“This is a world first, unprecedented since the start of the Covid crisis,” insists Lionel Callenge, director of the Reunion University Hospital.
For the first time this Thursday evening, four patients, suffering from an acute form of Covid-19 and followed in intensive care, were embarked on a stretcher aboard a specially equipped airliner, towards Roissy-Charles-de- Gaulle then Ile-de-France hospitals.
An unprecedented medical evacuation for Covid patients placed on respiratory assistance and transported over such a long distance, while almost 10,000 km and 11 hours of flight separate Reunion Island from Paris.
The plane was to take off around 9.15 p.m. local (6.15 p.m. in Paris).
Exceptional in its technical aspect, this operation was deemed "essential to prevent congestion in hospitals in Reunion," underlines Martine Ladoucette, director of the ARS Indian Ocean.
In recent days, the resuscitation services on the island, where the South African variant is in the majority, have experienced an occupancy rate ranging between 85 and 90% of the 122 available beds, close to the national alert threshold.
Hospital blood pressure
Since the beginning of February, the island has been welcoming four new resuscitation patients every day from the neighboring DOM of Mayotte, where the epidemic is galloping with an incidence rate close to 500 per 100,000 inhabitants, overwhelming its weak capacities. hospitable.
"We must take into account this context in Mayotte, but also that of Reunion with an incidence rate multiplied by three for three weeks, and a risk of amplification linked to the prevalence of the South African variant", specifies the director of the health agency, while the island will pass a general curfew at 6 p.m. starting this Friday.
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Also, in order to maintain acceptable reception capacities, the Samu of Réunion and Paris coordinated this extraordinary operation called "Hippocampe", involving a company specializing in medical repatriation, International SOS, the airline company Air Austral and the Directorate General of Civil Aviation (DGAC).
It was the latter who had to sign the exemption to transform this 276-seat Boeing 787-8 into a flying medical unit.
"A complex project since, if these planes can carry two stretchers, special arrangements were necessary to install two more in the central aisle, while taking into account the constraints of respiratory assistance and the high contagiousness of the virus" , observes Lionel Montocchio, Director General of Civil Security Indian Ocean
The plane divided into three zones
The cabin was thus divided into three zones.
At the tail of the plane, the red zone where the sick are followed.
In the middle, an orange zone or "decontamination airlock" where the personnel will change.
And at the front, a green area for rest and catering.
"We had to add outlets for the respirators, provide the locations for the 12 bottles of 3,200 liters of oxygen and install detectors in the event of a leak," explains Amine Tadjadit, head of airworthiness management at Air Austral.
If the aircraft can make the journey in one go, diversion aerodromes have also been provided in the event of a medical or technical problem.
To support the four patients in Mahor, four emergency doctors, six nurses, three pilots and eleven crew members were mobilized, not to mention the dozen stretcher bearers, technicians and logisticians essential for the mission, i.e. 40 people in total.
All of them volunteered.
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“The Smur 974 has good experience with aerial Evasans, with nearly 1,200 carried out each year between Mayotte and Reunion, and around a hundred between Reunion and Paris.
If this type of operation has never been carried out before, we do not take an disproportionate risk, estimates Professor Bertrand Guihard, head of Samu de la Réunion.
The patients were chosen on medical criteria and in agreement with their relatives.
We have done everything we can to make this happen as smoothly as possible.
It remains to be seen whether this type of operation, necessarily expensive, will have to be repeated regularly.
"It will depend on the evolution of the epidemic in the coming weeks", indicates the ARS, insisting on the essential "regional and national solidarity" in the face of a crisis which seriously disrupts the health systems of the two French departments of Indian Ocean.