" What are your symptoms? At the end of the morning, on the 3rd floor of the Henri-Mondor hospital, in Créteil (Val-de-Marne), the door of the Samu regulation room opens onto a real hive, crowded with doctors, their noses on screens saturated with numbers. The voices exchanging by telephone are superimposed in an uninterrupted hubbub. Road accidents, infarctions, simple gastros ... The coronavirus is now added to the long list of reasons. Out of 2,612 calls for Thursday alone, 400 relate to the Covid-19.
So, it was necessary to double the number of regulatory assistants, responsible for sorting patients according to their level of severity, general practitioners and emergency physicians. A few days ago, there were only ten in this room against twenty today. "We are a little tired but we have to hold on," breathes Charlotte Chollet, deputy medical director of the Samu 94. Behind a bay window, positions have also been added to the crisis unit.
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"The epidemic will develop and risks being long," she notes. If necessary, we can still put four more people in the room on the 2nd floor. The watchword: adapt. Among the emergency physicians responsible for responding to serious cases, Dr. Travers deals exclusively with calls to the Covid-19. A little apart, we can see it in a corner, headphones on the ears, facing four screens. "Here, I see the patient record, there, that six are waiting. "
Some, worried, only want advice. For this, there is however a toll free number (Editor's note: 0800 130 00, now open 24 hours a day, 7 days a week) . "But when it doesn't go down, they make up the 15th," he says, understanding. The rest are suspect cases. Cough, fever, flu, you have to assess their probability of having the virus.
“I ask them if they have gone to endemic areas, centers of contamination like the Oise or Mulhouse, if they have been in contact with the sick. In general, they already have the answer, they are the man who saw the man who saw the bear, ”he confides, with a smile. When he judges that a person should be tested, he requests confirmation from an infectious disease specialist and the patient is asked to go to a building to be screened.
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The ideal: come by car, avoid public transport. With this same idea: to protect others. But sometimes everything does not go as planned. "We must remember, they are too bad to move," interrupts a regulatory assistant. A couple, awaited for a test, is not in condition.
Immediately, Doctor Nicolas Travers seized the handset: “Describe to me what you feel… OK, you have to see a doctor anyway. He hangs up and informs the chief of service at Samu. “I have two subjects who have been in contact with a person infected with RATP. They are seized. He is completely stiff, he can no longer put one foot in front of the other, ”he said. It's decided, a specialized ambulance will be dispatched. But that means, additional caregivers when they are already overloaded.
Tested outside the hospital
We leave the control room, head for the screening center, open since Wednesday, on the ground floor. We have to get out of the hospital. A few dozen meters from the main entrance, we see two men, planted on the asphalt, masks on their noses behind a barrier watched by a vigilante, also protected. They have been classified as "possible cases" by 15 and must be tested in this emergency center. Next to the parking lot, they are standing between two white tents. The first on their left, the second on the right, standing under the hangar where health equipment is stored. It is even the Samu national reserve.
A woman arrives, a nurse hands her hydro-alcoholic gel: "Scratch your palm well with your nails", she specifies before handing him a mask. We will not be able to approach to question them. Since Wednesday, forty patients have been screened, three tested positive for the coronavirus. "They returned home because they had very few symptoms," explains infectious disease specialist Raphaël Lepeule. This does not overload the hospital. "
Behind the tarpaulin of the barnum, two offices act as medical offices where the interrogation begins again: "What are your symptoms? "; "Do you have heart, kidney, respiratory problems? The patient then enters an isolation box in the back or waits for a doctor in a suit, charlotte on the head, mask and protective glasses. "We put a sort of large cotton swab in his nostrils to recover cells," explains infectious scientist William Vindrios. The precious sample is then sent for analysis to the ultra-secure Henri-Mondor laboratory, at level -1. Of the 39 establishments of the Public Assistance-Hospitals of Paris (AP-HP) only nine are capable of diagnosing the coronavirus.
This is where Professor Pawlotsky, head of the biology division, awaits us. Technicians, equipped from head to toe, are analyzing a cotton swab. "They inactivate the virus and then go to look for the infectious agent which will make it possible to say if it is indeed Covid-19", he describes, pointing to the inside of a white room which can be seen by a window. The result will fall in four hours. Over the days, the number of tests multiplies with 70 carried out this Friday.
How will they do when we go to stage 3, the advanced phase of the epidemic? "We will only test the most serious cases," says the professor, as evidence. We cannot, either, put thousands of people in hospital, the country will not stop living. Others, carriers or not, can work with a mask if there are no symptoms. At the end of the evening, we learn that among the "possible cases", two tested positive during the day.
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