Covid-19 and vulnerable people: 7 high-risk diseases

Among those vulnerable to covid-19, patients who suffer from 7 chronic diseases are considered particularly vulnerable. We tell you what these diseases are.

A scientific interest group (called Epi-Phare), made up of the National Health Insurance Fund and the National Medicines Safety Agency (ANSM) carried out an almost exhaustive analysis of the data of the French population, i.e. more of 66 million people, to identify chronic diseases and factors such as age or gender that may present an increased risk of hospitalization or death for Covid-19.

During the first wave of the pandemic, scientists studied the link between 47 chronic diseases and the risk of developing a severe form of covid. During this period, just over 87,800 people were hospitalized for this pathology, of which 15,660 died in hospital. Not surprisingly, this study cconfirm that the elderly are the most vulnerable to the virus. Compared to 40-44 year olds, the risk of hospitalization is doubled in 60-64 year olds, tripled among those aged 70-74, multiplied by 6 among those aged 80-84 and by 12 among those 90 and over.

An even greater risk for death: it is multiplied by 12 among those aged 60-64, by 30 among those aged 70-74, by 100 among those aged 80-84 and by almost 300 among those 90 and over.

The study also confirms that men are more at risk hospitalization and death for Covid-19 than women, multiplied by 1.4 and 2.1 respectively.

Who are the most vulnerable patients?

But the scale of this study also made it possible to determine who were really the most vulnerable people to covid-19. These are the ones who suffer from one of the following 7 pathologies:

  • Trisomy 21 : 7 times more risk of hospitalization and 23 times more risk of death
  • Retard mental : 4 times more risk of hospitalization and 7 times more risk of death
  • Cystic fibrosis : 4 times more risk of hospitalization and 6 times more risk of death
  • End-stage chronic renal disease on dialysis : 4 times the risk of hospitalization and 5 times the risk of death
  • Active lung cancer : 3 times more risk of hospitalization and 4 times more risk of death
  • Kidney transplant : 5 times more risk of hospitalization and 7 times more risk of death
  • Lung transplant : 3 times more risk of hospitalization and 6 times more risk of death.

Who are the vulnerable people who can be kept in partial employment?

The decree of 5 May 2020 provided for an exceptional compensation scheme for vulnerable employees at risk of developing a serious form of Covid-19 infection. These precautions allow the most fragile not to take the risk of exposing themselves to the virus in the absence of treatment. But on returning from the summer holidays, a new decree published in the Official Journal of Sunday August 30, modified the criteria for identifying vulnerable employees and reduced the list of people who can request to be placed in partial activity.

October 15, a prescription of the summary judge of the Council of State pronounced the suspension of these restrictions. The judge considered “that the choice of pathologies which were kept as eligible compared to the decree of last May is not coherent nor sufficiently justified by the Government”. Finally, the decree defining the list of vulnerable people was published on November 11, 2020.

According to this new decree, are considered vulnerable people who are in one of the following situations:

  • Be 65 years olds and more.
  • Have a history of cardiovascular disease : complicated arterial hypertension (with cardiac, renal and vascular complications), cerebrovascular accident or coronary artery disease, history of cardiac surgery, cardiac insufficiency.
  • Have unbalanced diabetes or having complications.
  • Have a chronic respiratory pathology likely to decompensate during a viral infection: obstructive pulmonary disease (the disease that killed the singer Christophe), severe asthma, pulmonary fibrosis, sleep apnea syndrome, cystic fibrosis in particular.
  • Have kidney failure chronic dialysis.
  • Suffer from progressive cancer under treatment (excluding hormone therapy).
  • Present with obesity (ie a body mass index (BMI)> 30 kgm2).
  • Suffer from immunosuppression congenital or acquired.
  • Have cirrhosis Child Pugh score stage B at least.
  • Have major sickle cell syndrome or have a history of splenectomy.
  • Be in the 3rd trimester of pregnancy.
  • Have motor neuron disease, myasthenia gravis, multiple sclerosis, Parkinson’s disease, cerebral palsy, quadriplegia or hemiplegia, primary cerebral malignancy, progressive cerebellar disease or a rare disease

A new criterion to benefit from partial activity

But to be placed in partial activity, vulnerable people must meet a second cumulative criterion, which is “not to be able to use telework completely, nor to benefit from reinforced protection measures”. These protective measures are as follows:

  • Isolation of the workstation, in particular by providing an individual office or, failing that, its layout, to minimize the risk of exposure.
  • Respect, in the workplace and in any place frequented by the person during their professional activity, of reinforced barrier gestures.
  • The absence or limitation of workstation sharing.
  • Cleaning and disinfection of the workstation and the surfaces touched by the person at least at the start and end of the shift.
  • Adaptation of arrival and departure times and any other business trips, in order to avoid rush hour.
  • The provision by the employer of surgical-type masks in sufficient number to cover journeys between home and the workplace when the person uses collective means of transport.

If these protective measures cannot be ensured, the employee may request to be placed in partial activity, upon presentation to the employer of a certificate drawn up by a doctor. In the event of disagreement with the employer, he refers the matter to the occupational physician, who decides by calling upon, where appropriate, the multidisciplinary occupational health team.

If you live with someone who is considered vulnerable : teleworking should be encouraged as much as possible.


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