To prevent resuscitation services from overflowing in Ile-de-France, several massive transfer operations for patients with Covid-19 are in preparation, like those already undertaken from Hauts-de-France to Belgian hospitals the last days.
There is an urgent need to act to relieve hospitals in Ile-de-France on the verge of an explosion and which receive a new patient with Covid-19 every 12 minutes.
Where will Ile-de-France patients be received?
Three regions have, according to our information, already been selected to receive patients from Ile-de-France: Pays de la Loire, New Aquitaine and Occitanie.
In each of these areas, regional health agencies and hospitals are getting organized.
“We are preparing,” says Yann Bubien, Director General of Bordeaux University Hospital.
VIDEO. Covid-19: "dozens, even hundreds" of Ile-de-France patients could be evacuated, according to Véran
"We have a little space but we will still have to increase capacity to increase the number of our resuscitation beds", specifies the owner of an establishment which, during the first two epidemic waves, had hosted a around sixty patients from other regions.
On the side of Montpellier, there again, the teams are getting in working order.
“Nothing is fixed for the moment, discussions are still ongoing, we are told, but we are already launching a campaign to recruit more nurses and nursing assistants.
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Will operations be as large as in spring 2020?
From March 21 to April 10, 2020, at the height of the epidemic and while France was experiencing the very first confinement, 472 were transferred from one region to another by train, plane, helicopter and even by military ship to those hosted in Corsica.
The largest operation was carried out from April 1 to 3 with the transport, by plane, of 47 patients from Ile-de-France to Pays de la Loire.
Similar large-scale operations are being prepared since “dozens, even hundreds” of patients, according to the Minister of Health Olivier Véran, must be transported from the Ile-de-France region.
How are the sick chosen?
There are many criteria, but only “medical”, explains François Braun, president of Samu-Urgences de France.
Patients weighing more than 110 kg cannot, because of their excess weight, be transported, but also those with excessive oxygen requirements or in a worsening phase.
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“Their clinical situation is decisive,” explains the doctor.
On the one hand, they must be in a stable condition and not ventilated on the stomach to be evacuated.
On the other hand, we do not move patients who are likely to come out of intensive care in 48 hours because that would not be of interest.
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What means of transport are preferred?
It all depends on the strategy.
To relieve the resuscitation in tension, one carries out "bead or drainage transfers" to evacuate a few patients every day.
"This is only possible when one is in a phase of epidemic stability," warns Dr. François Braun, also head of the emergency department and the Samu in Metz.
In this case, ambulances are used for short distances, but the Samu can opt for small two-seater planes or helicopters, stable and fast to reach more distant destinations.
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The transfers that will be organized in the coming days will concern more patients at a time.
"What we call mass transfers will be privileged," said François Braun, sometimes with TGVs in which 24 patients and 56 accompanying persons can board.
"We worked with the SNCF so that the drivers change the way they brake, accelerate and decelerate", specifies the doctor.
There remains a primordial question that remains to be resolved: "In which region or hospital could 24 shea patients be accommodated at the same time, knowing that many departments are affected by the epidemic?"
»Asks François Braun.
Is this the only way to lower hospital pressure?
No.
As is already the case, cancellations of planned surgical operations of varying ages make it possible to relieve the congestion in hospital services.
The Ile-de-France Regional Health Agency thus gave, on Tuesday March 9, "the firm order" to hospitals and clinics in the Ile-de-France region to deprogram 40% of their least urgent medical and surgical activities in order to increase the capacities of 'Home.
And the Minister of Health is ready to push this requirement a little more: "We will go even further in terms of deprogramming if the situation were to impose it", assured Olivier Véran this Thursday evening, during his weekly press briefing. .
Another solution, less effective but quick to implement in the event that postponements of surgical operations are already effective, consists in transforming “classic” hospital beds into intensive care beds.
This is what is for example planned this weekend at the Bichat hospital in Paris, where six to eight additional beds must form, in the emergency room, a “temporary resuscitation unit”.