In Rennes, the hospital is rinsed by a month of sightseeing – Rennes

“Do not believe that the hospital held on thanks to the white-collar geniuses in the offices.” On the other end of the phone, Yann’s voice

oscillates between irony and bitterness. The nurse from the University Hospital of Pontchaillou has a thousand things to tell about this month of November, when the second wave of the covid-19 epidemic rocked the Rennes medical ship.

These tears in the eyes of a panicked colleague in front of a machine she did not know. This “camping side” of operating theaters transformed into intensive care rooms. Or this week without taste or smell, after having caught the virus one evening at work.

Despite the fatigue, he did not wait for the symptoms to end before returning to charcoal. The caregiver hammers it: “If the CHU has managed to cope, it is primarily thanks to the goodwill of the staff”.

All summer, we took a lot

In the spring, the first wave of the epidemic had rather spared the Breton capital. The second was more stormy. In April, at the height of the crisis, 72 patients from Rennes and the surrounding area were hospitalized. The CHU was also able to welcome 26 patients from other regions. This time, up to 129 patients were treated at the Pontchaillou University Hospital.

To keep up with the tide, this big liner that is the hospital had to reorganize itself from the hold to the upper deck, at a forced march. It was necessary to shake up entire departments, set up intensive care rooms in a few days and deprogram numerous operations. All while relying on a small crew. And already rinsed.

Sledgehammer

Since the outbreak of the epidemic, the daily life of caregivers confronted with covid has been exhausting. Heavy like the protections that they have to put on and take off several times a day. The mask, the gloves, the glasses, the charlotte, the blouse and the gown. Down there, it is extremely hot. “And you can stay almost two hours in this outfit to take care of a sick person”, insists Sonia

nursing assistant in intensive care.

For each patient, you have to change. And always remain very attentive because an error can lead to contamination. This was the case for a large number of professionals at the CHU, as Le Mensuel de Rennes indicates in its December issue.

“It takes a lot of concentration and energy, it’s very tiring”. Sonia is one of the professionals mobilized on the front line since the early days. From March, she is at the forefront, grappling with an unknown and contagious virus. She remembers the fear of bringing the disease home.

In town, doctors are starting to see spring symptoms again

Fortunately, in May, during the deconfinement, she can be reassured. A little. The pace is not slowing down in the hospital, despite the drop in the number of covid cases. On the contrary. The instruction is to make up for the delay in non-urgent operations, massively deprogrammed at the request of the government throughout France. “All summer, we took a lot,” says Sonia.

At the start of the school year, it is the blow of the club when the second wave looms. From mid-September, the signals go back to red in Rennes. 70,000 students, less attentive to barrier gestures no doubt because they know they are not at risk, are back in universities.

Hospital struggled to find additional arms to cope with the surge in activity

In town, doctors are starting to see spring symptoms again. The incidence rate is on the rise again. The testing system is quickly overwhelmed. On September 17, the prefecture gives a first warning shot. The bars are closed at 11 p.m. A week later, revelers are asked to have devoured their last pint by 10pm.

The measures, followed with more or less good will, seem to be bearing fruit. In October, the virus circulation remains at a high level. But it stabilizes below the alert thresholds in force. The carefree Rennes thinks she managed not to be surprised by the tide.

The situation is only getting worse

A second confinement? Impossible, it is denied, as in March. However, at the Pontchaillou University Hospital, throughout October, the situation only worsens. Emergencies are always full. “At that time, we see more and more covid patients arriving”, recalls Laurent.

, emergency doctor. “The problem is that we are already overloaded in normal times.” The epidemic adds to the lack of resources denounced for years. In the space of eight days, between October 7 and 15, the number of positive patients doubled at the CHU. Resuscitation beds, which the most serious patients need to survive, flirt with saturation.

The second wave takes shape before incredulous eyes. The department of Ille-et-Vilaine was briefly placed under curfew on October 24. Before being reconfined four days later, at the same time as the rest of France.

Two fights

This time, the instructions for the public hospital have changed. No more mass deprogramming like in the spring. “We cannot indefinitely postpone operations, even non-urgent ones. There is a risk of losing chances of success ”, underlines Professor Le Tulzo, head of the intensive care unit at Pontchaillou.

The CHU must lead two battles head-on: treat as many classic patients as possible while absorbing the second wave. The establishment sets up a plan in eleven stages. Each time a level is crossed, new beds are opened for covid patients.

Internally, it’s a huge set of musical chairs. The sinews of war: the staff. 155 paramedics have been recruited since the beginning of March. From September, the CHU also recalls students, some retirees and nurses in anesthesia training. This is not enough to compensate for the increase in needs. Some caregivers are redeployed to reinforce the exceptional systems.

The hardest to find are paramedics trained in resuscitation

Obviously, their original services cannot run at the same rate. Some have to deprogram. “This is why we try to open as few beds as possible because that forces us to lower our normal activity,” explains Professor Tulzo, who tries a metaphor. “Like a surfer, you try to stay in the right place on the wave so as not to be crushed by the roller or lose speed”.

The most difficult to find are paramedics trained in resuscitation. Few of them know how these austere and technical rooms work, where the patient is between life and death. “It takes two years to train them. We could not do it between the two waves, “explains Stéphane Mulliez, director of the Regional Health Agency.

” Quickly “

From October, professionals who have gone to other services are therefore asked to come back to work. And sometimes some are propelled there without enough experience, according to Yann *. One evening, the nurse came across a colleague, alone, with tears in her eyes. In front of her, a machine which sounds disturbingly. “It’s a device that does the job of the heart and lungs,” explains Yann. “But she didn’t know him, so she was panicking.”

On November 12, level 6 of the mobilization plan was triggered. 86 intensive care beds are now open, half of which are for covid patients. Ten more than the normal capacity of the CHU. After a few recovery rooms, it is the turn of several operating theaters to be transformed into a sheave room in a few hours.

Proof of the responsiveness of the CHU, praises the management. Affirmation makes Ewen jump

, mobilized in one of these ephemeral installations, “put together in a hurry”. This nurse deplores the absence of certain equipment on site, which forces him to travel miles to get supplies in other places of the vast hospital.

I would have gladly excused the administration of this DIY if it didn’t make it seem like the conditions are great

He is also surprised that the only doctor responsible for the night finds himself managing two sheaves services installed in two different pavilions. Not ideal in an emergency. “I would have gladly excused the administration of this tinkering if it did not make believe that the conditions are great”.

At Rennes University Hospital, the peak is reached on November 14. 129 covid patients are hospitalized, including 31 in intensive care. Then the wave slowly withdraws from the shores of Pontchaillou.

Monday, November 23, the management of the hospital lowered the level of mobilization a notch. Bravado, she is even a candidate to receive two patients from Annecy. The risk of saturation of resuscitation capacities is receding. But the mobilization plan remains in place. Medical teams can be called upon at any time to climb the levels again. With its eyes riveted on the numbers of the epidemic, the hospital no longer wants to be surprised.

Third wave

Even the most critical caregivers recognize this. The Pontchaillou ship held up to the tide. Others, in France, took the water. The CHU was nevertheless forced to postpone, depending on the specialties, 20% to 40% of operations. “In any case, management must do with the means at hand,” sighs Philippe Blin, FO representative of the staff.

The trade unionist believes that the second wave has once again revealed in broad daylight the errors of the health policy carried out for fifteen years. In particular on the lack of personnel. The Rennes hospital has struggled to find additional staff to cope with the increase in activity.

Will the measures presented by the government make it possible to attract young people again? Among the caregivers we interviewed, none think so. “I am very happy to have had an increase of € 180 per month but what we have also been asking for for years are additional resources and beds”, underlines Aurélie

. She is still waiting.

Positive effect: the public hospital and private clinics buried the hatchet. At least temporarily

In Rennes, the second wave had a positive effect. The public hospital and private clinics buried the hatchet. At least temporarily. “We have made a giant leap in cooperation. This is good news for everyone’s health, ”says the director of the ARS.

The CHP Saint-Grégoire took part in the war effort by opening a 30-seat covid service. Its ten resuscitation beds have relieved those at the CHU. Unthinkable just a few months ago.

The clinic has been claiming for years the right to open a “sheave” service. The ARS had always refused him, fearing to see the anesthetists of the public hospital giving in to the sirens of the private sector. She finally gave him a temporary authorization at the start of the health crisis. The agency is ready to think about its sustainability.

What will winter 2021 look like in the hospital? Usually the season is already busy, especially because of the flu. Doctors believe that current health measures and a record vaccination rate this year should at least slow this virus. Little consolation. As this summer, we will have to reprogram a large number of operations to make up for the accumulated delay.

-What will be the indirect consequences of the two confinements? Many patients have postponed consultations on their own. To be feared: too late management of a large number of pathologies.

The psychological consequences of the period are also feared. Already, the psychiatric services are sounding the alarm. All this without counting on a possible third wave in a few months, which would then force caregivers to start all over again.

Rennes Monthly

(The Monthly of Rennes)

* The first names have been changed to respect the anonymity of the testimonies.