CHRONIC — At the turn of this Time.news, you will learn about a new state scandal to the tune of nearly one and a half billion euros…
Today I invite you to explore the world of laboratory tests for medical biology analyzes (LABM) carried out in recent months and years, with the aim of diagnosing infectious diseases caused by respiratory viruses, through a exploitation of the public database BIOLAM (“OPEN DATA” of the Health Insurance: here). It should be noted that BIOLAM, which provides access to the annual (since 2000) and monthly (since 2013) numbers of procedures reimbursed, the amounts reimbursed and the basis for reimbursement, for all procedures listed in the nomenclature of medical biology procedures (NABM : here), concerns only medical biology procedures carried out on an outpatient basis by private LABMs or during hospitalization in a private for-profit health establishment. The scope of these data therefore does not cover procedures performed in public health establishments or in private health establishments of collective interest, whether in hospitalization or in outpatient consultations. When we draw the graph of the number of annual tests carried out on the 5 respiratory viruses since 2000 and until 2021, only one virus appears, the coronavirus 2019. Consider that nearly 100 million tests will have been carried out in 2020 and 2021 … In general, when you had contracted covid, you did a first “positive” test, then a second negative to be sure of being cured or to have the right to go to a nightclub, to a concert, to the cinema… and in all the cultural, sporting, commercial places,…, which were so often forbidden to us, at least during the first two years of the pandemic. If we halve the total of tests for 2020, 2021, namely 99,647,166, there would have been (conditional) at most just under 50 million French men and women infected with this virus. In reality, much less, some people having been tested every week or almost… And, above all, the positivity rate of the tests will only have been higher than 20% during the peaks of incidence at the height of the waves ( there are already 6…).
It takes a magnification of the previous graph of 533x to glimpse the second most tested respiratory virus. These are obviously the A and B viruses of the flu.
SARS-COV2, the covid-19 virus, was therefore tested 175 times more than influenza A and B virus(es) in 2020 and even 1,312 times more in 2021. Do you think that covid-19 is more than a thousand times more deadly than what is customary to call flu-like syndromes?
You have to zoom in, magnify again by 10 x, to see the pursuers:
– The respiratory syncytial virus, responsible for bronchiolitis in toddlers, which in 22 years has only exceeded 3 times the bar of 5,000 annual tests. More than 12,000 tests reimbursed in 2020, but half as many in 2021, when we were made a big deal at the end of October at the beginning of November 2021, and I don’t remember that we were told about it in 2020. See my Time.news N°77 “The respiratory syncytial virus has invaded in the midst of the covid-19 pandemic: should we fight with the same weapons?” ” (here)
– Adenoviruses for a long time below the bar of 4,000 annual tests, have been subject to a steady increase since 2013, at least until 2019 (highest point at just over 8,000 tests). They have a pathogenic power which is exerted mainly on the respiratory tree. About forty varieties can infect humans. These viruses are responsible for pharyngitis, pneumonia, as well as conjunctivitis and represent 1 to 9% of infantile gastroenteritis (Source: Wikipedia: here).
– Human Parainfluenza viruses (IPV) were tested 2,000 to 3,000 times a year between 2000 and 2009. Since 2010, the annual number of tests has stabilized at between 1,000 and 1,500. It is manifested by rhinitis, laryngitis, tracheitis . With RSV, they are responsible for bronchiolitis in infants, and can be the cause of severe acute bronchitis and pneumonia in the elderly and immunocompromised (source: Eurofins-Biomnis here, and Wikipedia: here).
It is still necessary to magnify 5 x to fully understand the curve of the tests of the VPI
We end up flush with the daisies with two respiratory viruses usually responsible for common colds:
– “Lambda” coronaviruses, which were hardly tested anymore, and are no longer tested at all, apart from SARS-COV-2. 38 tests carried out in 2001, 26 in 2002, 20 in 2003. Then a long crossing of the desert until 2015. A small burst of pride with 38, 98, 138, and 192 tests from 2016 to 2019, before the explosion of covid-19
– Rhinoviruses, which, it must be said, are no longer tested except by researchers from the Sentinelles network, tests which do not even appear in the health insurance data. A peak of 11 tests in 2004, swan song, since we will then have 15 years with zero tests, including the last 3, and only one test carried out in 2018. Poor France…
Since 2013, health insurance has also published monthly data concerning the number of medical biology procedures, the bases and amounts of reimbursement. On the graph below covering the period from January 2020 to February 2022, with a maximum scale of 12,000,000 monthly tests, only the tests for SARS-COV2 are visible. The record was set just above 11 million in January 2022
200x magnification is required to see influenza virus and respiratory syncytial virus tests. We had an outbreak of flu testing in March 2020, almost nothing in April 2021, and a flurry of testing in February 2022…
We magnify again by 15x to better discern the evolution of RSV tests, and the peaceful upward trend of adenovirus tests.
Here again, to better observe it is necessary to magnify x 5. In total, compared to the first graph from which only the SARS-COV-2 tests came out, it will have been necessary to magnify 15,000 x, to apprehend the evolution of the numbers monthly tests for each of the 5 respiratory viruses tested (or not). Although still listed in the nomenclature, the rhinovirus was not once tested in private medical biological analysis laboratories, or private for-profit clinics, between January 2020 and February 2022! Fortunately, there are INSERM researchers from the Sentinelles network who are still testing it, but sparingly (see below). Otherwise no one would have heard of an epidemic of colds caused by rhinoviruses in September 2021, before the arrival of Omicron…
The table below gives the number of cumulative acts, the basis for reimbursement (what it cost to health insurance and mutual insurance companies), and the average unit costs for the tests carried out to identify respiratory viruses in people samples taken from private LABMs and private for-profit clinics with a LABM.
With a total cost of nearly 6 billion euros including tests and multiple administrative packages, the bill is steep for health insurance. Knowing that it would obviously be necessary to add the tests and packages carried out in public hospitals…
We underlined it a little higher, fortunately that the nearly 1,400 general practitioners and pediatricians distributed throughout the territory, who make up the Sentinelles network, coordinated by INSERM and Sorbonne University, have been carrying out epidemiological surveillance since 1984 (here). Their weekly epidemiological bulletins make it possible to follow the evolution of the various epidemics which follow one another in metropolitan France in city medicine.
The graph below uses data from the last 31 weeks, between September 13, 2021 and April 17, 2022. For example, between March 14 and March 20, 2022, more than two thirds of patients seen s in consultation by the doctors of the Sentinelles network, presenting symptoms of acute respiratory infection, were tested positive for influenza A and B viruses. The flu was therefore predominant over the other respiratory viruses, including covid. Who talked about it?
The Sentinelles network also produces maps with weekly departmental incidence rates, regardless of the respiratory viruses involved (covid-19, flu, or others, etc.). The video animation below visualizes in about a minute the 31 weekly charts, and shows how these viruses move in time and space in a completely unpredictable way.
Locking ourselves up in March and November 2020 was a very stupid decision…
Finally, here is most likely a real scandal. How could everyone get through this irresponsible management of taxpayers’ money and social security?
In January 2021, an RT-PCR test combining the search for SARS-COV2, with that of influenza viruses A and B, appeared in the NABM nomenclature (here). This test, therefore, not only makes it possible to test positivity for Covid-19, but also those for the two main influenza viruses. A decisive advantage, since the viruses have cohabited together, there have been influenza + covid co-infections, and the symptoms of these two diseases are very similar. And that therefore, it is really useful to be able to distinguish between the A and B viruses of the Influenza, of covid-19. In addition, this test whose rating is 60 B, the letter in biology, and its basis for reimbursement of €16.25, against a rating of 95 B and a basis for reimbursement of €32.58 for the hegemonic test RT-PCR SARS-COV2 (here), would have more than halved the cost for health insurance and mutuals!
How is it possible that the most complete and least expensive test was almost 1,700 times less often performed?
To fully understand the considerable shortfall for health insurancelet’s examine together the table below, comparing the cumulative numbers of procedures performed and the cumulative amounts of the corresponding reimbursement bases, the unit amounts of reimbursement bases, over the period from January 2021 to February 2022 inclusive for these two tests “competitors” or “rivals”:
If the 91,844,479 tests carried out over the period had been carried out on the basis of the unit reimbursement of €16.25, the total cost for health insurance and mutual insurance companies would have been €1,492,472,784, i.e. a saving of 1.5 billion euros.
After the exorbitant price of “whatever the cost”, France really needed that…
What a mess!
Or, was it a way to thank the biologists who were so drudgery and malleable at will during this pandemic of tests?
Another state scandal. Maybe McKinsey was in on it. And, who says McKinsey, also says… Emmanuel Macron ????
The IGAS, or better, the Court of Auditors, should take up this case which really smells like powder…