Coronavirus : how the death toll in long-term care facilities is performed ? – franceinfo

The first official estimate has been given on Thursday. At least “884 death of the elderly” related to the Covid-19 have been identified in long-term care facilities, according to the director general of health, Jerome Solomon.

These figures were lying in wait for a long time. The director-general of health, Jerome Solomon, provided, Thursday, April 2, a first balance-sheet, provisional and partial, of deaths linked to the outbreak of coronavirus in the establishments of accommodation for dependent elderly people (Ehpad).

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At least “884 deaths” have been identified and 14 638 case “confirmed or possible” are registered. But this figure is still “interim”, “partial” and “non-consolidated”, according to the ministry of Health. Explanations.

Where does this balance ?

Gray area since the beginning of the epidemic, the deaths in the long-term care facilities were excluded from the official tally, which takes into account that the victims died in the hospital. But the reality has forced the ministry of Health to revise its indicators, in both the new catastrophic start to accumulate. Thus, 24 people died at the nursing home The Riviera Mougins (Alpes-Maritimes), according to a balance sheet prepared as of Thursday 2 April.

For a better understanding of the progress of the disease in these institutions, the directorate-general of health (DGS) asked them, since 28 march, to trace back the information via the portal for the reporting of adverse events. How the directors of long-term care-do they ? They must “fill out a questionnaire, stating the case and the state of health of the affected people, and the public Health agency of France centralizes the data”, explains the DGS.

Why is it partial ?

“The set of institutions of type long-term care facilities has not recovered all of the cases and deaths (…) therefore, The data is still in consolidation”, warned the director-general of health at its point newspaper of Thursday, 2 April. “It is a first digit partial, with large inequalities in the collection between regions, and important work is underway to consolidate all of this data,” he stressed.

But they nevertheless provide a first table. The regional agency of health of the Great East, the region most affected, with the Ile-de-France, believes that “the 570 elderly who have died are in a possible link with the Covid-19. This is cumulative data since the beginning of the epidemic on the basis of the statements of long-term care facilities.” The Upper Rhine, one of the first outbreaks of contamination in France, accrues to him only 314 of those deaths.

This number is aggregated to the other dead ?

No, these data “non-consolidated” remain less reliable than those dating back to hospitals, where the patients reported died of the epidemic have all been tested. This is not the case in the long-term care facilities. The setpoint of the ministry of Health is always to test only the first two patients with symptoms at one institution, the others being then suspected contaminated if they show the signs of the disease.

Also the number of deaths reported in the long-term care-is it “a figure that should be handled with caution, because [only] two people are being tested in these facilities. All deaths are not necessarily related to the Covid”, observes the regional agency of health of Ile-de-France, interviewed by franceinfo. She had already made the same remark on the 27th of march : “We can not say if the elderly died in a nursing home are actually dead of the disease, since they have not been tested, apart from the first two.”

Are there data consolidated and reliable ?

“Only the aggregated data, restated and consolidated by the public Health France have faith”, explains the regional agency of health of Ile-de-France. “Public health France has a surveillance of all-cause mortality, based on the returns of deaths sent to the national Institute of statistics and economic studies (Insee), which allows, in comparison with historical data, to detect an excess mortality, and, where appropriate, to estimate the magnitude.”

We need to be patient : “The channels of transmission of those data, related mainly to the time of declaration of death and seizure of information by the office of the civil registry require that you wait at least two weeks to estimate the excess mortality occurred in a given week.”

As is it clear, in this light, the latest epidemiological bulletin published on 2 April by public Health, France ? The agency notes that“in week 12 (16-22 march 2020), all-cause mortality at national level is significantly higher than expected mortality rates over this period ( … ), and especially marked in the region Is Great, particularly in the department of Haut-Rhin.”

People aged 65 years or more are mostly affected by this increase in mortality, as well as the adults of 15-64 years in the region Ile-de-France.Public health Francein a press release

But it is still too early to know how much comes back to the pandemic : “because of The usual time of transmission of the death by the offices of civil status, the data are still incomplete and will be consolidated in the next few weeks, specific public Health France in its newsletter. The estimates of excess mortality observed are therefore minimum values, intended to increase in the coming weeks. The increased mortality observed in these regions is probably related to the epidemic of Covid-19, without it being possible to estimate the proportion attributable to that date.”

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