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Self-tests greeted with skepticism in high schools

After the teachers, the students. As of Monday, May 10, high school students who volunteer and have authorization from their parents will be able to benefit from free self-tests in their establishment.

“Simple to use and painless, these antigenic self-tests on a nasal sample offer asymptomatic people who are not at-risk contacts an additional ease of screening”, praises the Ministry of Education, which provides sessions “Weekly”. “These are 60 million tests that will be distributed in schools between now and the summer holidays”, he promises.

→ EXPLANATION. Covid-19: what will the self-tests be used for?

Each high school will have to have a dedicated room, ventilated regularly and of a sufficient surface to spare two meters of distance between the people. In principle, there is an upstream educational awareness session, supported by video.

School nurses on the front line

The use of the self-tests should take place under the supervision of a “Supervisor”. As teachers overwhelmingly believe that this is not their mission, this task will often fall to school nurses, for lack of massive reinforcement from the teachers. “Mediators”, students recruited to facilitate screening campaigns in schools.

The protocol provides that a student detected positive ” is immediately isolated in a suitable room and taken care of as a possible case ”. He must then perform a PCR test ” as soon as possible “. If the positive result is confirmed, the high school student must isolate himself for a minimum of ten days, while his class is closed for seven days (1).

→ ANALYSIS Covid-19: is surveillance in schools really reinforced?

So much for the principles. But the implementation could be complex. First, because some high schools have not yet received the kits. But above all because school leaders are skeptical.

Heads of private establishments on the offensive

“Under current conditions, a majority of high schools in our network will not pass the self-tests”, affirms Arnaud Patural, vice-president of SNCEEL, organization of heads of establishments of private education under contract. “Our colleagues could be implicated if a student were injured while performing their self-test. Or if, detected false negative because the test was not carried out correctly, it then contaminated those around him ”, he justifies.

Arnaud Patural also raises organizational issues, taking as an example his establishment in Bourges (Cher), which has only one nurse for 2,600 students. “Impossible for her to supervise the screenings once a week for all the high school students. “

The vice-president of SNCEEL would like “That the establishments can distribute the self-tests to the pupils, so that they carry them out at home, under the responsibility of their parents”. A solution at this stage materially impossible. “Because we receive in each batch a quantity of revealing liquid to be distributed among several self-tests”, specifies Arnaud Patural.

According to one of our sources, Jean-Michel Blanquer was in favor of carrying out self-tests by students at their homes, but the Minister of Health Olivier Véran had the last word. A student who has performed a positive self-test at home may not inform the school. And some high school students might be tempted to sell their self-tests rather than get tested …

An effective device provided it is applied massively

In any case, predicted Bruno Bobkiewicz, national secretary of the union of management personnel SNPDEN, “The proportion of volunteer students is likely to be low”. In Île-de-France, in the fall, only 20% of students had participated in the first campaign of massive, antigenic tests in high schools.

“Admittedly, the self-tests are less painful but many people have the feeling, probably wrongly, that the third wave is behind us, thanks in particular to the vaccination efforts”, notes Bruno Bobkiewicz. “And then there is the prospect of the bac. Finding yourself a positive case as the tests approach means running the risk of not being able to sit the exam. Some people will therefore prefer not to try to find out ”, he anticipates.

However, the effectiveness of the system is based on massive acceptance. According to an Inserm-CNRS study cited by the Scientific Council and the High Authority for Health, 25% adherence to weekly screening would lead to a 30% reduction in the number of cases compared to the current situation. 75% adherence would lead to a 50% reduction in contamination.

If performed correctly, self-tests have an 80-95% reliability.


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