{"id":927,"date":"2020-06-15T13:50:11","date_gmt":"2020-06-15T11:50:11","guid":{"rendered":"https:\/\/www.svmed.ch\/blog\/?p=927"},"modified":"2020-06-15T17:04:18","modified_gmt":"2020-06-15T15:04:18","slug":"les-ems-au-coeur-du-tsunami","status":"publish","type":"post","link":"https:\/\/www.svmed.ch\/blog\/les-ems-au-coeur-du-tsunami\/","title":{"rendered":"Les EMS au c\u0153ur du tsunami !"},"content":{"rendered":"

Alors que nous d\u00e9confinons aussi bien que possible pour endiguer sa r\u00e9surgence, mais aussi mal que n\u00e9cessaire pour permettre l\u2019immunit\u00e9 gr\u00e9gaire, tirons \u00e0 chaud quelques le\u00e7ons de la pand\u00e9mie.<\/p>\n

Notre syst\u00e8me de sant\u00e9 a tenu. Fustig\u00e9 de toute part, pr\u00e9tendu pl\u00e9thorique et scl\u00e9ros\u00e9, il a brillamment surmont\u00e9 le tsunami Covid-19, l\u00e0 o\u00f9 d\u2019autres ont eu et ont encore tant de peine \u00e0 le faire.<\/p>\n

SARS-Co-V-2, plus jamais \u00e7a\u00a0!<\/em><\/p>\n

Apr\u00e8s avoir illustr\u00e9 la r\u00e9silience du corps m\u00e9dical dans un num\u00e9ro sp\u00e9cial en avril, le CMV donne la parole aux EMS meurtris par le tsunami. Nous sommes sans voix face au courage et \u00e0 l\u2019abn\u00e9gation du personnel des EMS qui a fait face \u00e0 une situation inimaginable il y a quelques semaines. Certes, la plupart des r\u00e9sidents d\u00e9c\u00e9d\u00e9s \u00e9taient \u00e2g\u00e9s et polymorbides, mais nous devons rapidement en tirer les cons\u00e9quences et adapter les plans pand\u00e9mies existants. C\u2019est \u00e0 eux, \u00e0 leurs proches, et plus largement \u00e0 nos concitoyens que nous le devons d\u00e9sormais.<\/p>\n

Covid-19 \u2013 circonscrire les r\u00e9surgences<\/em><\/p>\n

Tous les acteurs sont d\u00e9termin\u00e9s \u00e0 tirer les cons\u00e9quences d\u2019une mortalit\u00e9 \u00e9lev\u00e9e dans les \u00e9tablissements o\u00f9 il n\u2019a malheureusement pas \u00e9t\u00e9 possible d\u2019emp\u00eacher l\u2019introduction puis la propagation du coronavirus [1]<\/a>. Nous n\u2019avons pas r\u00e9alis\u00e9 ou peut-\u00eatre pas voulu reconna\u00eetre que contrairement au SARS-CoV-1 et d\u2019autres virus respiratoires, le SARS CoV-2 se transmet avant l\u2019apparition des sympt\u00f4mes [2]<\/a>,<\/sup>[3]<\/a>. \u00a0Non seulement une partie du personnel, mais jusqu\u2019\u00e0 pr\u00e8s de 50% des r\u00e9sidents en EMS et institutions de long s\u00e9jour sont porteurs asymptomatiques du coronavirus et le concept sanitaire doit \u00eatre rapidement adapt\u00e9 en cons\u00e9quence [4]<\/a>,<\/sup>[5]<\/a>.<\/p>\n

Parmi les mesures \u00e0 prendre, outre le respect des r\u00e8gles d\u2019hygi\u00e8ne en vigueur et le maintien d\u2019un stock de mat\u00e9riel de protection suffisant, le d\u00e9pistage syst\u00e9matique des r\u00e9sidents et probablement du personnel des institutions doit \u00eatre consid\u00e9r\u00e9 d\u00e8s le premier cas identifi\u00e9 ou suspect\u00e9 [6]<\/a>.<\/p>\n

Dr Philippe Eggimann, pr\u00e9sident de la SVM<\/p>\n

NB: cet article est \u00e9galement paru sous forme d’\u00e9ditorial dans le Courrier du m\u00e9decin vaudois<\/a> (CMV) n\u00b0 3\/2020<\/p>\n

[1]<\/a> Le Temps 29.05.2020 (https:\/\/www.letemps.ch\/suisse\/majorite-morts-vaudois-vivaient-ems<\/a>)<\/p>\n

[2]<\/a> JAMA Presumed Asymptomatic Carrier Transmission of COVID-19. BAY Y et al. JAMA Published online 21.02.2020 (https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2762028<\/a>)<\/p>\n

[3]<\/a> Temporal dynamics in viral shedding and transmissibility of COVID-19. Xe X et al. Nature medicine 2020;26(5): 672-5. https:\/\/www.nature.com\/articles\/s41591-020-0869-5<\/a><\/p>\n

[4]<\/a> EMS Outbreak Investigation of COVID-19 Among Residents and Staff of an Independent and Assisted Living Community for Older Adults in Seattle, Washington. Roxby AC et al. JAMA Internal MEdicine \u2013 published online 21.05.2020<\/p>\n

(https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2766448<\/a>)<\/p>\n

[5]<\/a> EMS Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility. Arons MM et al. NEJM 2020; 382:2081-2090 (Online 24.04.2020)<\/p>\n

[6]<\/a> \u00a0Asymptomatic Transmission, the Achilles\u2019 Heel of Current Strategies to Control Covid-19. Gandhi M et al. NEJM 2020; 382:2158-2160 (Online 28.05.2020) (https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2008457<\/a>)(https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMe2009758?query=recirc_curatedRelated_article<\/a>)<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"

Alors que nous d\u00e9confinons aussi bien que possible pour endiguer sa r\u00e9surgence, mais aussi mal que n\u00e9cessaire pour permettre l\u2019immunit\u00e9 gr\u00e9gaire, tirons \u00e0 chaud quelques le\u00e7ons de la pand\u00e9mie. Notre syst\u00e8me de sant\u00e9 a tenu. Fustig\u00e9 de toute part, pr\u00e9tendu pl\u00e9thorique et scl\u00e9ros\u00e9, il a brillamment surmont\u00e9 le tsunami Covid-19, l\u00e0 o\u00f9 d\u2019autres ont eu […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"wds_primary_category":0,"footnotes":""},"categories":[28],"tags":[],"class_list":["post-927","post","type-post","status-publish","format-standard","hentry","category-politique-de-la-sante-vaud"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-09-11 04:54:16","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/posts\/927","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/comments?post=927"}],"version-history":[{"count":3,"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/posts\/927\/revisions"}],"predecessor-version":[{"id":1008,"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/posts\/927\/revisions\/1008"}],"wp:attachment":[{"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/media?parent=927"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/categories?post=927"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.svmed.ch\/blog\/wp-json\/wp\/v2\/tags?post=927"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}