It has been almost a month since Professor Manuel Etienne had taken a day off. Like many caregivers currently, he is mobilized full time around the health crisis at the University Hospital Center (CHU) of Rouen completely reorganized to cope. He takes stock.
What do we know about the virus ?
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Manuel Etienne : “He is responsible for respiratory infections that can be trivial and minimal – and lead to rhinitis, pharyngitis – or severe with respiratory distress. On transmission, this is done by salivary droplets (postillons …) and by contact, not by micro-particles suspended in the air. ”
Containment and barrier measures are effective ?
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“The containment is positive and should help fight the spread of Covid-19. It worked in China. ”
How is the hospital organized today ?
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“During one of the last press briefings
(Editor’s note: March 5), we had a dedicated unit. There we are three open but not filled. We currently have around thirty confirmed patients and three in the intensive care unit. The number of patients is gradually increasing. This is also due to the fact that the hospital stay is longer, about fifteen days, than for, for example, the flu (ten days). It has taken more work in recent weeks to organize the hospital. It is not saturated but you have to be ready to welcome 200 to 300 people who, and this is the specificity, have the same pathology, with 30 to 40 entries per day. It was therefore also necessary to provide training for caregivers who are not usually in these specific units. Hence the need to de-schedule non-emergency operations to free up caregiver time and have plenty of reinforcements from all the other services. We must also welcome everyone’s solidarity. ”
How did hospitals in the Grand Est find themselves overwhelmed ?
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“The answers have been adapted. At the beginning, it was a bit abstract because it was in China, it was far away. It became more real with Italy. Mulhouse and Colmar found themselves in dramatic situations because they had too many patients too brutally and, there, we can no longer provide the care as it should be. Today, at the CHU, we are in a situation where we can welcome patients coming from these hospitals in solidarity. ”
Why has the situation become dramatic in these regions ?
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“Because they had less time to prepare compared to the Italian situation. And it is well known that the hospital operates in a very tense way on a daily basis. It was a bit brutal as a request for effort in these regions, especially since people who did not need to be in the hospital ended up there, causing a flood of cases, non-serious and serious . ”
Can the CHU today cope ?
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“I hope so and we are working on it. We will remain modest and cautious until the wave of cases has arrived in Normandy. ”
When is it scheduled ?
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“There is a forecast of an increase in the epidemic in Normandy by the end of next week. But be careful, because epidemiologists do not know how to see the impact of containment. ”
What about a treatment, a vaccine ?
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“For treatment, we still know very little. A few leads, including things that are not publicized but not trivial, but nothing that has not yet been proven in patients. Nothing convincing. Afterwards, we know that many cases improve with natural defenses, paracetamol and oxygenation. For a vaccine, there is no hope in the very short term. ”
Can the hospital continue to receive other urgent pathologies ?
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“Yes, the emergency is of course maintained, hence the interest of reorganizing the hospital with areas of high viral density – to avoid contact of patients affected by Covid-19 – and that of low density viral. ”
And on the equipment side ? We always talk about the lack of masks for example.
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“It is a sensitive issue. We have some. But we know the national tension on stocks so we cannot count on a massive supply. So it’s about rationalizing usage. Primary care providers use them according to the usual recommendations. On the other hand, for those who are a little more distant, in areas of low viral density, you may be asked to keep it for the day. Until we have a vision, it’s about being thrifty. ”
Solidarity around caregivers, applause in the evening, what does that inspire you ?
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“It supports us!” When you’re tired, stressed, it helps. We feel like sportsmen! ”
Eighth death in the region
A 73-year-old woman hospitalized since March 5 at CH d’’Elbeuf died of Covid-19. This brings to 8 the number of people who have died in Norman hospitals since the start of the epidemic, including 1 person from another region, now counted in their region of origin. Since February 24, 345 people have tested positive at Covid-19 in Normandy, including 58 new cases: 128 in Seine-Maritime (including 19 new cases); 40 in Eure, (including 4 new ones); 63 in the Manche (including 16 new ones), 99 in Calvados (including 14 new ones) and 15 in the Orne (including 5 new ones). As of March 21, the Regional Health Agency (ARS) identified 98 people hospitalized: 61 in Seine-Maritime, 7 in Eure, 17 in Manche, 9 in Calvados and 4 in Orne. On the controversial issue of masks, the ARS specifies that ” national stock is being delivered and distributed “
While the peak of the epidemic is expected in several days, the estuary hospital at Haven, the private establishment managed by Ramsay Santé, says it is ready to face the crisis. ” We have strengthened our continuous monitoring unit with 8 beds, which means that we can carry out a resuscitation mission, which we did not do until now, thanks to anesthetists and specific devices. “Said director Stephan Vales last night.
As for the Le Havre Hospital Group, it launched yesterday, already with some success, a call for donations (masks, gel, food) and free accommodation for nursing staff in Rouen. Write to [email protected].
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In hospitals, their funny war
On Facebook, young nurses from the same class are trying to stay in touch. And to share in these troubled and frightening times for these caregivers who have been in service for six months.
“ It has never been so calm. For now, Covid patients are coming in a dropper “, slides a nurse from the CHU into Réa. ”
Strength and honor, we are good nurses “, claims a private caregiver on the same Facebook page.
White plane
Since the passage of the hospitals in white plan, at the end of last week, everyone is on the war foot. A strange war, until now in Normandy facing an almost invisible enemy. Monday at the CHU
Roueneveryone is talking about possible containment.
“ Everyone knows someone who knows someone “, slips a caregiver.
“ Rumor swells : containment measures will be announced this evening. There is talk of a curfew at 6 p.m. h, forty-eight hours to choose his place of confinement, exit permits as appropriate. ”
Officially, nothing corroborates the rumors: the CHU employees do not even know if the self is open. At the same time, the wearing of masks has been generalized. The caregivers wear it conscientiously and the supply seems to go smoothly.
The deprogramming of non-urgent care desired by the Ministry of Health is effective and visits are now prohibited.
“ The last visitors are informed of this protection measure and are very understanding. “
On Tuesday, the first day of confinement, everyone continues to prepare: anticipate the presence of caregivers on the necessary equipment. Social distancing measures have also been implemented in places such as the self-service, the pharmacy: on the ground, adhesive tapes mark the famous meter.
Certificates, which will allow you to go to work without worry, are at the center of
conversations.
No information or instructions from management. Employees are concerned about how they are going to have to deal with law enforcement. In the rooms, between exits and deprogramming, the number of patients tends to decrease. The staff remains mobilized and motivated.
Communication
and difficult coordination
On Wednesday, activity is decreasing and
preparing for war against the virus
continues at each level but communication remains difficult and coordination is complicated.
Work continues as usual with hospitalized patients. The excitement due to the exceptional situation does not affect everyday life. Everyone carries out their missions even if one keeps in mind that this daily life is fragile and seems to be able to change at any time. AT
Fecamp, the trainers from the nursing institute closed the school and joined the caregivers. At
Haven, it’s the pediatric interns who help regulate the Samu’s call center.
In Rouen, on the third day of confinement, the streets are deserted, public transport almost empty. No control in sight. Faced with the invisible enemy, we start the day with an essential question: do we have patients with the virus, here or in other departments? Yes, but not as much as you can read here or there. The coming new day promises to be “normal” but everyone remains mobilized, ready to welcome many patients with the virus.
Each sector is preparing, we see new markings appear on the ground, surely in connection with this invisible health war but without understanding its meaning. A kind of Maginot line
Virtual.
Good news, parking has become free for caregivers at the Rouen University Hospital. In the evening, at 8 p.m., the Rouennais begin to show their support for the caregivers with applause. Not all. On returning home, a nurse found a message under his door:
“ We know you work at the hospital, we ask you to be careful in the common areas and if possible find a (Editor’s note: other)
housing during the crisis. “ Truly a funny war.
It’s in the air. To marvel at the carefree lightness of a butterfly, to be astonished already by these hands which clench in our series of yesterday. From before. In this issue, which was necessarily produced under special conditions, we wanted to capture the raw reality of eighteen Normans, whose daily life was invariably disrupted this week by the impact of the crisis we are experiencing (pages 6 to 11). Less anonymous and more privileged, eight regional personalities from the world of culture and business also offer advice on confinement, to escape, flee from boredom and anxiety (pages 26-27). Or not.
Because some people first evoke the urgency of interpreting this moment in the imminent metamorphosis. In understanding the urgency of another way of living together, in its environment. To come out alive, but also different. Then it will be time for our spring.
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