For the second time in a month, France is suffocating under the effect of a heat wave. The peak should be reached this Monday, July 18, with maximum temperatures expected between 36 and 38 degrees. That’s a week of heatwave in total. An episode of high heat which is reminiscent of that of August 2003. That year, nearly 19,000 people, mostly elderly, lost their lives as a result of this extreme heat wave episode. Hospitals were overcrowded. Morgues too, to the point that it was necessary to requisition a refrigerated warehouse at the Rungis market as a funeral home. Many dysfunctions were then pointed out. Since then, to avoid a new catastrophe, the State has implemented a series of measures.
The national heat wave plan
In 2003, one of the first reproaches formulated against the government of Jean-Pierre Raffarin and his Minister of Health, Jean-François Mattei, was that of not having warned or warned about the extent and the risks of heatwave episode. Thus in 2004, Philippe Douste-Blazy, who took over from Jean-François Mattei, presented with Hubert Falco, Minister Delegate for the Elderly, the national heat wave plan. It has since been automatically triggered each year between June 1 and August 31. It has four alert levels. The first consists of a seasonal monitoring of temperatures and verification of operational devices. The second, in which the country is currently located, “is a heightened monitoring phase allowing the various services to prepare for a ramp-up with a view to a possible transition to level 3”, indicates the Ministry of Health and prevention on its site. The latter, called “heat wave alert”, is triggered locally by the prefects. “At this level, prevention and management actions are implemented by public services and territorial actors in a manner adapted to the intensity and duration of the phenomenon: communication actions aimed at recalling the individual preventive actions to be taken implemented (hydration, protection from heat, etc.), specifies the ministry. Finally, level four can be activated when Météo France places departments on red alert. “It requires maximum mobilization and coordination of the State’s response with the activation of the Interministerial Crisis Unit (CIC) which brings together all the ministries concerned”.
The blue plan in nursing homes
In 2003, it was mainly the elderly who were affected by the heat wave. This is why in 2005, the blue plan was born. The device aims to coordinate and prepare the teams in the event of a crisis and recommends the acquisition of the necessary resources, such as bottles of water or foggers. “It seems crazy to say it like that, but in 2003 it was not obvious to offer elderly people food and drink even if they didn’t feel like it, comments Jérôme Guedj, deputy Nupes of the 6th district of Essonne and author of a report on the isolation of the elderly in 2020. Today this idea is well acquired”.
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In addition, since a decree of August 3, 2004, accommodation establishments for dependent elderly people are required to have an air conditioning system in at least one common living space. “The last twenty years have been those of the installation of refreshed rooms, and according to the renovations, the installation of air conditioning, underlines Jérôme Guedj. Normally, we no longer have problematic nursing home building structures which are thermal anomalies”.
Also, in 2003, many isolated elderly people succumbed to the heat alone at home, due to a lack of communication with the outside world, lack of vigilance on the part of the outside world as well. Since then, mayors have been responsible for keeping a heat wave register (updated twice a year), in which all disabled and elderly people must be listed. In the event of a heat wave, this allows the municipalities to check in on them to make sure that everything is fine or to alert their relatives and the emergency services in the event of problems. “The heat wave of 2003 revealed the isolation of the elderly at home, remembers the deputy. But on this point, I am not sure that has changed. I think that we still have large margins of progress in what is called the outward journey. The Covid has demonstrated this again”.
In the hospital, fewer caregivers than before
In nursing homes as in hospitals, the number of caregivers available is worrying. “The heat wave is a time when we most need to take time with patients, to check that they are drinking, eating, that they are cool, but for lack of sufficient personnel, the exercise can prove to be complicated”, estimates Jérôme Guedj, who also points to a ratio of carers and managers in nursing homes degraded compared to 2003.
A finding shared at the hospital. “What we see is that there are fewer beds and fewer carers than in 2003”, stings Arnaud Chiche, anesthesiologist-resuscitator at the Hénin-Beaumont hospital and founder of the Santé en collective. danger. For the doctor from Hauts-de-France, an influx of patients linked to the heat wave episode should lead to deprogramming, as at the height of the Covid-19 epidemic. Loïc Pen, emergency doctor at the Creil hospital center (Oise) and Nupes candidate losing in the last legislative elections, does not say anything else. “What has changed since 2003 at the hospital is that we had a stronger workforce of emergency physicians, whereas today it stands on three legs. But it’s not just linked to the heat wave , this applies to all crises”.
Obligations for employers
In addition to the measures taken by the health authorities, the Ministry of Labor at the time had also taken care to establish “a heat wave plan and working conditions”, through a circular published in June 2004. Because several accidents at work have recorded in 2003, some of them fatal. “Employers are required, pursuant to the Labor Code, to take the necessary measures to ensure the safety and protect the health of workers in their establishments, by integrating temperature conditions. They must also provide workers with fresh drinking water”, recommends the text.
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In the event of an episode of intense heat, employers must therefore adapt their organization to limit worker exposure, for example by arranging staggered hours or increasing the frequency of breaks, particularly for outdoor work, such as in the construction industry. . For indoor activities, the Ministry of Labor also recommends teleworking when possible. And in the event of triggering by Météo France of red vigilance in a department, “the employer must reassess daily the risks of exposure for each of his employees according to the evolution of the temperature and the nature of the work to be carried out. If the precautions taken are insufficient to guarantee the health and safety of workers, the activity must be suspended. Companies can then resort to the partial activity system or the recovery of lost hours, “says the ministry on its site. On the other hand, in the field of construction, “for stoppages which have been decided because of a heat wave, their admissibility under the compensation scheme will be examined on a case-by-case basis by a national commission according to the climatic conditions observed at the time of the stop”. Only stops declared in an area with alert level 3 (orange) or 4 (red) are admissible.
