During his presentation of the national strategy of déconfinement the 28 April last, the prime minister announced, in front of the national Assembly, the target of 700 000 PCR tests (made from a collection nasopharyngeal swab) per week from the 11th of may. But since then, the recession of the epidemic of coronavirus is continuing and the demand for screening is increasingly low.
Today, what are “only “ 250 000 PCR tests that are made every week, according to the directorate-general of health. These figures account for the tests performed in private laboratories, but also those carried out in hospitals, who continue to test almost systematically to their patients in some services.
Result : between may 13 (the date of the first lift in the national database IF-DEP) and the 17 June, public Health France counts 1 103 427 patients tested, compared with 4 200 000 according to the forecasts over the same period.
The big groups could be ” between 10 000 and 50 000 tests per day “
At the express request of the minister of health, each of the twelve French groups of laboratories liberals had to equip themselves according to their means. “At the beginning of the crisis, we have been completely excluded from the device screening, remembers Richard Fabre, biologist, medical Labège and president of the regional Union of biologists of Occitania. And then, in fifteen days, we had to increase our capacity exponentially to meet the requirements of the government. “
“The ministry of health has asked some of the largest networks of between 10 000 and 50 000 tests per day “, accurate Alain Le Meur, president of the Association for the advancement of medical biology (APBM).
These private laboratories are now with millions of tests unused. “We only use a third of our inventory “, ensures François Blanchecotte, national president of the Union of biologists. Difficult to know exactly the number of PCR tests locked-in today freezers. “We are in capacity to carry between 20 and 25 000 PCR tests by week, details Thomas Hottier, doctor, biologist, co-head of the group Inovie. Today, however, it can achieve 10 000 weeks of very, very big business. “
Same sound of bell on the side of Biogroup, whose laboratories are present in the region Is Great, and the Isle of France, the most affected by the epidemic of sars coronavirus. “We ordered about 3 million of reagents for the entire group, and now it uses less than 20 % “says Arthur Denoel, responsible for the plateau of microbiology Biogroup-LCD-Saint-Denis, near Paris.
Several hundred million euros of investment
The reagent, the substance that is mixed in the collection, is which is the most expensive. Between 20 and 30 euros per person. “The cost of the reagents PCR is calculated in millions of euros, the machinery necessary for the analysis of tests in hundreds of thousands of euros. And you still need to add the price of all single use equipment “details Arthur Denoel.
Because of the global demand, the laboratories have had a lot of trouble to provide testing, and materials. Of fear of missing out, the groups were ordered in very large quantities, payable in advance. The bill amounted to several tens of million euros for some.
The problem of cash is in addition one of the “waste “ of these tests. “The expiry dates are dependent on suppliers, but, for example, we have reagents that lapse as early as September and other in April-may of the next year “says Arthur Denoel.
Laboratories are trying to resell their stock, and several groups say they have begun discussions with foreign countries. “We are negotiating with Mexico, or the United Kingdom, reveals Francis Blanchecotte. You can keep a few thousands of tests, just in case, but not all. “
→ EXPLANATION. Covid-19, the reliability of the test in question
Tests they can’t sell in France. “We are subject to the accreditation 1589, which prohibits us from re-using material that comes from elsewhere, explains Benedict Debitus, purchasing manager at Inovie. On the other hand, nothing prevents those who would like to resell tests to countries that do not have such strict standards. ” And this is not the only option for stocks, says Arthur Denoel : “We participate in screening campaigns massive and encourage them. We use the tests in order of expiration and we are trying to take over the material by our vendors. “
Give us enough of PCR tests if the epidemic took ? “The State is not opposed, for the moment, the recirculation of the tests excess. He remains in contact with the biology laboratories to keep a safety margin and anticipate a possible resurgence of needs “, simply there to respond to the Directorate-general of health.
The private laboratories are demanding financial guarantees from the government
In the meantime, the unions are urging the government to find a solution. “We have received a letter which has the value of order, it seems normal for there to be a financial guarantee, if the target of 700 000 PCR tests weekly has not been reached “, said Alain Le Meur. Private groups are hoping in particular that the crisis of the Covid-19 be recognized as an exceptional event, so that it does not strike not their envelope three-year negotiated with the social Security.
But a draft ministerial decree has come to amplify the dissatisfaction in the sector. “The pharmacies will be able to do rapid tests for diagnostic orientation (Trod), reports the co-head of the group Inovie Thomas Hottier. If the decree goes beyond the recommendations of the High Authority of health (HAS) and allows for all pharmacies, not just in areas where there are no laboratories or nurses, to do these serological tests, it would be catastrophic. Pharmacies are not required, unlike us, to trace back the results to ensure the monitoring of the epidemic. “ Again, the issue is economic, recognizes Thomas Hottier : “We have almost as many serological tests that sleep in our labs as PCR tests. “
Three types of screening tests
► The PCR tests. They are to collect cells of the nose, using a swab, a long cotton swab inserted into the nostrils. Until now, this method was the most reliable in the event of symptoms.
► The serological tests. They must be able to detect antibodies in the blood of a patient and thus determine if it has already contracted the coronavirus in the past. There are 139 on the market, according to the ministry of health, but they have not all been deemed to be reliable.
► The tests salivary. Developed to Montpellier, their effectiveness would be very close to the PCR method, but much faster and less unpleasant than the nasal samples.