Covid-19 screening: we explain why the return to free testing is defended by several specialists

It was a decision that the government had taken to encourage the French to be vaccinated against Covid-19. Since October 15, so-called “comfort” tests are no longer reimbursed for unvaccinated people, unless they have a medical prescription or if they are identified as contact cases. A screening billed around 22 euros for an antigen test and 44 euros for a PCR.

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But faced with the arrival in France of the fifth wave of the epidemic, several specialists are calling for a return to free testing for all. "We dropped the screening and it's a mistake", estimated Wednesday November 17 Gilles Pialoux, head of the infectious diseases department of the Tenon hospital in Paris, on BFMTV. The idea was also invited into the political arena, when presidential candidate Jean-Luc Mélenchon pleaded on TF1 for the return to reimbursement of tests. Franceinfo takes stock of the various arguments put forward.

1Testing more would make it possible to better understand the rebound of the epidemic

It is above all the health situation that is put forward to defend the return to reimbursement of screening tests. Like Germany, which restored their free use in the face of an outbreak of cases of contamination. "In a period of epidemic rebound (...), we must be able to ensure that infected people, whatever their vaccination status, are detected as quickly as possible", defends epidemiologist Pascal Crépey in the columns of L 'Obs.

However, a month after the end of their free service, the number of tests dropped. While 440,000 samples were taken each day around October 10, 300,000 screenings were carried out daily at the end of October. A decrease which risks blurring the monitoring of the epidemic, advance several specialists. "There is probably an underestimate of the number of cases in France", explains for example Mahmoud Zureik, professor of epidemiology and public health, at L'Express (article subscribers).

“This poses a problem if we have to take measures based on a certain traffic threshold, because in this case, we need reliable indicators,” he continues.

Pascal Crépey argues that mass screening is crucial "when starting an epidemic phase", when "there are also more infected people, therefore more contact cases". For his part, Gilles Pialoux adds that as winter approaches, screening is essential to differentiate Covid-19 infections from those due to seasonal viruses. “There are going to be people who are going to have lots of symptoms that look like a mild Covid and are not going to get tested”, blows the head of the infectious diseases department at Tenon hospital.

2With paid tests, the time between the onset of symptoms and screening is getting longer

In addition, the end of free tests seems to have widened the gap between the appearance of the first symptoms and the date of the sample. This period is now 2.5 days, "i.e. the highest average value observed in 2021", points out Public Health France in its latest bulletin of tracing activities.

“This increase [of the delay] could be explained by the necessary passage to a prescribing doctor prior to the test for unvaccinated people”, advances SPF. Pascal Crépey also mentions those who "decide to wait, to see if the symptoms persist before paying to be tested" or "the asymptomatic, who could have been tested if it had always been free, but who will not do so. because it pays."

However, it is important that this period remains "as short as possible" to limit the spread of the virus and ensure rapid isolation of positive cases and contact cases, adds Public Health France.

“Not having rapid access to tests could be detrimental, because if you have symptoms or if you are in contact and you have to go through a medical prescription to be able to do this test, it delays diagnosis, treatment, and all of this also leads to the spread of the virus", summarizes Mahmoud Zureik. "It's one more tool to detect earlier, to isolate, abounds Gilles Pialoux. Someone who knows he is positive does not have the same behavior, it's human. He isolates himself, he takes measures. "

3The paid tests do not seem to have convinced the reluctant to vaccination

Finally, "using the delisting of tests made political sense to force the non-vaccinated a little more to become one", explains Pascal Crepey to the Parisian. But the goal is still far from being achieved. The number of first injections has not rebounded since the end of free testing. About 17,000 first doses of vaccine are now administered daily, far from the 350,000 injections carried out at the beginning of August, at the height of the campaign.

However, there is no question of the government changing its strategy. "A large majority of French people have access to tests, which remain covered by Social Security for people who are vaccinated, who are contact cases of positive cases and for people who have a medical prescription, which is still enough wide," pleaded government spokesman Gabriel Attal on Tuesday on France Inter. And to decide Thursday morning on the set of LCI: "It is not planned today" to return to free tests.