It was another time.
This January 30, 2020, the French had not yet taken the measure of the danger that awaited them.
That of a virus which was just starting to make people talk about it in our regions and which had then officially taken the lives of less than 200 people in the world.
A fifth case of contamination had just been declared in the country.
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The authorities, that day, are preparing the return to the national territory of French people who have resided in the province of Wuhan, an epidemic focus.
By a decree published in the Official Journal, the Minister of Solidarity and Health Agnès Buzyn calls on 80 volunteers from the health reserve to join the accommodation center intended to keep these nationals in isolation.
Their mission?
Provide information to people on medical items and hygiene and prophylaxis measures related to the virus.
Here they are also responsible for ensuring continuous care, health monitoring of people and the detection of possible symptomatic cases of infection by covid-19.
No summer break
This is one of the first times that the health reserve has been mobilized in the management of the health crisis.
Other missions were launched in the weeks that followed, so much so that by mid-March, some 300 reservists had been drafted for covid missions.
The thousands of volunteers registered in the health reserve were then a force of choice for the government.
The President of the Republic himself thus congratulated himself during a trip to Mulhouse on March 25 of the “formidable national mobilization” in action.
"The health reserve, with more than 40,000 registered, makes it possible to provide support and support to women and men who re-engage to help," he explained at the time.
Regularly, the executive invited all those who had the skills to get involved.
But as the second wave hits the country, as the French hospital system is under strain and the share of covid patients in intensive care units remains very high, where are we today?
Always in great demand, months away from the spotlight, it faces two major difficulties: the shortness of the troops, and the lack of profiles adapted to the scale of the current crisis.
"The reserve has not experienced a break between the two epidemic waves," says Catherine Lemorton, head of the health reserve at Santé Publique France, pharmacist and former socialist deputy.
We saw no difference this summer, with in particular a strong mobilization in the Overseas Territories, by sending up to 120 reservists to Guyana and 78 to Mayotte for example.
"
Ten times fewer responses to calls
The figures communicated to us by Public Health France indeed show that the use of these volunteers has not stopped thanks to the summer deconfinement.
Within these services, the activity of reservists is calculated on the basis of the volume of days worked.
"On May 11, the day of deconfinement, there were 11,853 days of mobilization carried out," explains our interlocutor.
As I speak to you, we have reached 40,897 days of mobilization.
"
However, despite the efforts made to respond as much as possible to the requests of French establishments, a certain shortness of breath is felt.
“When we issued an alert in April to a target of 22,000 reservists, we could get as many as 1,400 or 1,500 responses.
Today, it is ten times less, ”notes Catherine Lemorton.
These difficulties can be explained by several reasons.
Many potential reservists were called directly by the hospitals, without going through the intermediary of the health reserve.
This is the case, for example, of retirees under the age of 65 who have been recalled by the establishments in which they previously worked.
As for the older ones, the reserve no longer calls on them because of the obvious risks.
Since the start of the epidemic, she has faced a case of contamination of a reservist who developed complications and who came out of it.
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After months of service, too, the bodies tire, which can generate less mobilization.
While the first wave was concentrated in certain territories, allowing transfers of caregivers from one region to another, the second affects the country in a much more homogeneous manner.
“In a crisis like that of covid, we always need the same skills,” continues the head of the health reserve.
You can't train resuscitation volunteers in a few days.
We have had a wave of commitments, particularly from pharmacists and dentists, but they are not the ones who are mobilized in the first place.
It is often the same volunteers who leave, some are exhausted.
"
AP-HP has created its own reserve
The distribution of the profiles of volunteers from the health reserve further adds to these difficulties.
Of the 46,000 people registered, 18,000 are nurses.
Not all of them have a priori the skills necessary to integrate intensive care services.
Among doctors, for example, the reserve has to date only 614 emergency physicians and 68 resuscitators officially mobilized.
But the latter do not respond to calls from the reserve.
In fact, they are already mobilized on the ground, on a daily basis, to fight against the virus.
"It would still be worrying to have 68 resuscitators today at the height of the crisis", qualifies Catherine Lemorton.
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For her, the challenges posed today to the health reserve are ultimately only a reflection of the tension that reigns within hospital services.
This force seems to be able to fully express its capacities only during phase 1 (search for patients and contact cases to isolate them) and phase 2 (control of sources of contamination) of an epidemic.
"The reserve is not sized for such a degree of spread of the virus," continues Catherine Lemorton.
No country in the world has been able to boast of having a sufficiently large force.
This would mean training hundreds and hundreds of caregivers and doctors who would be put to sleep, a bit like the firefighters in their barracks, who would be asked to come and work on the occurrence of a future epidemic of which we know nothing of. does nothing about the characteristics.
It is unthinkable.
"
In Ile-de-France, the AP-HP services still saw fit to set up an internal health reserve.
“About 700 AP-HP personnel were trained in April and May to strengthen the resuscitation services,” we are told within the Paris Hospitals.
This reserve is made up of nursing staff or nursing students who have followed a short training course in intensive care.
"These trainings, which last only a few days, aim to" support and relieve more expert resuscitation teams.
These 700 personnel were mobilized by the management of the AP-HP to withstand the shock of the second wave, in addition to the 1,371 dry recruitments of nurses which have already been carried out with postings between August and December 2020. Proof all the same that the sanitary reserve, first of the name, gives rise to some initiatives.
Despite the difficulties, the work of the health reserve therefore continues.
Eight nursing homes now benefit from its services, including seven for the Occitania region alone.
And the Covid does not occupy full-time volunteers.
For example, 14 reservists were mobilized in the Alpes-Maritimes after the devastating passage of storm Alex, to provide psychiatric monitoring.