Finally, after weeks of waiting, general practitioners will soon be able to order serological tests for their patients. “The reimbursement order by Social Security will be published in the coming days in the Official Journal by the Ministry of Health. We expect it from this Saturday, May 23, ” says Dr. Cédric Carbonneil, immunologist and head of the service for the evaluation of professional procedures at the French National Authority for Health (HAS). Recall that their objective is not to detect the presence of the virus, unlike the virological test (called PCR), but to note the presence of antibodies. That is to say to verify that one has been in contact with the virus.
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The immune response takes a long time to manifest, and antibodies can take several days to be detected in the body. These tests are therefore not intended to establish a diagnosis immediately after infection. They should be performed from the fourteenth day after the first symptoms for symptomatic patients without sign of severity, and from the seventh day only for patients in serious condition and hospitalized. The goal is not to determine if a patient is ill with Covid-19, but to find out if someone who has had symptoms has been infected. In addition, the multiplication of serological analyzes will make it possible to have a slightly more precise idea of the progress of the disease on the territory. "Apart from epidemiological studies, they will therefore affect millions of people, especially for the catch-up diagnosis," explains Dr. Cédric Carbonneil. They will tell if you have been in contact with the virus, especially for people who have had Covid-19 symptoms since March and who have not had a virological test. ” They will also be used to refine the diagnosis for patients who have all the clinical signs of the disease but whose virological test has been negative. Also affected by these tests are non-symptomatic health personnel who have worked with patients in medical centers, but also employees and employees in nursing homes and in confined spaces.
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In all, twenty-three tests have been validated by the National Reference Center and are listed in this reimbursement decision. Seven of them are Elisa-type automatic tests, including one from French bioMérieux, another from Swiss Roche and a third from the American group Abbott. They consist in analyzing a sample after a blood test. The other sixteen are so-called rapid diagnostic tests, that is to say they are carried out by means of the analysis of a drop of blood on a strip or by blood test in a medical analysis laboratory. . If the HAS advises the reimbursement of all these tests, this will not be the case for self-tests carried out at home, without the intervention of a healthcare professional to read and interpret the result. On the other hand, the rapid diagnostic orientation tests which will be carried out in a pharmacy or at his general practitioner's are a priori also reliable, and will be the subject of a specific decree from the Ministry of Health.
Note that the French did not wait for the decision of the HAS to try to find out if they were indeed sick with Covid-19. But their exact number is impossible to know. " It is still too early to know how many people have benefited, it is very variable according to the regions", explains François Blanchecotte, president of the Union of biologists. For an average of thirty euros, city laboratories have already been offering these tests for several weeks. "The laboratories that had moved ahead will have to put themselves in order in relation to this list," continues François Blanchecotte. If they have performed analyzes using other types of tests, they will have to repeat them. ”
The reimbursement could be effective as early as Monday morning. "However, updating our computer systems may take a little longer," warns François Blanchecotte. Reimbursements will certainly not be automatic at the start and we will have to go through the filling of treatment sheets.