Doctor Hamma Djerad is head of the internal medicine and infectiology department at Nevers hospital. He explains what progress has been made in the fight against Covid.
“The incidence and positivity rate remain high. It’s not something trivial. The Covid does not date from the past. Fortunately, the transmission rate has dropped. This is due to barrier gestures, vaccination, group immunity, screening and existing treatments.
What risks does the Covid present today??
“It has a mortality rate of 2.3%. It causes a huge amount of absenteeism, especially in the hospital environment. It also leaves sequelae ranging from loss of taste and smell to neurological problems, general fatigue, respiratory problems, depression. Some still need oxygen even when they return home”.
In view of the demand, at least twenty cases just to his knowledge, the doctor will ask the management to open consultations every fortnight for people suffering from long Covid. For now, depending on their symptom, they are referred to the appropriate service. But the Covid reaching all the organs, a long Covid consultation would make it possible to take care of all the symptoms at the same time.
A risk of death multiplied by 300 for the over 90s
He recalls: “The elderly and those with comorbidities are most at risk. Compared to 40-44 year olds, the risk of hospitalization doubles in 60-64 year olds. It is multiplied by 6 for the 80-84 year olds, and by 12 for the over 90s. And the risk of death is multiplied by 12 for the 60-64 year olds, by 100 for the 80-84 year olds, and by 300 for the over 90s. The comorbidities most at risk are kidney transplant recipients, chronic renal failure, and lung transplants”.
What treatments are there?
“Doctors now have a common base. Oxygen if the patient is short of breath. Analgesic treatment if he is unwell. An anticoagulant to prevent thrombosis (phlebitis, pulmonary embolism, etc.). An antibiotic if there is an infection, for example if the person spits up yellow. Cortisone if there is respiratory impairment. On a case-by-case basis, we can also decide to give immunomodulators, but this is only done in the hospital, often for patients in intensive care, or if, despite cortisone, the condition does not improve. Finally, there are antivirals. In particular Paxlovid, and monoclonal antibodies”.
Medicines available on prescription, in pharmacies
“Paxlovid is a tablet that reduces severe forms of Covid by 90%. It must be taken within five days of the onset of symptoms, and is indicated above all for immunocompromised patients and those over 65, but also for those who have already had a painful or severe form of Covid. It is distributed in pharmacies, on medical prescription because it may be contraindicated with other drugs”. Dr. Djerad regrets that it is still little prescribed. “At the beginning, only the hospital and the specialized doctors could do it, but this is no longer the case, and it is not known”.
“If you are concerned, do not hesitate to contact your doctor”.
For people who are not receptive to the vaccine, “there are also monoclonal antibodies, which make it possible to avoid serious forms for 3 to 6 months.
Any doctor can prescribe them. This is an injection that can be done by a nurse, at home”. They can even be used curatively to treat long Covid. “If you are concerned, do not hesitate to contact your doctor. And if you don’t have the possibility, turn to my service”, insists Dr. Djerad, who believes that “these treatments are underused, whereas they are recognized in a consensual way”.