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Covid-19: for Dr Gérald Kierzek, “we must put all means on the vaccination of people at risk” – France

The number of daily cases of covid-19 is exploding in France and already exceeds 20,000. You, usually so reassuring, are you now worried?

I do not like this reassuring word because it has been overused. From now on, you are considered to be reassuring, conspiratorial, alarmist, etc. I am a “pragmatist”. A doctor is there to appease, not to lie or panic. The first, second and third waves were waves of hospitalization. I hear the Prime Minister say “We are in the fourth wave”. No, we are in fear of a fourth wave. He uses a rhetorical formula to scare people. We are in a somewhat coercive pedagogy to convince people. We certainly have departments above the alert threshold (48 Tuesday, Editor’s note), but it is mainly young people who are affected. As for hospitalizations, things are not moving.

However, in Great Britain, the number of hospitalizations is now clearly increasing. In a few days, this could also be the case in France …

One thing is certain: there is an increase in cases which will inevitably spread outside the under-29 age group and spread among those most at risk.

Many scientists believe that all over 12s need to be vaccinated. You, you want to privilege the vaccination of only people at risk. Why ?

A figure quoted by the Prime Minister is very worrying: more than three million people over 50 years of age with co-morbidities are not vaccinated. If 10% of them are hospitalized, that makes 300,000 and it is problematic for the saturation of hospital services. There are three categories of people at risk: those over 50 with co-morbidities, all over 65 and obese of all ages. We must put all the means on them.

How do you get there since the incentive doesn’t seem to work and you don’t advocate obligation?

I would like there to be an obligation, but I think there is a legal problem in discriminating against people by their age. So we have to convince them, rely on the treating doctors and nurses, reassure them, tell them that the benefit-risk balance is, without possible discussion, in favor of vaccination. There are people who want to be vaccinated but cannot come to the vaccination centers. Buses are needed to pick them up, send mobile teams to vaccinate. If 95% of these people are immune, we are fine.

Can the health pass be effective in encouraging these at-risk people to be vaccinated?

No, I don’t think it is necessary. We do quantitative instead of qualitative. And I am against this freaked out and coped society.

If we do not vaccinate young people, they can transmit the virus to their older relatives who risk developing serious forms …

Of course, but you have a choice: either you try to vaccinate 100% of the population, or you say to yourself, I will try 100% of three million.

And doesn’t letting the virus circulate among young people increase the risk of new variants?

Talk to vets: when they vaccinate flocks in the midst of an epidemic, this is where the variants appear.

And, by vaccinating en masse and quickly, can we not speed up the virus and its ability to mutate?

No, it is on the contrary a pressure of selection. You introduce competition between the virus and the vaccine. We will have variants, anyway. We cannot prevent it, it has been the natural evolution of viruses for millennia. As soon as he begins to have barriers, whether people make antibodies naturally or because they are vaccinated, his job, to the virus, is to reproduce, to make mistakes, what we call mutants .

“If the health system is in danger of failing, then let’s dop it! “

You say that infected young people will not saturate the health system, but they are affected by sometimes serious syndromes such as long covid …

The long covid, we do not know what it is. There is still a lot to discover. These are somewhat autoimmune syndromes, we do not know what is linked to covid and what is not. We are not facing a problem of urgency and saturation of the health system. It is nevertheless a question of chronic care which will be fundamental.

Your second hobbyhorse concerns the strengthening of healthcare offers in the territory. How can this improve the management of the covid-19 crisis?

If the health system is in danger of failing, then let’s dop it! Let’s put a number of things in place so that there are local hospitals that can accommodate these patients. I am not talking about resuscitation but of early treatment, offering oxygen, cortisone, scanner, in order to avoid resuscitation. It is still a more positive speech, less anxiety!

Doesn’t the Health Segur provide an answer?

This is a salary increase, and again, which makes fun of nurses. These are display measures and none are structural to densify the hospital fabric and the offer of care in the territories. Local hospitals have been unraveled, and small emergency or emergency services have closed. Everything is now focused on the big centers.

Vaccination has been made compulsory for caregivers, isn’t this a good way to fight against clusters in hospitals?

With us, the whole team is vaccinated. I am embarrassed by the words of carers’ guilt: we have gone from heroes to the guilty. Even with all caregivers vaccinated, hospital clusters can still happen: an infected patient can spread throughout the hospital.

We still greatly limit hospital cases by vaccinating all caregivers, right?

Of course, I never said I was against caregiver vaccination. I am for incitement, conviction and against obligation. In March and April 2020, we told them: “You’re positive, you’re going back to work”. They have it a little bad now …

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