{"id":1054,"date":"2020-05-30T21:21:01","date_gmt":"2020-05-30T19:21:01","guid":{"rendered":"http:\/\/sceaux-lagazette.fr\/?p=1054"},"modified":"2020-05-30T21:43:50","modified_gmt":"2020-05-30T19:43:50","slug":"medecins-traitants","status":"publish","type":"post","link":"https:\/\/sceaux-lagazette.fr\/index.php\/2020\/05\/30\/medecins-traitants\/","title":{"rendered":"M\u00e9decins traitants"},"content":{"rendered":"\n

LGdS a rencontr\u00e9 des personnes h\u00e9sitantes sur la conduite \u00e0 tenir par rapport \u00e0 la covid. Un a \u00e9t\u00e9 atteint, test\u00e9 positivement en mars puis sorti d\u2019affaire apr\u00e8s 2 semaines de fi\u00e8vre. Quand les tests s\u00e9rologiques ont \u00e9t\u00e9 accessibles pour le grand public, il s\u2019est pr\u00e9cipit\u00e9 bien que la Haute Autorit\u00e9 Sanitaire ait \u00e9mis des r\u00e9serves sur la g\u00e9n\u00e9ralisation de ces tests. Pour se rassurer. Une autre se demande si elle a eu la covid, ce qu\u2019il faut faire pour le savoir et surtout s\u2019il convient de faire quelque chose pour le savoir. <\/em><\/p>\n\n\n\n

Le point commun entre ces deux situations est probablement \u00e0 rechercher dans le doute que ne dissipe pas, au contraire, le flot de choses entendues. Pour apporter une modeste pierre \u00e0 la compr\u00e9hension d\u2019une situation par nature compliqu\u00e9e, nous donnons la parole au Dr CG.<\/em><\/p>\n\n\n\n

S\u2019y retrouver malgr\u00e9 les zones d\u2019ombre<\/h2>\n\n\n\n

Je comprends la r\u00e9action de la personne \u00e9voqu\u00e9e en premier. On veut souvent, comme le dit Dr M.P. dans son article<\/a>, un passeport d\u2019immunit\u00e9.
Dans la population, un certain nombre de personnes touch\u00e9es par la Covid l\u2019ont transmise en ayant peu ou pas d\u00e9clar\u00e9 de sympt\u00f4mes, ils \u00e9taient porteurs sains.
D\u00e8s lors chacun esp\u00e8re, qu\u2019il ait \u00e9t\u00e9 malade ou non, avoir d\u00e9velopp\u00e9 des anticorps durablement protecteurs contre une nouvelle attaque virale, comme nous le serions apr\u00e8s une vaccination ou apr\u00e8s une maladie infantile, telle la varicelle ou la rub\u00e9ole.<\/p>\n\n\n\n

Dans le cas de la Covid, maladie \u00e9mergente, des \u00e9tudes ont d\u00e9j\u00e0 \u00e9tabli que les anticorps produits lors des formes aigu\u00ebs de la maladie sont neutralisants, c\u2019est-\u00e0-dire protecteurs, et que leur taux augmente d\u00e8s le 10\u00b0 jour, en proportion de la gravit\u00e9 de l\u2019infection.
Concernant les formes l\u00e9g\u00e8res \u00e0 mod\u00e9r\u00e9es, l\u2019\u00e9tude d\u00e9crite par le Dr <\/a> <\/a>M.P.<\/a>, conduite par l\u2019institut Pasteur et le CHU de Strasbourg aupr\u00e8s de 160 soignants et personnels infect\u00e9s, r\u00e9pond sans \u00e9quivoque en d\u00e9tectant des anticorps chez tous les participants sauf un, avec une proportion d\u2019anticorps neutralisants atteignant 98% entre le 28 et 41\u00b0 jours apr\u00e8s l\u2019apparition des sympt\u00f4mes.<\/p>\n\n\n\n

Point important, il ne sert \u00e0 rien de faire une s\u00e9rologie, pour confirmer cette immunit\u00e9 si on est tout \u00e0 fait s\u00fbr d\u2019avoir eu la Covid. Mais tant qu’il reste des incertitudes sur le temps dure cette immunit\u00e9, sur la quantit\u00e9 minimale d\u2019anticorps qui conf\u00e8re cette immunit\u00e9, tant que la s\u00e9rologie ne peut garantir une protection durable, ces tests doivent rester des outils de diagnostic lorsque la maladie est suspect\u00e9e, que la recherche du virus par PCR est n\u00e9gative ou n\u2019a pas \u00e9t\u00e9 pu \u00eatre faite dans les d\u00e9lais, globalement au-del\u00e0 de 7 jours.<\/p>\n\n\n\n

Si on a pr\u00e9sent\u00e9 des sympt\u00f4mes \u00e9vocateurs, quelques semaines plus t\u00f4t, toux s\u00e8che, mal de gorge, fi\u00e8vre ou frissons, diarrh\u00e9es, perte du go\u00fbt, de l\u2019odorat, courbatures, c\u00e9phal\u00e9es, diarrh\u00e9es, et que la PCR n\u2019a pas \u00e9t\u00e9 faite, le m\u00e9decin traitant prescrira certainement une s\u00e9rologie de confirmation qui sera rembours\u00e9e.<\/p>\n\n\n\n

Le r\u00f4le cl\u00e9 des m\u00e9decins de ville<\/h2>\n\n\n\n

Il est clair qu\u2019on a manqu\u00e9 au d\u00e9part de mat\u00e9riels et de tests, de protection, de lits. Mais il est \u00e9galement clair que la mobilisation de tous les acteurs de la sant\u00e9, des autorit\u00e9s sanitaires, que les mesures de protections et de confinement accept\u00e9es par la population et, gr\u00e2ce aux aides de l\u2019Etat, par les acteurs \u00e9conomiques, ont permis de casser la circulation du virus. Elles ont permis de franchir une \u00e9tape importante et d\u2019organiser le d\u00e9confinement.<\/p>\n\n\n\n

C\u2019est toute une strat\u00e9gie de protection de la population que les autorit\u00e9s sanitaires ont d\u00e9ploy\u00e9 avec une mont\u00e9e en puissance de la capacit\u00e9 \u00e0 tester les patients, avec le d\u00e9ploiement des t\u00e9l\u00e9consultations par les structures de soins et les m\u00e9decins de ville, qui ont permis d\u2019\u00e9tablir des diagnostics, d\u2019orienter les patients tout en limitant les contacts physiques.<\/p>\n\n\n\n

Ce sont les m\u00e9decins de ville qui sont aujourd\u2019hui au coeur de ce dispositif de s\u00e9curisation du d\u00e9confinement. Ils testent les patients ayant des signes \u00e9vocateurs, en isolant les formes non suspectes de gravit\u00e9, et en identifiant leurs contacts avec l\u2019aide de l\u2019assurance maladie qui organise leur d\u00e9pistage et leur propose des mesures adapt\u00e9es.<\/p>\n\n\n\n

Les progr\u00e8s tr\u00e8s importants, qui ont \u00e9t\u00e9 accomplis dans la r\u00e9ponse collective \u00e0 l\u2019\u00e9pid\u00e9mie, ont remis la m\u00e9decine de ville au centre de la lutte contre l\u2019\u00e9pid\u00e9mie. Et les d\u00e9cisions n\u2019ont pas \u00e9t\u00e9 sans d\u00e9bats. Il ne faut pas pour autant oublier les zones d\u2019incertitude d\u00e9j\u00e0 \u00e9voqu\u00e9es plus haut : le pourcentage de porteurs sains n\u2019est pas vraiment connu et, en plus, il d\u00e9pend du territoire. Il est sans doute plus fort en \u00cele-de-France ou dans l’Est qu’en Bretagne ou en Auvergne. <\/p>\n\n\n\n

Si on sait maintenant que les anticorps prot\u00e8gent, il reste \u00e0 pr\u00e9ciser la dur\u00e9e de cette protection. Seul le temps pourra r\u00e9pondre \u00e0 cette question essentielle tant que nous n\u2019avons ni traitement efficace ni vaccination.<\/p>\n","protected":false},"excerpt":{"rendered":"

LGdS a rencontr\u00e9 des personnes h\u00e9sitantes sur la conduite \u00e0 tenir par rapport \u00e0 la covid. Un a \u00e9t\u00e9 atteint, test\u00e9 positivement en mars puis sorti d\u2019affaire apr\u00e8s 2 semaines de fi\u00e8vre. Quand les tests s\u00e9rologiques ont \u00e9t\u00e9 accessibles pour le grand public, il s\u2019est pr\u00e9cipit\u00e9 bien que la Haute…<\/p>\n","protected":false},"author":20,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[53],"tags":[102,107],"class_list":["post-1054","post","type-post","status-publish","format-standard","hentry","category-analyses","tag-covid","tag-sante","entry","simple"],"yoast_head":"\nM\u00e9decins traitants - La Gazette<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sceaux-lagazette.fr\/index.php\/2020\/05\/30\/medecins-traitants\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"M\u00e9decins traitants - La Gazette\" \/>\n<meta property=\"og:description\" content=\"LGdS a rencontr\u00e9 des personnes h\u00e9sitantes sur la conduite \u00e0 tenir par rapport \u00e0 la covid. 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