Containment affects most administrative services in France – which rely on dematerialization to liaise with users. The post office is not spared. The company formerly administered by the French state became a public limited company in 2010.
The La Poste group also remains responsible for four public service missions, including the mission of the “universal postal service”, which includes in particular the collection and distribution of mail and parcels carried out six days a week throughout the national territory. affordable prices for all users. This role of provider of the “universal postal service” has been confirmed. by the law of February 9, 2010 for a period of fifteen years, i.e. until 2025.
This public service mission is now seriously affected by the health crisis. Everywhere in France, mail collection and distribution are no longer provided, sorting centers slowed down, post offices closed. These delays are particularly worrying for another service, overlooked: the national newborn screening program.
Newborn screening, a health issue
Newborn screening in France concerns all births, i.e. each year, approximately 750,000 newborns. Screening tests can detect certain diseases that are not visible at birth, but which can have serious consequences in affected children if they are not treated very quickly. Five diseases are currently screened : phenylketonuria, congenital hypothyroidism, congenital adrenal hyperplasia, cystic fibrosis and sickle cell disease.
Without screening, the child may not be recognized as potentially ill and may not be treated in a timely manner. The results of this screening are thus very important. In fact, children with one of these five diseases benefit from support and treatment from their first weeks of life. This very early care allows most of these children to grow and develop normally.
In 2019, like every year, nearly 1,000 children were confirmed sick after a “positive” screening and were thus able to benefit from effective and adapted care, avoiding premature death, disability or developmental delay.
La Poste, a key player in the sanitary circuit
Newborn screening, strongly recommended, is based on a sample of a few drops of blood, performed on the 3rd day after birth, by pricking the child’s heel and collected on a blotting paper, after parental consent, by a health professional. from the maternity ward (nearly 500 maternity hospitals), or sometimes by the midwife during an early return home.
The blotters are then placed in envelopes and then routed, in principle, by post to the Regional Center for Neonatal Screening (CRDN) or, when there is one, by a shuttle system between hospitals. The analyzes are then carried out by one or more medical biology laboratories. It is here that stopping or delaying the delivery of blotters by La Poste endangers neonatal screening and the health of the children concerned. The speed with which the tests are carried out, a few days for some of the diseases detected, depend on the consequences on the health of the affected children.
France would have taken a certain delay before applying newborn screening measures, France Culture, 2019.
From the first alerts to the solutions implemented
From March 17, the CRDNs alerted by email and direct contacts the regional health agencies and the National Center for the Coordination of Neonatal Screening (CNCDN): blotters no longer arrive in usual numbers at CRDNs.
There are many reasons for this: mailboxes not collected, exercise of a right of withdrawal for teams from a sorting center, non-distribution of mail from the sorting center.
The CNCDN and the services of the Ministry of Solidarity and Health intervened, separately and then during joint meetings, at the national level with the La Poste Group, to try to resolve the problem. After a week of discussions, Le Groupe La Poste has however confirmed the absence of a possible and lasting solution through the usual postal circuit.
The use of “private” mail transport providers could be possible but this will not be effective without implementation delay or without additional cost (from a few cents to several tens of euros per envelope).
The voluntary displacement of health professionals? They will then have to bring the blotters from the maternity wards or from the midwifery offices to the CRDN, adding tasks during this epidemic period. The requisition of postal staff? Is it legally possible, operationally feasible and politically acceptable?
The unwavering involvement of healthcare professionals
The difficulties encountered underline the importance of coordination and complementarity between all actors, caregivers or non-caregivers. In an emergency, at the end of March 2020, the CRDNs and health professionals are looking for and put in place, at best, territory by territory, maternity by maternity, solutions for the routing of blotters, numbering 60,000. each month. It is a question of both “catching up” with the blotters blocked during the last few days and “organizing” a new robust and exhaustive distribution circuit of the blotters for the weeks to come.
For the time being, thanks to the involvement of health professionals and the great solidarity of the health world, most newborns have been able to benefit from these screenings, but we must be vigilant to maintain this system at all costs.
Once the COVID-19 epidemic has been brought under control, all the lessons should be learned. This is all the more necessary as the extension of newborn screening to new diseases is already engaged for a sixth disease and recommended for seven other diseases, for a total of 13.
This article was written with Professor Frédéric Huet, CHU Dijon Bourgogne, President of the French Society for Neonatal Screening (SFDN), Dr. David Cheillan, Hospices Civil de Lyon, President of the National Commission for the Biology of Neonatal Screening, Dr. Diane Dufour CHU Tours, National Center for the Coordination of Neonatal Screening (CNCDN), Dr Paul Brégeaut, CHU Tours, National Center for the Coordination of Neonatal Screening (CNCDN).
Emmanuel Rusch, Director of the Health, Ethics Education research team (EA7505), University of Tours This article is republished from The Conversation under a Creative Commons license. Read the original article.