PARIS (AP) – During an overnight shift this week, three new COVID-19 patients were taken to Dr. Kareem Depot’s small intensive care unit in the southern French city of Arles. At his service are now more viral patients than the first wave of infections, and are working to create new ICU beds elsewhere in the hospital to accommodate the sick.
Similar scenes are unfolding across France. COVID-19 patients now occupy 40% of the ICU beds in the Paris region and almost a quarter of the ICUs across the country as the infection spreads to the vulnerable population, which has been growing for several weeks among young people.
Despite being one of the richest countries in the world – and when the epidemic was first washed around the world – France did not add the staff needed to manage significant ICU capacity or extra beds, according to National Health Institute statistics and doctors. Like the recurring epidemics in many countries, critics say, French leaders have not learned their lessons from the first waves.
“It’s very tense, we do not have seats yet,” Dr. Debt told the Associated Press. His hospital converts recovery rooms into ICUs, delays emergency surgery and sends more staff to high-care cov- eral patients. When asked about additional doctors to help with new cases, he simply said, “We don’t have them. That’s the problem. “
When Paris General Hospital staff confronted French President Emmanuel Macron this week to demand more government investment, he said: “This is no longer a question of resources, it is a question of organization.”
He defended his government’s handling of the crisis, citing the 8 8.5 billion investment promised in July for the hospital system. After years of spending cuts, protesting doctors said funding was too low and coming too slow, as France had half the number of ICU beds in 2010 by 2020.
ICU aggression rates are considered to be an important indicator of how complete the hospital system is and how effective health officials are in protecting people at risk.
France’s numbers are not good.
It recorded more than 18,000 new daily cases on Thursday, and viral patients now occupy 1,427 ICU beds across the country – doubling in less than a month. According to figures provided by the National Institutes of Health, the total ICU capacity in France is 6,000.
In comparison, Germany entered the epidemic with five times more intensive care beds than France, with a similarly well-developed health care system and a slightly smaller population. To date, the number of confirmed virus-related deaths in Germany is 9,584, up from 32,521 in France.
Getting ICU capacity right is a challenge. Spain was caught short in the spring and has expanded its permanent ICU capacity by about 1,000 beds. Britain expanded ICU capacity by creating emergency field hospitals. The so-called Nightingale Hospitals have been moth-eaten because they are rarely used. However, the British government says they can reuse them if needed.
In the spring France added extra temporary beds – including those built by the military to the country’s first peace field hospital – the health agency said French hospitals could eventually double ICU capacity if needed this fall.
Compared to March and April, doctors say French intensive care wards are better equipped this time around, with more safety equipment and more knowledge about how this corona virus works. Medix now puts fewer patients on respiratory machines, and hospitals are being trained on how to restructure their functions to focus on COVID-19.
The number of viral patients in the ICU at the New Civilian Hospital in Strasbourg doubled rapidly last month, but the atmosphere was surprisingly calm. An OP reporter looked at teams of physicians who closely coordinate to manage each patient’s course and treatment according to the strict protocols they are now accustomed to.
But that extra practice does not mean that it will be easy to manage recurring virus cases in ICUs. In addition to additional respirators and other equipment, adding temporary ICU beds can be time consuming and time consuming – just like treating patients with COVID-19 in them.
Pierre-Yves, head of the intensive care ward at Lauren Military Training Hospital in Marseille, said the work was “harder and more time consuming” than other patients. He has no authority to identify by his last name due to military policy.
Seven or more of his 47 staff are required to rotate a patient slowly and carefully each time. Now entering and exiting the ward involves a long, careful dance to shift full body gear and disinfect everything they touch.
Dr. Depot, in Arles, said it took several months to train ICU staff, so he relied on the same staff positions in the spring, and he worries that they might burn out.
“I’m like a coach, I only have one team, no reserve players,” he said.
He also worries about non-viral patients who were already placed in the back burner earlier this year. He worries about the upcoming flu season sending about 2,000 patients to ICUs in France every year.
With more than 7,000 viral patients in intensive care at the height of the crisis, Serge Smatza, head of the emergency medical service SOS Medecins, did not think France would face the same situation it saw in the spring. She died in nursing homes without going to hospitals. But he said it was wrong for the French public and its leaders to think “the virus was behind us”.
“There are not enough beds … especially there is a shortage of staff,” he said. Seeing his service wear off a consistent progress in cases and epidemics, he warned that “missing is a deadline.”
Jean-Franோois Padias in Strasbourg, France contributed to this story.
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