FDA approves COVID-19 test to be done at home, while in Miami they test people without symptoms – Telemundo Miami (51)

The COVID-19 diagnostic center at Charles Hadley Park in Miami-Dade County now extends its capacity to asymptomatic adults over 65. Located at 1350 NW and 50th Street, those interested should call 305 – 960 – 5050 to request an appointment.

But if you can’t get out of the house, the
US Food and Drug Administration, FDA,
authorizes home coronavirus testing.

The test, created by the Corporation of
Laboratorios de America, (LabCorp), can be done by the patient himself and
consists of collecting a nasal sample, using the self-collection kit of
LabCorp. It contains the appropriate cotton swabs for this type of
exam. Once finished, the patient must send their sample in a package
isolated, to the LabCorp laboratory for later analysis.

FDA Commissioner Stephen M. Hahn said
that this new coronavirus test variant is as reliable and safe as
those currently practiced in diagnostic sites.

These kits will be available to the population in the coming weeks at a cost of $ 119. The first LabCorp Kits will be for healthcare personnel and for emergency personnel.

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Cured Covid-19: “As if you were touching your marrow with a trowel”

They drooled. Sweat. Coughed. Sometimes kept a log of their symptoms. They managed their fear or considered making a will. But they survived. With or without antibiotics. With or without the famous chloroquine of which the Marseille professor Didier Raoult extols the merits. “98% of people recover”, recalls Jérôme Salomon, the director general of health who, since March 17, gives every day the number of Covid-19 patients discharged from the hospital, while comforting the litany of deaths (Wednesday evening, there were nearly 31 000 “cured” discharged from hospital). With data from the hospital environment, “We must add the probable tens of thousands of cured people in town“, Underlines the general direction of health.

Are these survivors now immune? If yes, for how long? The question remains thorny (read page 6-7). Have they all been really infected with the virus? If some have been tested, many have had to rely on a diag

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Pierre-Henri Allain in Rennes

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Stéphanie Maurice in Lille

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Catherine Mallaval

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Stéphanie Aubert in Marseille

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François Carrel in Grenoble

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Gilles Dhers

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Stéphanie Harounyan in Marseille

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Guillaume Tion

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Tania Kahn

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Juliette Deborde

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Jérôme Lefilliâtre

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Guillaume Krempp in Strasbourg

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“Never in our resuscitation department we had received 34 patients with the same symptoms”

D-18. The patient in room 172 has been fighting the Covid-19 for the last eighteen days. Intubated and ventilated, the man is 52 years old. Several probes gravitate around his naked body. His cheeks are pale, his eyelids yawn, his swollen hands are motionless. Everything seems extinct in him. Only his chest moves, under the impulse of the artificial respirator. At D-15, the resuscitators tried to free him from the machine. The latest analyzes indicated that the patient had regained enough strength to oxygenate himself. The family had been notified. But when he was extubated, the patient whistled, unable to breathe: edema had formed in his windpipe. We put him back to sleep and put the hose back on. “In the face of this disease, the fight for recovery is not a sprint. It’s a marathon “, recalls Jérôme Fichet, physician-resuscitator at the North Cardiological Center of Saint-Denis.

In this private clinic in Seine-Saint-Denis, 33 other patients

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Anaïs Moran

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Cha Gonzalez Photos

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Caregivers: “I think Covid, I eat Covid, I sleep Covid”

They evoke a “enemy”. Sometimes see themselves as “Infantrymen”. They have much more “Fear for others” that they do not fear falling ill, without playing the heroes: “This is our job”, they say. Nurses, interns, emergency physicians, resuscitators, hematologists, psychiatrists… Their lives are now entirely dedicated to saving patients from the coronavirus. What is their daily life? How do they stand? How are they organized? What do they fear? A dozen of these caregivers applauded every evening by grateful French in Mulhouse, Bordeaux, Paris, Bobigny, Poitiers, Rouen or Marseille have agreed to keep a log book for Release.


Friday March 27

“Last time”

19 hours,
Mélanie Roussel, emergency doctor at CHU Charles-Nicolle, Rouen

“End of a day as a reception and emergency sorting doctor. For the past few days, patients have been arriving and looking alike. Same symptoms, same shortness of breath, same worries

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SOCIETY SERVICE

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The private health sector only attends emergencies and its idle capacity is 80%

“There were stages. First, most people excluded themselves from sanitariums, before quarantine. Then the norm of preventive and compulsory isolation was issued. And then doctors began to advise that you only attend health centers in emergencies so as not to occupy places that others might need. ”

The racconto did it, in dialogue with this newspaper, the head of the Federation of Clinics of the province of Buenos Aires (Fecliba), Néstor Osvaldo Porras, who indicated that the establishments of the private health sector “today have approximately 80 per percent of its idle capacity. Or more”.

And the economic effect that this causes? “It will be serious. But now we cannot think about it. We are in line with the ministries (of Health of the Province and of the Nation) preparing ourselves for what may be coming, “he stressed.

This includes, first of all, “extreme care” of the personnel. “Doctors, nurses, clerks, stretcher bearers, ambulance drivers, housekeepers, everyone is on the front line of fire, starting with the person who receives the patient at the entrance. Also, it should be borne in mind that we already suffered a significant decrease in workers, because all those at risk (due to age or previous pathologies) went home, “said Porras.

Returning to external clinics, he insisted that “only emergencies are attended to,” and clarified: “In our sector there are no directives that come down from one place and everyone is obliged to comply with them. That is, it may be that a person who requires a shift for other reasons (not urgent) in one center is treated and in others not. But at a general level, dedicating only to urgent cases is what clearly prevails, “he said.

In this context, he commented that as a result of the confinement, “telephone or via WhatsApp inquiries skyrocketed.”

This reality has put the issue of medical care between the sword and the wall, since it is true that it cannot be provided properly without establishing the traditional doctor-patient relationship, but, on the other hand, fear does its own thing. “And professionals work more from our homes and do not get paid,” noted days ago from different organizations that bring them together.

Beds and supplies

Porras said that today, for each private sanatorium, there must be “on average” complete protective equipment to care for 14 or 15 patients with coronavirus.

That leads directly to the lack of inputs. “Suppliers have disappeared, and those with items sell them at impossible prices. So the Ministry of Health monopolized purchases, including respirators. In this framework, we are in permanent contact with the health authorities, who already know what supplies we need, “said the head of Fecliba.

He added that “the contact is daily, one calls and if the minister does not answer, the vice minister does. They ask us for information, we make our requests, and that is how we are working for the critical moment ”.

The information, above all, refers to the number of beds available. From the federation of clinics it was indicated that 160 of the sanatoriums located there have 1,076 intensive care beds and 691 ventilators. Meanwhile, they have 230 coronary unit beds – which will be made available to those infected by COVID-19 if necessary – with a total of 112 respirators.

To this number of beds we must add those of non-integrated institutions in Fecliba and “the common beds that, once they provide us with the necessary equipment, we will convert into therapy beds,” said Néstor Porras.

It is worth remembering that, according to the provincial direction of Hospitals, it aims to have 2,000 beds in the private health sector by the time the pandemic peak arrives, now projected for mid-May.

The head of the Buenos Aires entity emphasized: “The health system has been in trouble for many years, it is not a secret for anyone. Now a lot of work is being done to get it in shape. But there needs to be, above all, a very firm social behavior regarding self-care, which automatically translates into caring for others ”.

“The community cannot relax, in strict quarantine or without it, because we are facing a very, very aggressive virus for which there is no treatment. Isolating oneself, taking care of distances, not slowing down in terms of personal and environmental hygiene is essential, “said the professional.

Meanwhile, different organizations that bring together doctors have been insisting that the State “agreed with the clinics but did not consult us. We are supposed to be the heroes of this movie, but there are thousands who are out of work (in private practices) and unpaid. There is a lot of uncertainty. The government has to listen to us, which it has not done, ”they shot.

2,000

Intensive care beds He hopes to have in the sanatoriums and private clinics the Buenos Aires Ministry of Health when the peak of the pandemic arrives. The nucleated centers in Fecliba have 1,076 and 230 coronary units, which would be made available.

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every day in the emergency room “the ball in the belly”

TESTIMONY – A nurse in one of the hospitals in Paris, Marc * expresses his anxiety about being infected, infecting his family or endangering his “Covid negative” patients.

A doctor phones the intensive care department at the University Hospital Center (CHU) in Tours, March 31, 2020.
A doctor phones the intensive care department at the University Hospital Center (CHU) in Tours, March 31, 2020. GUILLAUME SOUVANT / AFP

It’s with the “Belly ball” that Marc * takes daily care in the emergency room, in one of the establishments of the Assistance Publique-Hôpitaux de Paris (AP-HP). He was reminded of his duty of reserve, like all caregivers, at the start of the health crisis.

But the nurse wants to anonymously tell of his daily anxiety of being infected, of infecting his family, and of endangering the “negative Covid” patients treated in this busy emergency service, on the front line of the epidemic.

Risk increase

“The more the epidemic spreads, the more the protection rules soften in my servicehe said. According to the latest instructions received, overshoes, charlotte and gloves are no longer mandatory. The FFP2 mask (the most protective) is only used for nasal swabs and aerosols. We no longer change the gown between each patient, which increases the risk of spreading the virus from room to room. And the level of general alertness

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“Our oxygen consumption has increased by 800%”

La Croix: What is the situation in the province of Lodi in Lombardy, where are you?

Claudia Lodesoni : Lodi is in Lombardy, in the province which was hit first by the epidemic. Everyone here knows each other and everyone has lost a family member. Once this tsunami has passed, it is certain that society will be changed for good. It has been three weeks since the epidemic hit us.

→ LIVE. Coronavirus: France enters its 4th day of total containment

It’s hard to say if we’re at the peak of the epidemic, but we’ve seen the same daily number of new admissions to the province’s hospital center for the past ten days, some 40 patients. So no increase. 700 people were treated for this epidemic. Most are people over the age of 65. The difficulty is that they often suffer from other chronic conditions. That said, we also receive patients in their 40s.

How were the health services organized?

Our hospital center, with three separate units in the province, has a total capacity of 800 beds. We have reviewed our entire organization. First, emergencies other than those related to the coronavirus are limited. We have gone from 200 to 20 admissions for other pathologies. Hence the importance of city medicine which takes over so that these other pathologies do not arrive at the hospital.

→ READ. Pope Francis calls Italians to prayer

In the center, we have created mixed teams, composed for example of an anesthesiologist and a geriatrician or an ophthalmologist: a practitioner close to this type of pathology and another coming from another specialty. We have 22 intensive care beds.

→ READ. Doctors and nurses in search of masks

The arriving patients begin to develop fever. Some remain stable, others suddenly go into respiratory distress. This is the difficulty of this epidemic. Patients require constant monitoring and possibly respiratory support.

What are your needs ?

Oxygen consumption for artificial respirators has increased by 800% since the start of the crisis. We are at the limit of our capabilities. Of the 300 beds occupied by coronavirus patients, 90% are on oxygen. The critical critical issue today is the lack of masks and protections for caregivers and the sick alike. This creates considerable stress for everyone.

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Coronavirus: caregivers “head in hand”

For three days now, around 8 p.m., the confined French have been applauding them from their windows. These thanks and encouragement, to say the least welcome, undoubtedly put a balm on the hearts of hospital staff. The fact remains that at a time when the Covid-19 is deploying in France and mobilizing more and more beds in the intensive care units, it is the certainty of the time to come which is particularly tense and difficult which imposes itself on all these caregivers.

This apprehension stems from the unprecedented nature of the current epidemic and is increased by the lack of protective means (masks, gloves, hydroalcoholic gel) and equipment (artificial respirators). This maximum stress is added to the fatigue that preexisted Covid-19, in personnel already in tense flow because of budgetary savings. This is what the caregivers of the hospitals say: Release collected testimonies, across France.

Some are already hard, confro

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Nathalie Raulin

,


Arnaud Vaulerin

,


Sabrina Champenois

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Sibylle Vincendon

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Catherine Mallaval

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Fabrice Drouzy

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Clementine Mercier

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Sarah Finger

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Coralie Schaub

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Virginie Ballet

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Hala Kodmani

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Kim Hullot-Guiot

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Frantz Durupt

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Jérôme Lefilliâtre

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Eva Fonteneau

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city ​​medicine is reserved for real emergencies

If some people still think they are escaping the epidemic wave that has swept across Asia, Italy and then eastern France, this is not the case for doctors in town as in the countryside. On the wooden wall of his cabinet, next to the front door, the Dr Réginald Balcerek, general practitioner in Hauts-de-France, posted his “New office guidelines during the coronavirus epidemic”.

He warns his patients that they should not go directly to the emergency room or be crowded on the 15th unless they are in distress. “In phase 3, have the reflex cabinet and not emergencies, he adds. I will not prescribe a mask or hydroalcoholic solution which are in short supply everywhere. If you are sick, you must stay confined! Respect barrier gestures. People in contact with patients should only go out if necessary and should wear a mask. ”

In a neighboring group practice, time slots dedicated to patients who could be infected with the coronavirus are indicated on the online appointment booking site. “We ask them to call us first to sort it out (who needs to be examined, who stays at home …) then we call them back to do a second sorting”, says one of the group’s doctors. They fear that some patients may not consult when they should. In practice, apart from the usual “bobology”, it is difficult indeed to know if a medical consultation is urgent or not when one is not a doctor. “We sort through the phone when worried patients call us, explains this cardiologist from the south of France, if it is for a simple regular check-up appointment for a patient over 70 years of age, the appointment is postponed, but if there are cardiac symptoms we can see it of course. Pacemaker and coronary heart rate checks remain scheduled ”.

Same thing in ophthalmology. “We only keep emergencies and follow-up of pathologies that would cause a loss of luck and vision in the event of non-continuity of care, such as AMD, severe glaucoma or postoperative follow-up …”, explains an ophthalmologist. “I remain available for emergencies, such as suspected phlebitis, explains the Dr Christophe Krawiec, vascular doctor at Orchies (Nord). However, appointments which do not relate to progressive diseases or which are of interest to patients with comorbidities (other diseases, Editor’s note) particular are carried over “. Same in orthopedics, “We deprogram everything, we prepare for the wave, so I only operate in emergencies”explains a surgeon.

We see a lot of patients with fever, who cough, but don’t believe it when they are told that it is probably the Covid!

A general practitioner

Do patients adapt easily to this new organization? “There are always those who don’t understand anything and get sick in the waiting room. I grab them, I stick a mask on them and I make them wait outside! Or I ask them to come back, or stay at home and I call them back, brief on a case by case basis. For fragile people at risk and reluctant to come to the office for a standard follow-up, they are informed of the possibility of renewing the prescription remotely until May 31 “, explains a general practitioner.

“You have to be exemplary”

In any case, there is no question of accepting consultations without an appointment or with others, apart from real emergencies. The Dr Balcerek reminds patients that they should only arrive 5 minutes before the scheduled time to avoid overcrowding and adds: “Come alone to your appointment and unaccompanied, the fewer people in the waiting room the better.” His colleague asks his patients “To wait in the parking lot for me to call them when it’s their turn. I also ask them not to touch anything, it is I who open the doors “.

We must face the facts, confinement or not, many French people have not realized the gravity of the situation, even for them! “We see a lot of fever patients who cough but don’t believe it when they are told it is probably Covid. They want to keep going to work. We have to tell them that they would have dead on their conscience! ” A 63-year-old doctor did not hesitate to stick yellow and black safety lines on the ground that should not be exceeded. “You have to be exemplary. If people don’t understand that you have to stay within safe distances even in the doctor’s office, they’ll never understand. ”, he explains.

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caregiver health at the challenge of continuity of care

When the pressure subsides after the epidemic, the management of front-line staff by hospitals will be another area of ​​health concern.

Through Guillaume Mollaret

Wetsuit, gloves, mask and glasses: the work clothes of a nurse from the Lenval pediatric hospital in Nice.
Wetsuit, gloves, mask and glasses: the work clothes of a nurse from the Lenval pediatric hospital in Nice. ERIC GAILLARD / REUTERS

This is a taboo subject at the Regional Health Agency (ARS) Occitanie. Asked by Le Figaro for the cases of nursing staff affected by the Covid-19, the administration has been silent for two days. However, the protection of healthcare personnel constitutes a major issue of continuity of care. Tuesday, the positive diagnosis with the coronavirus, of a doctor of the service of infectious and tropical diseases of the CHU of Nîmes, a service precisely in charge of patients affected by this same virus, resulted, according to our information that the ARS did not not wish to confirm or deny, screening by nasopharyngeal swab of all staff having been in direct contact with this doctor.

On paper, such an approach seems relevant. However, it involves a risk: that of seeing the hospital empty of its specialists, whether they are doctors, nurses or nursing assistants since the fortnight or hospitalization, depending on the severity of the symptoms,

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