Lot and the Cher, many tests conducted in Ehpad would have been counted among the emergency visits. Mechanically, greatly increasing the proportion of passages for suspected Covid, the population in these two departments and therefore the total number of emergency visits being quite limited.
A single criterion retained
“A few weeks ago, we had two Ehpad very affected by the coronavirus. We insisted on testing everyone and it is the emergencies of the Cahors hospital that manage the tests, ”said deputy Aurélien Pradié, who spoke with the hospital's emergency manager on Wednesday evening. In an email sent to local elected officials in the evening, the director general of the regional health agency (ARS) Occitanie also writes that "the practice observed is to count emergency visits for sampling for the purpose of virological testing", which "distorts the national assessment of the situation".
All these tests conducted in Ehpad, very often for suspicion of Covid-19, would have increased the proportion. However, to establish its departmental virus circulation card, the Ministry of Health relied only on the rate of suspected cases of Covid-19 in the emergency room, and not on the total number of positive tests, consultations with the general practitioner or calls to SOS Doctors, for example. "It turns out that using only one indicator makes the system very sensitive, especially in departments for which the population is rather low like the Lot," added the director general of ARS Occitanie in his e-mail. .
The same situation probably occurred in the Cher. "It would seem that tests made in Ehpad were recorded in the passages to the emergencies of the hospitals on which they depend", advance Christophe Lugnot, director of cabinet of the regional health agency Center-Val de Loire, joined by the Parisian . The ARS was as shocked as we were. 300 tests done in the Ehpad were recorded as passages to the emergencies of Bourges ”, abounds the deputy of the Dear Loic Kervran.
The provisional map published this evening classifies the Cher department in red. BY MISTAKE !
After an exchange with the Prefect and the ARS, we asked for a quick rectification. pic.twitter.com/0okAepOck5
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“I had the explanation by the director of the hospital who explained to me that the tests carried out in large numbers in certain Ehpad were recorded in the column of the passages to the emergency rooms. Inevitably, we therefore have a Covid rate when going to the emergency room which is important, ”estimated the prefect of Cher, as of Wednesday evening, in Le Berry Republicain.
"The real subject will be the May 7 card"
In Haute-Corse, the regional health authority indicated that "the modalities of coding by the Bastia hospital center lead to an overestimation of the number of emergency visits for Covid out of step with the number of positive cases tested", without the we know if this was also due to screening in nursing homes.
In summary, these “coding biases within the reference hospitals could have led to an overestimation of the percentage of emergency visits for suspected Coronavirus in their territories,” recognizes the Directorate General of Health, which relies on the data provided by Public Health France.
The health authorities in these three departments ensure that, from Wednesday evening, forwarded this information to the national level, so that the correction is made, if possible, as of Friday evening. "The real subject will be the May 7 card [which will determine the level of deconfinement from May 11]", concludes Christophe Lugnot.