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"Health scandals and epidemics have caused, overseas, a certain mistrust of political speeches"

2021-08-13T16:48:08.449Z


FIGAROVOX / INTERVIEW - According to the LR deputy of Reunion, David Lorion, the health situation of the overseas departments and communities calls for an assessment on a case-by-case basis.


In Reunion, travel is limited to ten kilometers around the home, bars and restaurants have been closed since August 1.

Is the situation on the spot “dramatic” as Jean Castex asserted?

Where are we today?

To discover

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The Prime Minister undoubtedly had in mind the situation in the two departments of the Antilles, which are experiencing indeed dramatic rates of incidence and positivity, especially given the weakness of the health system to cope with it. In Reunion Island, the incidence rate is 420 cases per 100,000 inhabitants, never seen before, but we have, I believe, succeeded in stabilizing the situation at the cost of partial containment and a very curfew. early which started on Saturday July 31st.

The declaration of the state of health of emergency on July 12 by the President of the Republic allowed the prefect of Reunion to quickly take appropriate containment measures that limit travel to 10 km around the home with the possibility of extend this perimeter for compelling reasons (work, health, justice ...), followed by a curfew between 6 p.m. and 6 a.m.

All air travelers are subject either to a complete vaccination or to compelling reasons with a 72-hour PCR test.

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The containment and curfew measures decided upon at the first warning signs, in consultation with local elected officials, will, I hope, prevent a human tragedy in Reunion.

But the situation is serious and remains tense.

Last week, health workers from Reunion Island went on strike to protest against the health pass and the vaccination requirement.

Are hospital staff playing the immunization game enough?

Some caregivers, like everywhere in France and therefore in Reunion, protested against the vaccination obligation and the health pass. They were not proportionately more numerous in Reunion than in mainland France. This protest is not illegitimate. As with many people, doubt and mistrust are normal reactions to new drugs or vaccines about which we are not sure. Even for those who have no doubts about the effectiveness of vaccines, and fortunately they are the most numerous, the brutality of the announcements of eviction of caregivers when they would not be vaccinated by September 15 had enough to arouse negative reactions. The hospital staff of Reunion play, no more and no less,the game of vaccination with 90% of non-nursing medical staff and only 50% for healthcare professionals and administrative and technical staff.

It is not yet sufficient but the rates are increasing rapidly in recent weeks.

Also, the staff feel they are at the forefront of the pandemic and rewarded with chocolate medals.

More than the vaccination obligation or the health pass, it is this lack of recognition that frustrates caregivers.

About 33% of Reunion Islanders have received two doses of the vaccine

David Lorion

Only a little more than 30% of Réunion Islanders are fully vaccinated.

How do you explain it?

We are in a good dynamic and vaccination is accelerating in Reunion.

With 40.43% of people who received a first injection at the beginning of August and around 33% for both doses.

At the end of the month, health authorities are aiming for 50% for a vaccination schedule for all over twelve years old.

But undoubtedly vaccination rates overseas are lower than on the mainland. This delay has been the subject of inappropriate statements or comments on an alleged "cultural reluctance". I have the impression of going back centuries in the history of the overseas territories. The reasons for this delay are easier to understand than they appear. Doses in limited quantities were received later due to the logistical challenge of the cold chain between the mainland and the islands. We certainly remember that these first doses were reserved for the elderly who were sometimes very little mobile. Then, only the important towns of the various territories benefited from vaccination centers. Even though the situation has changed,many municipalities or neighborhoods have been very isolated.

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Finally, yes, there have been health scandals overseas such as chlordecone in the West Indies (NLDR, a pesticide banned in France in 1990 but which continued to be authorized in the banana fields of Martinique and Guadeloupe by ministerial exemption. until 1993), or the chikungunya or dengue epidemics in Reunion, which caused a certain mistrust of political speeches in the face of these crises which still have not found lasting solutions or vaccines. In the case of chlordecone, I am talking about a scandal because of the responsibility of the State: the absence of a rapid ban on this product and the failure to compensate the victims. Regarding chikungunya, the state had promised that there would be a vaccine or a treatment within two years and we did not see either.

In fact, the mass vaccination campaign could not really begin until April.

No cultural dimension in this approach, therefore, even less religion, only a sequence which strongly penalized overseas, except those which had a very small number of inhabitants like Saint-Pierre and Miquelon or Wallis and Futuna.

The government is only realizing the particular fragility of our territories, in particular because of their remoteness, their insularity and the weakness of the resources allocated to the public hospital.

Transfers of patients to the metropolis are mentioned.

Is Reunion paying for a lack of investment in its public services?

Not only are transfers mentioned, but they were performed last year with patients from Mayotte who could no longer be taken care of in the face of the saturation of their hospital. Many of them arrived in Reunion Island while our intensive care unit was itself in tension and four of them were directly evacuated to mainland France.

This episode of the health crisis marked the spirits because it highlighted the role of France as a regional power in the southwest of the Indian Ocean compared to countries like Madagascar, The Comoros, Mauritius and other East African countries which knew they could count on European level hospitals, especially for all our French nationals. But the obligation to evacuate or the sorting of patients currently practiced in West Indian hospitals is a real suffering for all medical staff and caregivers.

Is the situation the consequence of a lack of investment in our hospitals overseas?

The answer is not evident.

The public health situation has improved overseas with heavy investments in very high-tech buildings and equipment and reference services for certain health sectors.

David Lorion

Is this situation the consequence of a lack of investment in our hospitals overseas? The answer is not obvious as the public health situation has improved overseas with heavy investments for buildings and very high-tech equipment and reference services for certain health sectors. But today, these beautiful health infrastructures are struggling to recruit doctors and nursing staff as the financial conditions are so degraded.

The structural deficit of the CHU in Reunion Island has imposed closures of beds and services on the basis of a disparaged territorial organization.

This contraction of the various services is precisely at the origin of the operational difficulties and the exhaustion of personnel at the time of crises.

The revision of the “geographic coefficient” allowing the real costs of fee-for-service payments to be adjusted in a medical environment has still not been decided.

A public hospital on an island or on overseas territory is the showcase of France but also the last house that must remain standing during all crises.

In Martinique and Guadeloupe, hospitals are saturated.

Has the French state abandoned overseas?

Can we speak of state bankruptcy in this regard?

The health situation is different depending on the overseas territories and we cannot globalize in one formula.

It remains to make a success of the start of the school year which is maintained on August 16 in Reunion Island and to ensure that this is not a cause of resumption of the spread of the virus!

David Lorion

In Martinique, the incidence rate exceeds 1,200 cases and hospitals are already overwhelmed. Despite the opening of new beds and the contribution of the national health reserve, patients are dying of not being treated. In Guadeloupe, the incidence rate is over 1,800 cases on a majority of islands. At this point, more than 100 intensive care beds are already missing. The sorting of patients who will be able to benefit from resuscitation has started. It is most regrettable. Indeed, we are experiencing a human tragedy comparable to what happened in India, which was therefore predictable and which we did not know how to anticipate.

The health situation in Réunion is much better for the moment with an incidence rate of 420 cases, and even if we are well above certain regional thresholds, I have the impression that we have succeeded in confining to the right one. moment.

However, it remains to make a success of the start of the school year which is maintained on August 16 in Reunion Island and to ensure that this is not a cause of resumption of the spread of the virus!

Read also: Covid-19: a critical situation in much of the overseas territories

There is no bankruptcy of the State overseas, but often a secondary treatment of the substantive problems. France has a chance that other European countries do not have, it is to be an oceanic France which can rely on territories and territorial waters which rank it second among world powers for the area of ​​its exclusive economic zone. However, faced with this observation, France does not derive any advantage for a better anchoring of each of its overseas territories in its regional basin with an intensification of mobility. When China bases its project on major infrastructures, on the Silk Roads, France seems more concerned with disengaging from its territories than giving them the means to develop, to shine, to promoteto be France in the world and to promote this special place within Europe.

What solutions do you recommend?

We must remain cautious in the face of so much suffering, sickness and death.

There are no ready-made solutions, only lessons from experience.

The very contrasting health situation in the overseas territories calls for differentiated policies decided locally by the prefects in good contact with local elected officials.

The decision to initiate measures to curb the epidemic at the right time, depending on the evolution of the health situation in real time, seems to me to be more effective than the intensity of the measures taken. The strict national confinement applied to overseas in March 2020, at a time when the virus was not circulating much, made the population believe that the situation was permanently safe. All the “stop and go” measures, associated with mutant forms of the virus, raise fears of an eternal recommencement of the constraints initially announced as temporary.

Beyond the measures to limit contacts and outbreaks, extending vaccination coverage is currently the only way to regain an essential social life for all in which we must make the health past a bad memory. It is also about the recovery of economic life and the health of our businesses and all social and economic players, who must continue to be helped and encouraged.

Source: lefigaro

All news articles on 2021-08-13

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