Covid-19 in Ile-de-France: the inexorable rise in intensive care patients

“We are no longer in an alert mode but in a maximum tension mode with the prospect that during the week we will exceed the ceiling of patients known during the second wave”, warned Aurélien Rousseau, the head of the ARS, on Sunday. (regional health agency) of Ile-de-France, in an email addressed to hospital managers. The figures speak for themselves and worry: it took 10 days for the number of Covid patients in intensive care to drop from 805 to 900 (from February 24 to March 5). But only five short days for the curve to take off and today reach 1032 patients in a vital emergency.

A symbolic number, but not only. “On average, in normal times, Ile-de-France has between 1,100 and 1,150 intensive care beds,” explains David Heard, communications director of the ARS Ile-de-France. This means that the number of Covid patients occupies, in theory, almost all of the available resuscitation beds. “However, emergency response services are intended to accommodate vital emergencies, all causes combined. They must be able to absorb the victims of a train derailment or a Bataclan, ”he recalls.

“Go find beds elsewhere”

If the number of Covid patients is today very close to the peak of the 2nd wave (1138 on November 5), there is nothing to say that it is about to go down, on the contrary. With the English variant, ultra-contagious, progress is panicking. “With regard to the curves, we are able to estimate, in particular from the incidence (Editor’s note: number of positive coronavirus cases per 100,000 inhabitants), the needs at 15 days, specifies David Heard. Hence the need to have 1,500 resuscitation beds for Covid patients within 15 days. “

We must therefore “go and find beds elsewhere”, while still deprogramming non-urgent interventions, currently set at 40%. “An orthopedic operating room, for example, has the equipment but above all an anesthetist, a nurse anesthetist, describes David Heard… All the personnel qualified to carry out resuscitation. Closing the unit therefore makes it possible to recover the recovery beds to accommodate Covid patients in shifts. “

Soon patient transfers

Another technique to relieve hospitals: patient transfers. Government spokesman Gabriel Attal announced at the exit of the Defense Council on Wednesday that transfers would be organized to the least affected regions, but without specifying a timetable yet.

“There is not, today, a state of saturation of hospitals in Ile-de-France such that it would require transferring patients to other regions”, considers for his part Gérald Kierzek, emergency doctor at the ‘Hôtel-Dieu and Cochin Hospital (14th century) for 18 years. These are communication operations which present risks and which, in addition, keep patients away from their families. Better to redirect patients to private clinics where there is room. “

At the Henri-Mondor hospital in Créteil, everyone is ready

Anxious to play down, the doctor explains: “We are not in the situation of March 2020. There is no over-saturation in the Ile-de-France hospitals which nevertheless experience tension in the intensive care units like every winter. The problem concerns more non-Covid patients, 40% of surgical interventions are deprogrammed, including for cancer, in anticipation of a risk of saturation. However, postponing an operation for a few weeks can be fatal for the patient ”.

At the Henri-Mondor hospital in Créteil (Val-de-Marne), Eric Tricot, nurse anesthetist and SUD-Santé delegate, assures us that “according to the information I have with the doctors, those in charge of intensive care, we still has a mattress ”to accommodate Covid patients, he says. But everyone is “ready”. “We are in the starting blocks every morning, saying to ourselves: that’s it, it’s for today. The staff is exhausted, summarizes Eric Tricot. Here, the problem is not so much the number of beds as the staff that can be put around. ”.