ABSTRACT
Covisan a été mis en place à partir du 14 avril 2020 au niveau de quatre sites pilotes de l'Assistance publique-Hôpitaux de Paris (APHP) pour casser les chaînes de transmission au SARS-CoV-2 selon un modèle original déjà éprouvé en Haïti pour éliminer le choléra dans les années 2010. Le dispositif consiste en un dépistage systématique des cas possibles de Covid-19, un accompagnement dans leur confinement et une prise en charge de leurs proches. Des équipes mobiles se sont déplacées au domicile des cas contacts afin d'évaluer les possibilités d'un isolement au domicile, de proposer des aides matérielles (courses, blanchisserie, hébergement externalisé) et de dépister leurs proches. Au 17 juin 2020, 6 376 patients ont été orientés vers Covisan, parmi lesquels 153 avaient une RT-PCR (reverse transciptase polymerase chain reaction) positive au SARSCoV-2. Covisan a permis un partenariat ville–hôpital innovant, en impliquant de multiples acteurs (personnels soignants, administratifs, logisticiens, métiers de service). Les autorités sanitaires se sont d'ailleurs inspirées de ce modèle pour lutter contre l'épidémie en mettant en place le contact tracing. Covisan, qui a appris en marchant, a également rencontré quelques difficultés, en particulier au niveau de la gestion des différents statuts des personnels ainsi qu'au niveau de la communication interne et externe.Alternate abstract: COVISAN was set up from April 14, 2020 at 4 pilot sites of Assistance publique-Hôpitaux de Paris (APHP) to break the sequence of transmission of SARSCoV-2 according to an original model already proven in Haiti to eradicate cholera in the 2010s. This device relies on a systematic screening of the possible COVID-19 cases, assistance in their containment and care for their close relatives. Mobile teams carried out home visits to evaluate the possibilities of home confinement, to propose material help (errands, laundry, outsourcing accommodation) and to propose a screening of their relatives. By June 17, 2020, 6376 patients have been moved towards COVISAN, and 153 had a positive RT–PCR to SARS-CoV-2. COVISAN has made possible an innovating town-hospital partnership, involving multiple actors (nursing staff, administrative staff, logistician, and service professions). Health authorities have decided to model their strategy to control the SARSCoV-2 spread closely to COVISAN's, and implemented "contact tracing”. COVISAN that learned by doing, has also encountered some difficulties, mainly concerning the different staff statutes and also with the internal and external communication.
ABSTRACT
COVISAN was set up from April 14, 2020 at 4 pilot sites of Assistance publique-Hôpitaux de Paris (APHP) to break the sequence of transmission of SARSCoV-2 according to an original model already proven in Haiti to eradicate cholera in the 2010s. This device relies on a systematic screening of the possible COVID-19 cases, assistance in their containment and care for their close relatives. Mobile teams carried out home visits to evaluate the possibilities of home confinement, to propose material help (errands, laundry, outsourcing accommodation) and to propose a screening of their relatives. By June 17, 2020, 6376 patients have been moved towards COVISAN, and 153 had a positive RT-PCR to SARS-CoV-2. COVISAN has made possible an innovating town-hospital partnership, involving multiple actors (nursing staff, administrative staff, logistician, and service professions). Health authorities have decided to model their strategy to control the SARSCoV-2 spread closely to COVISAN's, and implemented “contact tracing”. COVISAN that learned by doing, has also encountered some difficulties, mainly concerning the different staff statutes and also with the internal and external communication.