As the epidemic spreads throughout France, Aurélien Rousseau, director general of the regional health agency in Ile-de-France, explains to us how hospitals are preparing in the Paris region where the virus affects 363 people and has just caused two new victims.
How is the region organizing against the spread of the virus?
AURÉLIEN ROUSSEAU. First of all, there are very different territorial realities: few cases in Essonne and Seine-et-Marne, the virus circulates more actively in the north of the region, near the Val-d'Oise cluster. We are implementing measures to slow the spread of the virus, with "tracing" which consists of assessing the risk of spread in each patient circle. We do not know how quickly the epidemic will evolve. Hopefully not all the seriously ill will be arriving at the same time, but we are able to free up beds more quickly.
Which hospitals do you rely on?
In Ile-de-France, 46 establishments are ready to treat patients. On the front line, with the greatest resuscitation capacities: Bichat, La Pitié, Necker, Bégin. For the past three weeks, eight other establishments have been strengthening care (Melun, Versailles, Sud Francilien (Evry), Pontoise, Mondor (Créteil), Avicenne (Bobigny), Percy (Clamart) and the Kremlin-Bicêtre. Last week, 34 other establishments can also take care of patients affected by Covid-19.
How many beds are available?
We have not reserved beds for the Covid-19, the aim being not to destabilize the health system. The overall resuscitation capacity in Ile-de-France is 3,200 critical care beds. For weeks we have been working on freeing beds, transferring patients elsewhere, to maintain a capacity for critical care and we have room for adaptation. A month ago, with the peak of the flu, 95% of the beds were occupied, I would not have said the same thing!
Will operations be deprogrammed?
Yes, these are heavy operations but not vital so as not to occupy resuscitation beds precisely. Another room for maneuver is that recovery rooms can be transformed into a follow-up room for seriously ill patients. And the more we advance, the more the recourse to the hospital will be reserved for the most serious cases. The follow-up of the epidemic will pass routinely to city medicine.
In Italy, voices are raised to denounce the sorting of patients, is it imaginable in France?
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This is a choice of doctors, these are extremely heavy and complex ethical questions, which arise every day in all hospitals and which are growing in light of epidemics. The Italian example shows one thing: we must protect the health system, like our treasure, allow carers to work in the best possible conditions.
The testimonies of exhausted caregivers, precisely, are heard. Are reinforcements being considered?
I asked all the establishments to list the personnel recently retired, to call upon them when the time came. We have also released the ceiling on overtime in hospitals, and we already have reinforcements of students and interns.
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