"We are at the end of the end.
"The president of Samu-Urgences de France, François Braun, sums up in one phrase the" very, very tense "situation of Ile-de-France hospitals in the face of the influx of people with Covid-19.
And this emergency doctor says it bluntly: "While fifteen to twenty additional patients enter emergency rooms in Ile-de-France every day, medical evacuations to other regions are the last card to be played to avoid ends up treating people in poor conditions.
"
As in the first containment, where 472 patients were transferred from one region to another by train, plane or helicopter, a similar large-scale operation is being prepared.
Already this Saturday, three people with the coronavirus were evacuated from Hauts-de-Seine, Seine-Saint-Denis and Paris to hospitals in Angers, Le Mans and Nantes.
Three others will be this Sunday, including two to New Aquitaine via a medical aircraft from the Samu.
"We put ourselves in order of battle"
A first wave of “massive” evacuation by TGV should follow: the first operation could take place Thursday, March 18 and another the following Sunday, at the rate of 24 patients evacuated for each train.
SNCF is currently on stand-by, waiting to be contacted.
“It's a logistics that is both extremely heavy and delicate to put in place,” confides Frédéric Adnet, head of the emergency department at Avicenna hospital and owner of Samu 93. We are getting ready to start.
"
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This is because organizing patient transfers does not happen overnight.
They must first be selected according to very strict medical criteria: "They must be patients in a serious but stable condition and who do not require therapeutic gestures during the transfer", continues Frédéric Adnet.
“They must not suffer from heart failure and consume too much oxygen,” adds François Braun.
The logistics of their transfer obviously implies for the Parisian hospitals that received them to coordinate with the SNCF because it takes between 48 hours and 72 hours to fit a train.
"The ideal in the long term would be to have a TGV dedicated to these operations", estimates François Braun.
Once the transport has been stalled, it remains to be organized with the care establishment supposed to take care of the patients at the end of their evacuation.
If the first operations took place towards the west of France, it is because these regions are easily accessible by helicopter.
"And areas less affected by the Covid," says François Braun.
Brittany has also been used for ten days as a fallback for patients with covid in the Paca region ”.
Not without the consent of the families
Last but not least: obtain the consent of the families.
“No transfer is authorized without their consent,” explains Frédéric Adnet.
However, they do not always take a positive view of the fact that a loved one has been moved away to the other end of France to be treated.
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The objective of these evacuations is twofold: to improve the quality of care for patients treated in shifts, but also to free up beds in Ile-de-France for new patients.
To increase the reception capacities of patients with Covid, the Regional Health Agency (ARS) has asked hospitals and clinics in the Ile-de-France to deprogram up to 40% of their least urgent medical and surgical activities.
For ten days, private clinics have already entered the dance, like what happened during the first wave a year ago.
"At the time, the partnership was easier to set up, because our operating theaters were already no longer occupied," relates Lamine Gharbi, president of the Federation of private hospitalization.
Since last Monday, we have started deprogramming to free up new intensive care beds, and we are on track to ramp up.
"
If the private establishments in Ile-de-France now take care of between 17 to 20% of intensive care patients, this activity could rise to 30%, after reaching around 27% during the first wave of 2020. The Prime Minister, Jean Castex , was also this Saturday visiting a private clinic in Aulnay-sous-Bois (Seine-Saint-Denis) to display this public – private partnership on which the government is counting to cope with the influx of patients.
