Coronavirus: For this Vaudois clinic, everything has changed – Vaud & Regions

Here, the intensive care professionals are protected from head to toe by integral white coveralls, like cosmonauts. The entire staff of the La Source Lausanne clinic is masked to stop the spread. The clinic – which receives patients with private as well as basic insurance – has opted for maximum protection measures. Twenty employees are affected out of 580; management says they are fine.

To read: Intensive care in the eye of the storm

The first Covid-19 patient arrived at Intensive Care on March 20. Today there are four of them, hospitalized in a unit created especially for the coronavirus eleven days ago to protect the rest of the establishment.

Very fragile patients

Let’s enter this sensitive sector, duly equipped. The atmosphere is calm and applied. No frenzy during our visit but attention at all times for these patients. He will soon be able to leave acute care. This other, behind the wall, is being weaned from the fan. A third, unconscious, is struggling to get out of his respiratory distress. No deaths have been reported yet.

Among patients infected with SARS-CoV-2 who have developed pneumonia and require intensive care, some are more unstable than others. Private establishments in Vaud such as La Source take care of lighter cases, just to free up beds and forces at the CHUV. They are sent by the university hospital as part of a collaboration set up in good intelligence. The “intensivists” on both sides know each other well. “In times of crisis, there is no public-private separation,” said managing director Dimitri Djordjèvic.

The cases hospitalized here remain very serious, said Dr. Carlotta Bagna, head of the unit. “They are difficult, unstable, fragile patients. It’s hard to predict how the disease will progress. ” “It has been a long time since I have seen such fragile intubated patients,” said one nurse. It’s very complicated to turn them, wash them, massage them… ”An intensivist doctor is now sleeping on site.

The special coronavirus unit was set up in a few days with an imperative formulated by doctors: to absolutely separate those affected by the virus from the rest of the population. “I am proud of what has been done here,” said Dr. Bagna. Condemned access, new changing rooms for caregivers, door leading to the parking lot for ambulance arrivals, “Normal” intensive care moved to a lower floor… It was necessary to reorganize the entire patient flow to separate the departments. Civil Protection members filter the entrances; nursing students helping teams. In front of emergencies, a temporary structure allows people with symptoms to be tested.

“Who knows if it will be enough?”

The clinic’s Intensive Care capacity has almost tripled. Today, it has 10 beds equipped with respirators dedicated to Covid-19 * patients (4 of which are currently occupied). “A priori, that’s enough, but who knows?” comments Dr. Bagna. The anesthesia respirators were repatriated to the special unit. Right now, no need to find machines elsewhere.

The same is not true of certain protective equipment. Mask stocks have been replenished, but the famous full-length suits are being distributed drop by drop. “We avoid going to the bathroom because we should throw them out and put in a new one every time,” said one nurse. Increased hardship for caregivers, already under constant stress.

Also read: Follow the situation of the Covid-19 pandemic in figures and graphs

At La Source, as in all hospitals, some caregivers are overwhelmed while others find themselves unemployed (see box). Management is looking for the profile that everyone is working on right now: the nurse specialized in intensive care. “We made a request to the state,” said the director general. The anesthesia nurses were reassigned to the Covid sector.

In addition to the respirator, La Source uses the same therapeutic arsenal as the CHUV and many Swiss hospitals (see opposite). Three drugs whose effectiveness is not yet proven but which present beneficial signals are administered: Kaletra (antiviral used against HIV), Plaquenil (the famous hydroxychloroquine) and Remdesivir (used to treat Ebola). “It is impossible, with only four patients, to draw conclusions about their effectiveness,” says Dr. Bagna. Like the rest of the profession, it awaits the results of the first scientific studies.

* Plus 4 non-Covid-19 intensive care beds.

Testimonials

“My 3-year-old son said to me, ‘Mom, are you sick?’

Dr. Carlotta Bagna, Head of Intensive Care, The Source, Olivier Vogelsang

My first feeling was of fear when I saw what was happening in Lombardy and these hospitals on their knees (note: Dr. Bagna is of Italian origin). I know the quality of the health system there. It was all the more worrying.

Then the anxiety turned into a feeling of awareness and above all into a will to act to defend the community and the teams. The Covid Unit project was launched at The Source.

Since the arrival of the first patient, I have been more relaxed. With family too, it’s easier. Before, I worked on this project from morning to evening; I was quite absent. I have two small children, my husband teleworks. As soon as I saw that the house was driving without me, I was able to dedicate myself to setting up a Covid sector.

My 3-year-old son asks me every morning, “Mom, are you sick?” It breaks my heart. Of course my family is worried. I reassure them by telling them that catching the coronavirus in the coronavirus unit, equipped as I am, is much less likely than catching it at the Coop or Migros. And I say to my son, “Don’t worry, mom is strong, she won’t be sick.”

It is clear that I am sacrificing my private life quite a bit during this period but, ultimately, I do nothing more than fulfill my mission as a doctor and respect the Hippocratic oath.

It must also be said that these patients are difficult, medically and socially speaking. They can never be with their loved ones. This situation is heavy to bear for them but also for the teams who are in close contact with families and their suffering.

“We are applauded, but our job was also painful before”

Séverine Louis-Chioetto, intensive care nurse, La Source.Olivier Vogelsang

I have been working for twenty-four years and I did not expect to live anything like that. I feel safe at work; we have the equipment we need. But on a human level, it’s something else … The patients we receive arrive intubated, we can’t talk to them and we don’t know anything about them. Families cannot see them.

I arrive at 7 a.m. at the clinic and leave at 8 p.m. In terms of fatigue, I am preparing for difficult weeks. It’s intense but people forget that it’s our daily life. When I hear applause, I say to myself: this is our job and it was also painful before! Recall that the initiative “For strong nursing care” has not passed (note: it aimed to hire more qualified nurses to ensure quality care). Nurses shouldn’t be seen as heroines just because there is the coronavirus.

What stresses me the most is the behavior of people outside. There are too many, I think. It’s heavy for me to see people who break the rules.

I hate going to the supermarket. I’m more comfortable working than shopping. Many young people have not realized that it is not only their grandparents who can be affected.

My husband is in the funeral home; he also works a lot. We’re lucky: my sister takes care of my 6-year-old daughter. I find it very hard for her to be confined, not to see her friends. I wonder a lot about the future of these children. Will the epidemic repeat itself? Are they going to have to live with it?

Created: 04.04.2020, 08h14

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