PRESS RELEASE

06 December 2022

FLASH AUDIT

TRACING THE CONTACTS OF PEOPLE INFECTED WITH COVID-

19:

THE

HEALTH

INSURANCE

ORGANISATION

HIGHLY

INVOLVED, UNCERTAIN EFFECTIVENESS

Between 2020 and August 2022, 34.5 million cases of Covid-19 contamination were

identified in France (excluding the results of self-tests). More than 150,000 people died, of

which almost 126,400 were in hospital. Contact tracing, deployed from May 2020 after the

first lockdown, is one of the tools for combating this epidemic. It consisted of contacting by

telephone, SMS or email, the people who tested positive so that they could identify the

people with whom they had been in contact, and then contacting them to inform them -

while preserving the anonymity of the positive individuals - and to give them prevention

instructions. Since its introduction, the health insurance organisation has reached more than

32 million people tested positive for Covid-19 and almost 22.7 million contact persons.

The involvement of the health insurance organisation in an unprecedented, large-scale and

evolving public health mission

In an emergency, the health insurance organisation

1

created this information system, set up

departmental platforms of investigators, recruited thousands of fixed-term and then

permanent contract workers, and continuously adapted its system. Since May 2020, the

organisation has reached more than 32

million people who tested positive and almost

22.7

million contact persons, first by phone and then mainly by SMS or email. In total,

expenditure on contact tracing, particularly on personnel, could exceed €600

million for the

years 2020 to 2022.

Overall effectiveness uncertain

Without contact tracing, it is likely that contaminations would have been more numerous or

rapid and the impact on hospitals greater, but these impacts cannot be quantified in the

absence of scientific assessment.

More than nine out of ten people who tested positive or were

reported to the health insurance organisation as contact cases were reached, and more than

90% of the positive people reached were reached within 24 hours of the test result. However,

1

Caisse nationale d’assurance maladie / Cnam

only 70-80% of the contacts were reached within 24 hours of being identified. Only a fraction

of contact persons could be identified - on average, one out of every two persons who tested

positive did not report any contact persons in 2020 and 2021. Successive waves of epidemics

have increased the workload of the health insurance organisation and have therefore led it to

lighten the procedures for tracing contact cases, which has significantly reduced their impact.

Indeed, sending SMS messages to positive people inviting them to report their contacts on a

website resulted in fewer contact reports than telephone calls. Thus, in the first half of 2022,

almost 90% of the positive persons reported no contact.

A scheme on the verge of extinction, lessons to be learned

Vaccination has become the main instrument for fighting the epidemic, while contact tracing

now only records a small proportion of contacts (less than 0.5 on average per positive person

in July 2022, compared with almost 2.5 in November 2021). The law of 30 July 2022 putting an

end to the exceptional systems created to combat the epidemic linked to Covid-19 leads to the

interruption of this scheme on 31 January 2023. The number of staff dedicated by the health

insurance organisation to contact tracing has been drastically reduced (350

FTEs of fixed-term

and permanent contracts in September 2022, compared with an average of 6,500 in 2021).

However, it seems essential that the tools, procedures and learning effects of contact tracing

be developed for the future. In the event of new large-scale epidemics, the public authorities

should be able to rapidly activate an operational and more effective system pending effective

vaccination coverage. Thus, the Court recommends that, on the basis of a scientific assessment

of the impact of contact tracing on the Covid-19 contamination chains, a crisis mechanism can

be activated and then deactivated within a short timeframe in order to break these chains.

Read the report

PRESS CONTACT:

Julie Poissier

◼

Head of Press Relations

◼

T

+33 (0)1 42 98 97 43

◼

+33 (0)6 87 36 52 21

◼

julie.poissier@ccomptes.fr

@Courdescomptes

ccomptes

Court of Accounts

Court of Accounts