This is “a matter of major concern”. While the Covid-19 epidemic is not over and is even picking up again in France, the government is looking into the prolonged symptoms of the disease, called long Covid. The causes of persistent forms of the disease are still unclear, but they remain real. In a document sent to the press on Thursday, March 17, the Ministry of Health provides for various areas of work to fight against these long forms and refer patients who are affected.
“The quality of the listening, the precision of the diagnosis, the empathy of the carer, the sincerity of the relationship and the therapeutic project are all stages which must be built together”, underlines in particular the ministry in the document. The long Covid affects around 700,000 people in France, according to the ministry’s calculations. In order to best support these people, certain measures have already been put in place by the health authorities and others will follow.
The creation of a group of experts
As it had done at the beginning of the epidemic in France with the Scientific Council, the government plans to bring together a group of fifteen “scientific personalities from multiple specialties, professionals from the psychosocial sector, the world of work and representatives of user associations” able to guide it and “work in consultation” on this long Covid.
In this list, we find epidemiologists, doctors, sociologists, virologists, pediatricians, radiologists, neurologists and infectious disease specialists. In particular, they will have to ensure “the proper implementation of a roadmap set by the Minister of Solidarity and Health”.
Better support
The government also wants to improve the care of patients with long Covid by developing a roadmap with many points. These include an investment of up to 20 million euros over three years, financed by the regional investment fund (FIR), “to support the structuring of the long Covid care network, and in particular post-covid coordination cells”.
In order to monitor the proper care of patients, the ministry intends to develop indicators, without specifying their nature, as well as precise criteria for the pathology. By emphasizing the training of health personnel, in particular for primary care, the government wishes to improve the detection of those affected.
A digital platform will also be developed for professionals and patients to coordinate care, which will be modeled so that it can be used for other forms of post-infectious syndromes. The platform, created by the Health Insurance, in partnership with the association TousPartenairesCovid, “will make it possible to considerably improve the information of the population, the identification, the care and the follow-up of patients suffering from long forms of Covid. “. This roadmap will finally look at the long pediatric Covid, without it being specified to what extent.
Better knowledge of the disease
The Ministry of Health has set itself the task of improving scientific knowledge on the still poorly understood long Covid. And it starts with research. In addition to the 20 million intended for the care network, the ministry will thus invest 10 million euros in research on the long Covid specifically.
Emphasis will also be placed on the proportion of the pathology in the population, which requires a “census and modeling” of the number of people affected by a form of long Covid and delivering “the main characteristics”. This evaluation will be accompanied by “the establishment of post-Covid patient monitoring registers”.
Better communication
Patients will be at the heart of the project for better information transmitted to the population and to professionals. The government would thus like to train patients to develop “expert patients” of the disease capable of being “co-actors in the course of care”. Patient associations are also called upon to participate in the “co-construction and communication of information on long Covid and other post-infectious syndromes”.
To better inform the population about the risks and consequences of the pathology, information media, campaigns and communication tools will be developed. They should make it possible to “improve the accessibility of information to the general public”, “improve information and awareness in occupational medicine” and “improve information and awareness in school and university medicine”.
The training of health personnel will be reinforced in order to have, in addition to “expert patients”, more “expert caregivers”. Professionals will also be able to access educational material through an institutional platform on which they can share information with organizations. In this concern to develop specialists in the question, the government finally wishes to develop “an international scientific network specific to Covid long in order to share knowledge on the disease” at the global level.
Arrangements already in place
Among the measures already implemented mentioned by the Ministry of Health, a support network throughout the territory has been structured following the recommendations of the High Authority for Health (HAS), from winter 2021. Three more or less complex levels of care exist for patients: general practitioners at the center of the system, community or hospital specialists and aftercare and rehabilitation services.
These different levels are organized by the Regional Health Agencies (ARS). “These cells aim to support, inform, guide professionals and patients and coordinate the interventions necessary for the management of ‘complex’ post-Covid cases in all territories”, explains the ministry.
Moreover, if the pathology is not yet recognized as a long-term condition (ALD), because still too little studied, some of the symptoms may allow “an exemption from the moderating ticket [qui représente la part des dépenses qui reste à sa charge après remboursement de l’Assurance maladie, NDLR] in adults or children”, such as chronic respiratory failure or severe chronic kidney disease.
The ministry has also “worked with continuing education organizations to ensure that Covid is a priority training topic” so that doctors can be well informed of the pathology and its implications. In January 2021, a coordinated action called “Covid long” was also carried out by the ANRS-MIE (National Agency for AIDS Research – Emerging Infectious Diseases) in order to accentuate and deepen research on the pathology.