Pandémie : quel lien entre la première ligne et la santé publique ?

Réunir les professionnels de la première ligne et les responsables des politiques publiques pour définir les missions et les rôles de chacun.

New French guidelines to adapt the "Isolate/Detect/Trace" strategy for COVID-19 adult peoples or contacts considering the exponential spread of Omicron variant.

Introduction: The objectives were to elaborate new recommendations for the French Government taking into account the new epidemiological situation due to Omicron variant of SARS-CoV-2 virus and to maintain essential functions of the State through socioeconomic and health life. Method: Two self-decision matrix were built for isolation (cases) and quarantine (contacts) and for citizen testing, respectively. The recommendations included in the two matrix were validated internally by experts and scientists from the scientist literature. Results: A strategic breakdown into five phases corresponding to the possible phases of Omicron variants spread was built. Exceptional and transitory derogation for essential activities was proposed in fully vaccinated professionals. Suspension of quarantine period for fully vaccinated contacts and professionals was proposed with routine self-testing program. Conclusion: These new HCSP guidelines aims to preserve public health as a whole and to minimize the socioeconomic and health consequences linked to the emergence of the Omicron variant by making trade-offs/adaptations in dependent scientist contexts. Patient or Public Contribution: HCSP scientists and experts were in charge of drafting the recommendations and promoting them to the Government for their application by regulatory decree voted by law.

Syndemic analysis of the pandemic COVID-19 crisis: a multidisciplinary "Understand-Anticipate - Propose" meta-method.

BACKGROUND: In order to understand the pandemic COVID-19 crisis in a forward-looking way, the French High Council for public health (HCSP) has designed a conceptual scheme for public health planning based on L. Green's model in order to better understand the issues at stake, by identifying dangers and levers for action. The final aim was to establish priorities and guidelines in order to anticipate the collateral consequences of the management of the crisis and be better prepared for the next one. METHOD: A public health conceptual framework PRECEDE-PROCEED adapted to the Covid-19 health crisis was developed using both a graphic (concept map) and analytic (to make the conceptual scheme functional) approaches. Then, a "meta-method" was applied using three distinct cognitive stages: understanding, anticipation and proposals of action. RESULTS: The conceptual framework was broken down into 10 technical sheets covering essential diagnoses and integrating different public health determinants. Each of these was broken down into three cognitive stages, allowing for a diagnosis of understanding, a scenario of anticipation and a strategic analysis of action according to the chronology: understand-anticipate-propose. From these 10 technical sheets, 32 guidelines have been proposed. CONCLUSION: This work is intended to allow reflections on public health approaches to strengthen and anticipate health crisis management and health planning by politic managers working at national or sub-national level.

Syndemic analysis of the pandemic COVID-19 crisis: a multidisciplinary “Understand—Anticipate – Propose” meta-method

Background In order to understand the pandemic COVID-19 crisis in a forward-looking way, the French High Council for public health (HCSP) has designed a conceptual scheme for public health planning based on L. Green's model in order to better understand the issues at stake, by identifying dangers and levers for action. The final aim was to establish priorities and guidelines in order to anticipate the collateral consequences of the management of the crisis and be better prepared for the next one. Method A public health conceptual framework PRECEDE-PROCEED adapted to the Covid-19 health crisis was developed using both a graphic (concept map) and analytic (to make the conceptual scheme functional) approaches. Then, a "meta-method" was applied using three distinct cognitive stages: understanding, anticipation and proposals of action. Results The conceptual framework was broken down into 10 technical sheets covering essential diagnoses and integrating different public health determinants. Each of these was broken down into three cognitive stages, allowing for a diagnosis of understanding, a scenario of anticipation and a strategic analysis of action according to the chronology: understand-anticipate-propose. From these 10 technical sheets, 32 guidelines have been proposed. Conclusion This work is intended to allow reflections on public health approaches to strengthen and anticipate health crisis management and health planning by politic managers working at national or sub-national level.

Development and Validation of the COVID-19 Knowledges and Behavior Questionnaire in a French Population (CoVQuest-CC).

BACKGROUND: The SARS-CoV-2 pandemic has led most countries to take restrictive measures affecting social activities and individual freedoms to limit viral transmission. It was shown that practical, motivational and social barriers impact on adherence to the isolation and social distancing measures advocated by the health authorities. The purpose of this study was to develop and validate a COVID-19 Knowledges and Behavior Questionnaire adapted to a teenager and adult French population. METHODS: CoVQuest-CC was developed by a multidisciplinary team made of infectious diseases physicians, medical virologist, specialists of infectious control, experts of the questionnaires methodology, experts in public health and prevention, and statisticians. CoVQuest-CC was responded to by a big cohort from the general population during their participation in a massive SARS-CoV-2 screening campaign in 2021 in Saint-Etienne, France. RESULTS: The confirmatory factorial analysis yielded good results (CFI = 0.94, TLI = 0.94, RMSEA = 0.04), and confirmed the five-dimensional structure of the questionnaire. Each dimension had a satisfying internal consistency, with Cronbach alphas of 0.83, 0.71, 0.65, 0.72 and 0.83 for transmission knowledge, barrier gesture respect, tests acceptability, home isolation possibility and test practicability, respectively. CONCLUSIONS: According to our knowledge, CoVQuest-CC is the first validated, consistent and reliable self-administrated French-specific questionnaire investigating the general population's knowledge and attitudes towards COVID-19. It shows acceptable psychometric properties and can be use by Public Health teams or caregivers for public health and research purposes. TRIAL REGISTRATION: The study protocol was approved by the IRB ILE-DE-FRANCE 1 (No. IRB: I ORG0009918). All participants were given written and verbal information about the study and gave informed consent to participate. CLINICALTRIALS: gov identifier (NCT number): NCT04859023.

Interaction between science advice and policymaking in time of COVID-19: a French perspective.

BACKGROUND: In the coronavirus disease 2019 (COVID-19) context, many governments relied on scientific consultative bodies to advise their policy, but their contribution remains poorly documented. This article aims to fill this gap by reviewing the role played by the French High Council for Public Health (HCSP) in the French government's response to COVID-19. METHODS: We studied the time distribution of the COVID-19 guidelines produced by the HCSP until November 2020, computed their delay of production and analyzed the thematic areas they cover. To assess their use by the authorities, we looked for references to these guidelines in the regulatory texts, protocols and press communicates issued by national and local authorities until January 2021. RESULTS: The HCSP was strongly demanded with 102 guidelines produced following 97 official requests and two self-referrals. Most of them (N = 43) concerned protective measures to constrain the infection, while health inequalities and mental health were poorly addressed. Timing was very constraint as half of the guidelines were requested within 4 days. In total, 73% of the guidelines were used by policymakers to implement new obligations or within communication toward the public at national and local levels. CONCLUSIONS: This article informs on the HCSP's contribution during the crisis and stresses the difficulties it encountered to provide quality recommendations in very short times. It prompts governments to enlarge the competencies of their advisory boards and to consider the multidimensional aspects of health in policy design.

What face mask for what use in the context of COVID-19 pandemic? The French guidelines.

In the context of the COVID-19 pandemic, wearing a face mask has become usual and ubiquitous, in both hospitals and community. However, the general public is consuming surgical or filtering face piece (FFP) masks irrespective of their specificity, leading to global supply shortage for the most exposed persons, which are healthcare workers. This underlines the urgent need to clarify the indications of the different categories of mask, in order to rationalize their use. The study herein specifies the French position for the rational use of respiratory protective equipment for healthcare workers.