"Don't stick me! ", Martin Hirsch launches to Aurélien Rousseau who speaks to him, masked. The first is the director of Public Assistance-Hospitals of Paris (AP-HP), the second, that of the regional health agency Ile-de-France. At the old Broussais hospital in the capital, the visit will begin. A brand new lab, special coronavirus, opened just five days ago in these empty premises. It is 11 o'clock.
It is here on the 1st floor that part of the tests of Covid suspects from the Ile-de-France region are analyzed. Politics, media, doctors, everyone is there. "This building is called Leriche, it will have to be renamed," jokes Martin Hirsch. "You point out that the AP-HP is poor and that it is therefore necessary to change its name? "Bounces Michel Cadot, prefect of Ile-de-France, leaning on his cane. "No, Leriche, he was the president of the order of doctors under Vichy! "
Already 4000 PCR tests
A joke, the small group climbs into the elevator. A geneticist receives them. He explains: since the opening of the lab, 4,000 PCR tests have been carried out. But the machines are able to make the same figure per day. "And out of solidarity, will you take tests from other regions"? continues the prefect, curious. "Po, po, po, for the moment it is only Ile-de-France", stops Aurélien Rousseau. Increasing the number of tests to 700,000 per week in France to identify and isolate future patients is the huge challenge of deconfinement. Among them, contact cases, these people, families or not, who have been around a patient. "On average, more than 8% are positive," says the boss of the AP-HP in the cramped corridor where we pile up.
How are these tests analyzed? It all starts in a first room where a noisy machine spits out labels. Several laboratory technicians, external and internal, stick these bar codes on the tubes, which are still empty. And check with a sharp eye if they are not broken. Same examination for the swabs, these famous cotton swabs, which will be pressed into the noses of the Covid suspects and inserted into the tubes. "Here we are in the shipping part," explains Youcef Kadri, an external pharmacy. The boxes are ready to go to nursing homes or to the homes of individuals targeted as suspects.
Thirty minutes at 56 degrees
Other tests ready to be analyzed are back in the lab. In four hours, the experts will know who is positive and negative. Caution, they must be handled with extreme caution. At the entrance to the lab, large yellow plastic boxes on a table indicate "receipt of samples", brought by a delivery man. "They contain a solution to make the virus inactive and prevent it from contaminating us," emphasizes Théodora Maillard, laboratory technician.
The inside of the tube is safe. But what if the enemy was walking around on the sampling bag? "As a precaution, we put it for half an hour in an oven at 56 degrees," continues Chrystel Leroy, engineer. Understand, in the oven!
The bar codes are then scanned to verify that they correspond to the patient's identity. "Here, we call that, acknowledge receipt," says the engineer. A small tool shakes the mixture to make it homogeneous. Then the tubes are introduced into a super machine. Its name the "MGI" to pronounce in the American way. It transfers their content into each hole of a plate, 96 samples can be analyzed at the same time instead of 8 with traditional devices.
Result a good hour later
New step, on another machine which extracts RNA from the virus, a small part of its genome. What if he is not present? "It means the patient is healthy," she says. But if there is, it is too small to detect it. So, the experts add to the sample “an amplification reagent”. The plate is then inserted into a device, similar to a Minitel. “After a good hour, we read the results on this computer screen, I show you an example, launches Chrystel Leroy. Look, this curve indicates that this case is positive and there, no curve, it is negative ”.
A biologist then analyzes this data. At the end of the morning, another round of tests will arrive in the yellow boxes. "They come from all these places," says Aurélie Toussaint, showing her painting with the names of nursing homes or establishments for the disabled.
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They are all tired but voluntary and they know it, their role is essential. Each case can be a new outbreak. A fire that must be extinguished, at all costs.
