Despite the encouraging signs of epidemic curves, the coronavirus is continuing its journey within nursing homes.
Local dailies are relaying new sources of contamination every day: in a few days, the retirement home "Les Vignes" in Château-Porcien has become the largest cluster in the Ardennes, with 56 residents and 21 staff members testing positive for the coronavirus mid -November.
In Le Mans, more than a third of the residents of the Le Monthéard retirement home are infected.
And out of the 180 clusters under investigation in Normandy by the ARS on November 18, most concerned EHPADs.
In all, more than one in five establishments would harbor a source of contamination, according to the latest figures from Public Health France, which on November 16, 1539 identified clusters in accommodation establishments for dependent elderly people.
Read also: Despite the health measures, the second wave of the Covid hits EHPADs
“
The following weeks will be crucial.
Everything is now being played out so that the second wave does not look like the first in EHPADs
”, confirmed Thursday evening the Minister for Autonomy, Brigitte Bourguignon during a press briefing alongside Olivier Véran, his minister of guardianship.
Faced with this increase, the ministry now recommends that EHPADs submit their staff to weekly screening by antigenic test, just like visitors entering establishments.
"
The State will deliver 1.6 million antigenic tests to EHPADs, which will then supply themselves
", indicated Brigitte Bourguignon.
For visitors, a questionnaire must be completed before their entry "in
order to allow them to assess for themselves the risk of bringing the virus into the establishment
".
No wave of mortality in nursing homes
If the strengthening of tests is timely in nursing homes exposed to the virus, it also explains the increase in confirmed cases in establishments: for the moment, the multiplication of clusters is not accompanied by a wave of mortality, according to the figures of Public Health France.
On November 15, 791 new deaths were recorded in nursing homes, less than the 924 recorded on April 15 around the peak of the first wave.
The arrival of antigenic tests, distributed since the end of October in hospitals and retirement homes, had
"a magnifying effect"
, underlined in early November Marie-Sophie Desaulle, the president of the Federation of hospitals and aid to the private non-profit person (Fehap).
“The situation is different.
The first wave mainly affected two regions, Grand-Est and Hauts de France,
today the virus is everywhere and potentially affects all establishments, ”explains Annabelle Veques, director of the National Federation of Associations of Directors of Establishments and Services for the elderly (Fnadepa).
“Today, we test and identify patients very quickly, many of whom are asymptomatic.
This allows us to very quickly set up isolation measures
”.
EHPADs must learn to live with the virus
Pascal Champvert, President of the Association of Directors at the Service of the Elderly
Unlike spring, establishments now have the necessary equipment to ensure the safety of residents: masks, gowns, tests ...
“We fought a lot to have the necessary means;
today we have them.
EHPADs now need to learn to live with the virus, ”
greets Pascal Champvert, President of the Association of Directors at the Service of the Elderly (AD-PA).
Read also: A nursing home who refuses a visit
Problem: who says identification of a cluster, says new closure of the establishment, despite the simplified protocol of the second confinement which makes visits to residents possible.
With the multiplication of cases, it is the life of EHPADs which is once again on pause:
“There is real tension in the establishments.
The psychological impact is very strong, with a very strong fear of the virus and a fight every second so that the normal life of the residents is maintained.
After spring, we know all too well the devastating effects of isolation, ”
notes Annabelle Veques.
Staff must find the right balance between the benefits of isolation and the risk of slipping.
Some establishments, such as the La Mesnie nursing home in Saint-Pierre-en-Auge in Calvados, have decided, on their own, to close their doors to protect themselves.
“You can turn establishments into hermetic fortresses, but that's madness.
EHPADs are part of society, with the risks and the benefits,
”notes Pascal Champvert.
The director of an EHPAD Ile-de-France welcomes the government recommendations of Thursday evening, which recommend, "
if it is an obligation
", visitors to perform a PCR test within 72 hours before the visit or an antigen test during the day in pharmacy. Relatives who come very often will be able to access the weekly screening campaigns of professionals.
“We will have to find a balance. Some families come several times a week, we will not test them daily, ”he
adds.
"The virus enters the EHPAD, we know, it is inevitable".