Minister outlines French measures to tackle Ebola virus

Ebola briefing – Speech by Mme Marisol Touraine, Minister of Social Affairs, Health and Women’s Rights

Paris, 10 October 2014

(Check against delivery)

Directors-General,

Ladies and gentlemen,

I wanted to provide a very detailed update on how France is organizing itself in the face of the Ebola epidemic.

This epidemic, which is hitting West Africa very hard, is serious, very serious. We’re having to combat a massive and unprecedented epidemic which has already affected more than 8,000 people and killed almost 4,000. These official figures are probably underestimates.

For months, I’ve been preparing our health system to handle patients infected by the Ebola virus, should any cases arise. We had to do so recently for a young Médecins Sans Frontières [Doctors Without Borders] nurse.

At this time, no other Ebola patients are being treated in our country.

Since the start of the epidemic, 11 patients have undergone biological testing to determine if they have the Ebola virus or not. All test results were negative.

This procedure was used last night in a case that has been reported in the press. Just a few moments ago, the test results ruled out any possibility of Ebola.

In the current context, in which an initial case has been identified in the United States and a nursing assistant was contaminated in Spain, everything must be done to avoid raising or spreading concern in our country. From the outset, I wanted to be transparent. And this requirement will continue to guide my action, because transparency is a key condition for trust.

I want to be very clear about the principles behind this message. No comment will be made regarding possible suspected cases. At the same time, if a case is confirmed, I pledge once again to inform the general public through you. Furthermore, all communication will be at the central level of the Ministry and not at the level of the regional health agencies.

I would like to thank you for the responsibility you are demonstrating in covering these events, as I’ve been able to appreciate once again over the last few hours.

In the face of the spread of the epidemic, in the face of the emergence of cases in certain Western countries and in the face of the worry that may grip our fellow citizens, it seemed to me essential to respond to the questions you may have in a fully transparent manner.

Above all, let me remind you that:

- It’s in West Africa that the epidemic is spreading;

- Our primary responsibility is to help Africa to combat the epidemic;

- France is assuming this responsibility.

The French President personally vowed to demonstrate our country’s solidarity with the West African countries particularly concerned.

France will set up an Ebola treatment centre with 50 beds in Macenta in the forest region, in principle for nine months.

The centre will operate in collaboration with Médecins Sans Frontières and the French Red Cross. I would like to draw your attention to the fact that the President has chosen to intervene where we’re needed most. It’s a difficult area to access, right in the middle of the forest, which poses considerable logistical challenges. The President’s commitment is unwavering and resolute.

A large number of French volunteers, identified by the Health Emergency Preparedness and Response Agency (EPRUS), have left or are ready to leave for missions in the region lasting several weeks. Ultimately, 20 to 25 experts will be in the region for a period of several months.

The health professionals working on the front line in the region are paying a heavy price for this epidemic. They are exhausted and face very high risks. Among healthcare workers, 395 cases have been identified and 216 people have died.

We repatriated a young volunteer nurse from Médecins Sans Frontières in Liberia very quickly. She received excellent care at Bégin Hospital. The healthcare teams in that hospital demonstrated the highest level of professionalism.

The nurse was able to fight the disease; she was in good spirits and had confidence in our country’s health system. She received several experimental treatments. I wish her all the best in her recovery at home with her family and pay tribute to her courage and commitment.

All healthcare professionals who treated her are being regularly monitored.

We immediately took measures to protect our fellow citizens, notably those most at risk who are living in or travelling to areas affected by the epidemic. French residents, humanitarian workers and travellers are receiving advice.

I want to emphasize once again that travel to the affected countries is strongly discouraged. I want to stress this. In order to reinforce the travel information, travellers are provided with documents when they board their departure and return flights.

A written procedure was circulated on 6 August to all airlines and airports, in collaboration with the Directorate-General for Civil Aviation.

Since the situation is evolving, tighter controls could be introduced for departures and arrivals in the next few days.

I want to repeat that all those travelling to the area must register with our diplomatic posts or on the Ministry of Foreign Affairs’ Ariane website, so that we can monitor them and contact them again if necessary. On their return these individuals must monitor their temperature for three weeks.

A person who does not have a fever is not contagious.

A person who has a fever in the three weeks following their return from a country affected by the epidemic should not consult a doctor or go to the emergency department, but must immediately dial 15; the situation will be assessed together with the Health Monitoring Institute.

I have reiterated to all healthcare facilities in our country the measures to be taken in the event of a suspected Ebola case. In April, the Directorate-General for Health raised the alert level of CORRUSS (Operational Centre for Emergency Health Response and Regulation) and the “ORSAN Bio” plan was activated. This relates to the health system’s response to the risk of an epidemic.

On 1 August, I reiterated to the directors-general of the regional health agencies and to the préfets [senior regional and departmental civil servants] the measures to be taken in the event of a suspected case. A new message was conveyed to hospitals which included the recommendations of the High Council for Public Health and the group of experts focused on the “coordination of the epidemic and biological risk” (COREB).

The French Health Monitoring Institute (InVS) is on high alert and is coordinating the alerts. In practical terms, following each alert, the InVS conducts a detailed analysis with further examination to determine if there is any exposure to risk or not. Two situations, and only two situations, are then possible:

- the examination immediately removes all doubts. This is what happened yesterday evening in Cergy-Pontoise;

- the possibility of Ebola cannot be ruled out, and in this case the patient is immediately placed in isolation and biological tests carried out. That’s what happened last night in Bichat.

I repeat once again that only 11 cases, including the case in Bichat, have required tests; all test results were negative.

Bacteriological analyses are then carried out by the National Reference Centre for Viral Hemorrhagic Fevers in Lyon, which operates seven days a week, 24 hours a day. This is a highly secure laboratory.

In terms of treatment, in cases where Ebola has not been ruled out or has been confirmed, the patient must be hospitalized in a reference healthcare facility. The patient will be transferred by mobile emergency medical staff equipped with protective suits. Biological testing and the level of contact must be kept to an absolute minimum. An EPRUS medical team is standing by with two isolation units in order to repatriate patients or bolster French facilities if required.

There are 12 reference centres. These are the university hospital centres of Bichat, Necker, Lyon, Lille, Strasbourg, Marseille, Bordeaux, Rennes, Réunion, Rouen, Nancy and the Bégin Military Hospital.

All these hospitals have been assessed and inspected. They are operational and are on pre-alert to provide high security facilities for infectious disease isolation (23 beds) or resuscitation (18 beds).

The Bégin Military Hospital will treat Ebola patients repatriated from Africa.

On 18 September, after consultation with the General-Directorate for Health, the French Agency for Medicine and Healthcare Product Safety and INSERM experts, I authorized access to innovative treatments and authorized prescribers to use, where necessary, four experimental drugs: TKM (Canada), ZMabs which is close to ZMapp (which is also authorized but currently unavailable) and Favipiravir (Japan). During this major crisis, research is making huge advances and France is playing its full role in this.

In order to ensure a strong coordinated response to the epidemic, the government has established an interministerial task force. Within this task force, I have appointed Professor Thierry Debord to manage the healthcare section.

In order to ensure that we provide our fellow citizens with comprehensive and transparent information, I have decided that a weekly briefing will be given here at the Ministry, under the responsibility of the Director-General for Health, in the presence of all national agencies and bodies involved in these measures. The first briefing will take place on Thursday.

Furthermore, I decided to set up a freephone number to provide information to the public. It will be activated at 9.00 a.m. tomorrow. The number is 0800 13 00 00.

In addition, from the beginning of next week the Ministry’s website will include a section devoted to the Ebola epidemic. It will include all of the relevant information for the general public as well as for hospital and private practice healthcare professionals.

Regular updates will be provided to all healthcare professionals. As of today, all doctors will again be informed through the AMELI health insurance network and the medical associations.

Thank you. I am available, together with my Ministry’s officials, to answer your questions./.

Ebola virus – Reply by Mme Marisol Touraine, Minister of Social Affairs, Health and Women’s Rights, to a question in the National Assembly

Paris, 8 October 2014

Africa is severely affected, and the toll is getting worse by the day. More than 8,000 people have already been affected, and there have been 4,000 deaths. This toll is no doubt an underestimate. So France is sending significant resources to Africa to help combat the illness wherever it is killing a lot of people. Cases have been identified in the United States, and a health worker has been contaminated in Spain. In this context, concerns are likely to arise, and I’m mindful of them. I want to tell you as transparently as possible: as I speak, there are no Ebola cases on French territory.

Zero risk doesn’t exist, and that’s why we’ve been mobilized for months. We’ve identified 12 university hospital centres capable of taking charge of patients in maximum security conditions, as the young nurse was at Bégin hospital, and I welcome her recovery. The professionalism of the medical teams at Bégin hospital was absolutely outstanding. We put the Health Monitoring Institute’s network – which operates 24/7 to answer health professionals and identify possible situations of concern – on heightened alert. We’re mobilized. Full information will be provided and there will always be full transparency, as was the case with the young nurse who was treated. We’re mobilized./.

Published on 21/10/2014

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