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Covid-19: the call for associations to save immunocompromised patients

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Faced with the Omicron wave, viral circulation is becoming more intense in France, a phenomenon which is not without concern for people in risk of severe COVID-19 infections like immunocompromised people, whom vaccination does not protect as effectively. What can be done to ensure effective and long-term protection for these patients, but also to prevent them from contributing disproportionately to the overload of the health system in the coming weeks? Proposal: an urgent operation to protect these severely immunocompromised people, and this is what several patient associations are asking for* in a grandstand published on January 1 in the Journal du Dimanche (JDD).

In this open letter, the associations appeal to the President of the Republic to strengthen the protection of severely immunocompromised people against Covid-19: people who have been transplanted, on dialysis, suffering from certain cancers or taking certain treatments. According to their estimates, they represent up to 30% intensive care stays in some hospitals, while they are less than 300,000 in total in France and their vaccination schedule is complete. Due to a very high mortality in the event of contamination, all the signatories of this forum fear that the weak response of these patients to the vaccine risks being even more insufficient. against the Omicron variant.

When will there be an information campaign aimed at this public?

Thus, “the risk incurred by each of them is very much higher than that of the non-vaccinated because of their weaknesses. “, she says, not without deploring a lack of availability of curative treatment for COVID-19 for them. “Due to the loss of effectiveness of most monoclonal antibodies against Omicron, no more curative treatment of Covid is not available in France, until the expected deliveries in February of Sotrovimab and Paxlovid. “, they note. A situation that is all the more worrying in this context of hospital tension: due to this lack of treatment, immunocompromised people whose condition will worsen risk being refused access resuscitation services, in favor of patients with a better prognosis.

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To avoid such a situation, the open letter from these associations is accompanied by a more detailed note also addressed to Emmanuel Macron, who presents the concrete measures proposed. The first would consist of launching a major information campaign aimed at severely immunocompromised patients and their relatives to inform them of the risks and advice to optimize their protection, or even to recommend transitory self-confinement. It is also a question of “informing the general public of the need for joint protection to be provided to them. » Currently increasingly recommended FFP2 masks should, according to the signatories, be supported by health insurance.

“The circulation of Omicron today poses the risk of excess mortality as heavy as it is avoidable”

On the treatment side, they recommend early emergency access preventive treatment Evusheld, because its administration at home by service providers, “is a crucial issue”, they believe. Contaminated immunocompromised patients should be able to have priority access to screening tests in the event of symptoms and to alternative treatments pending availability. Sotrovimab and Paxlovid: derogatory access to Evusheld as a curative, use of convalescent plasma… “The very intense circulation of Omicron today puts immunocompromised people at risk of excess mortality that is as heavy as it is avoidable. We are counting on you so that France makes a clear choice that it does not happen. », concludes the panel.

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An immunocompromised person has a weakened immune system who do not respond adequately to invading pathogens, which means that their body cannot fight infections such as COVID-19 as well as a person with a normal immune system. Last November, i.e. before the arrival of the Omicron variant, a study published in Nature Communications hypothesized that immunocompromised patients are a source of the emergence of potentially concerning variants of Sars-CoV-2. In question, an infection which can last several months for them because their immune defenses fail to get rid of the virus. A condition that favors its mutations and therefore allows it to become possibly more dangerous.

*Ellye, Transhépate, France Rein, Overcoming cystic fibrosis, SOS hepatitis, Renaloo

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