This Tuesday morning, Benjamin Clouzeau, resuscitator at Bordeaux University Hospital (Gironde), accepted four new cases of Covid-19, two of which were under 35 years old.
“Out of 25 heavy sheave beds, fourteen are occupied by patients with coronavirus.
They arrived with us during the last ten days ”, confides the anesthetist.
Even if the hospital tension there is more and more strong, Bordeaux and the department of the Gironde do not appear however in the list of the “red” zones, like Paris and the Ile-de-France.
But for how long?
"I find it hard to believe that we are not there quickly", fears the Bordeaux doctor, who considers that this new wave is totally different from the others: "Contrary to what happened previously, there is a real dissociation between the incidence rate and the number of patients hospitalized in intensive care which is rising very, very quickly.
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Since Saturday, March 20, sixteen departments (those of the Ile-de-France and Hauts-de-France regions as well as the Alpes-Maritimes, Eure and Seine-Maritime) have been subject to new restrictive health measures.
The reign of "inside with mine, outside as a citizen", the government's new anti-Covid slogan, is now the rule to be followed for at least four weeks.
In question, an incidence rate, that is to say a number of new cases per 100,000 inhabitants recorded over the last seven days, too high, but also an occupancy rate of hospital intensive care units greater than 100 %.
Very disparate situations
At the country level, the average incidence rate is now 308. A high figure but which, for the moment, allows the public authorities not to consider in the short term more stringent general measures, such as a re-containment of all over France.
But the situations are very heterogeneous, with rates that can peak at more than 600 in Val-d'Oise or Seine-Saint-Denis in the Paris region, while it does not exceed 100 in the Gers, Creuse or the Pyrénées-Atlantiques.
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By applying the gauges that have tipped these areas into a territorialized reconfiguration, it appears that a dozen new departments are now on borrowed time.
With incidence rates above 400, associated with resuscitation services in very high tension, several departments in the South-East (Var, Bouches-du-Rhône, Alpes-de-Haute-Provence, Hautes- Alps and Vaucluse), but also the Aube and the Rhône, in turn, risk toppling over.
About twenty others, with incidence rates greater than 250, ie the “maximum alert threshold”, are to be placed under surveillance if cases of contamination continue, as in recent days, to increase.
The scientific council, which guides the government in its fight against the virus, calls for immediate measures for "these regions which are in a state still under control but which in three or four weeks will be in a critical situation".
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"The idea is to be in anticipation of the epidemic, but it is the government that will decide," said the epidemiologist and member of the scientific council Arnaud Fontanet on Tuesday on BFM.
"We expect that in May, we will have reduced hospitalizations by 50%," he hopes.
If the government's measures are followed, it can work.
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Avoid late measurements
Should the same restrictions be imposed in these regions under pressure as in the 16 “red” departments?
"Difficult to answer because everyone is a little taken aback by the current situation", indicates the infectious disease specialist Anne-Claude Crémieux.
"The tipping point in the Paris region was indeed the filling rate of intensive care units, more than the number of cases of contamination", explains this specialist in infectious diseases, who works at Saint-Louis hospital (Paris).
“The cleaver must be the filling rate of intensive care units.
This is why decisions are taken on a day-to-day basis to match reality, because the projections are uncertain, recognizes the infectious disease specialist.
But the disadvantage of this way of reacting is inertia, because there is a risk of taking measures too late.
And then, if the master of time is the virus, the master of the decision remains Emmanuel Macron.
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