"Out of a few patients eligible for transfer, only one family has given its agreement in principle, the others refuse to have their loved one removed", explains Frédéric Adnet, medical director of crisis at Avicenne, in Bobigny (Seine-Saint-Denis).
In this department, the incidence rate peaks at more than 440 cases per 100,000 inhabitants.
It is more than 4 p.m. this Friday and all of the 46 resuscitation beds at the Avicenna Hospital (APHP) are occupied, more than half of them by Covid-19 patients.
Everywhere in Ile-de-France, we are pushing the walls.
More than 5,500 Covid patients are hospitalized, including nearly 1,100 in intensive care.
Dozens of new patients arrive in critical care every day.
This Thursday, there were only a hundred beds available.
The health authorities have set a target for hospitals, including private hospitals: to deprogram 40% of non-emergency operations to free up beds.
To date, 23% have been.
At the Regional Health Agency, we are careful not to reveal the details of the first patient transfers that are looming this weekend, but we will have to rely on medical TGVs.
"It takes 48 hours to equip a TGV, the government first asked us for a feasibility study on Thursday, but for the moment we have no official order", we told SNCF on Friday evening.
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Transfers of Covid-19 patients: hospitals on the war footing
The carrier can rely on the experience of the first “Chardons” operations, as these medical transfers by TGV are called.
This name was given in reference to the plant symbol of Lorraine, where the first evacuation exercise for people in absolute emergency took place in 2019.
Ten months later, ten TGVs made it possible to evacuate between March 26 and April 10, 200 patients from Ile-de-France and Hauts-de-France.
As many beds vacated.
But at the time of the first wave, there were reinforcements by the thousands in the Ile-de-France hospitals.
Precise logistics
Equipping a TGV is not the only challenge to be taken up.
Choose the patients, obtain the family's agreement, establish a waiting list, if that very morning some are no longer compatible in view of the extremely strict medical criteria ... Logistics are millimetered from the hospital of departure to on arrival, the ideal being to be able to benefit from the equipment of the destination hospital.
Because one of the principles of these evacuations is obviously not to draw on local resources.
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“Each car transports four intubated patients, in acute respiratory distress, with a senior doctor, a junior, four nurses and a logistician to carry out monitoring and care, in each train, a medical regulation team is present for coordination ”, Details a report of“ evacuations by TGV ”published in August 2020, of which we were aware.
The first Chardon operation was prepared in less than 48 hours, the following ones in less than 24 hours.
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"We are studying the possibility of starting the TGV for 24 patients every two days, if we have a fixed TGV equipped, we will be able to continue", rejoices a health source in Ile-de-France, confident on the logistical and medical aspect.
But basically, she doesn't hide her concern: “It's as if we were in a boat with a leak and the water was rising.
There, we bail, but the water rises even faster.
Vaccination does not stop the leak quickly enough.
"