Contact Covid and health brigades: healthcare professionals on the front line
Faced with the backlash to the StopCovid application, two digital tools are currently being developed and deployed by Assurance Maladie and the Ministry of Solidarity and Health. "Health brigades" will be responsible for tracking and tracing cases of potential exposure. Made up of nearly 4,000 people, most of whom are employees of the Assurance Maladie, they will get their data from general practitioners, who themselves will receive a flat-rate fee for participating in the system. This manual tracking is likely to be extremely time-consuming and will require an enormous amount of human resources, compared to a digital application.
This large-scale system will be based on a screening information system called "SI-DEP", which will automatically collect diagnostic test results (RT-PCR) and create alerts for any new cases, and on a remote monitoring system called "Contact Covid". From mid-May onward, Contact Covid will be available to healthcare professionals (doctors, biologists, and pharmacists) as well as authorised agents of the Assurance Maladie and Regional Health Agencies (ARS), but patients "won’t be required to do anything", said Nicolas Revel, the director of the Assurance Maladie.
This remote monitoring service enables doctors to provide a wide range of information during consultations about people who have tested positive: name, social security number, address, telephone number, symptoms, the screening test used, place of work or other - retirement home, daycare, school, prison - and individuals they were in contact with within two weeks of diagnosis. The platforms set up by Assurance Maladie in each department then call those exposed, to inform them on how to proceed and to figure out any potential needs. This data is required to be deleted after three months.
The Regional Health Agencies are then responsible for identifying and treating chains of infection and managing the reported concentrations of positive tests. People exposed to the virus will be encouraged to comply with quarantine instructions, and they and everyone in their household will receive sick leave, as well as those outside the household showing symptoms of the disease. For symptomless out-of-home cases, quarantine will be maintained until testing has been completed. The sick leave will be extended if the result of the PCR test is positive, reduced if it’s negative.
The aim of this system is also to provide testing in Biology Laboratories and to allow masks to be distributed in pharmacies for all close contacts, whether or not they are presenting symptoms. This would explain why biologists and pharmacists are involved in the process beforehand.
According to the Ministry of Solidarity and Health, Contact Covid was "developed in compliance with French law for the protection of personal data and the GDPR (General Data Protection Regulation)". The identity of the infected person will be revealed to those they have been in contact with, after they have consented to do so. The stored data will be accessible to the patient, the doctor, the French Public Health Agency, Assurance Maladie, and the Regional Health Agencies.
The system was submitted to the CNIL for an opinion. They called for great vigilance as data relating to health and to certain aspects of private life will be recorded in two national files, accessible to a large number of people. They also call for a certain number of guarantees, in particular regarding the data to which each category of user of the two files will have access, and calls for more detailed consideration of the data storage periods. There are therefore still some reservations concerning Contact Covid, which has not yet been the subject of the same outrage that StopCovid created, although it has been developed in close collaboration with patient associations.
StopCovid and Contact Covid: avoiding silo thinking