At the end of March, Eure-et-Loir is the department of the region where Sars CoV-2 circulates the most. At the limit of saturation, the hospitals of Chartres and Dreux manage for the moment to cope, but they hope that they will not soon have to “sort” between the patients.
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260 March 16, 324 March 23, 368 March 30… In Eure-et-Loir, the incidence rate – that is to say the number of positive coronavirus cases per 100,000 inhabitants – continues to climb, and to be higher than all the other departments and cities of the region.
The only glimmer of hope this week: the positivity rate fell from 10.30% last Tuesday to 9.60% this Tuesday.
Faced with this 3rd wave of Covid-19, the hospitals of Chartres and Dreux each opened 6 beds resuscitation and additional intensive care. They also deprogrammed approximately half of the interventions non-urgent in the operating room, in order to be able to free up beds and staff.
Younger and younger patients
For now, the Eure-et-Loir hospital teams are able to cope with the influx of patients, thanks to the additional beds but also because of the age of the patients.
“People in intensive care are much younger, between 40 and 60 years old, details Yvon Le Tilly, deputy director of the hospitals of Chartres. Who says younger, says more ability to overcome the disease. Instead of spending several months in an intensive care bed, they stay there for a few weeks at most.”He explains in particular this rejuvenation by vaccination of the elderly and vulnerable.
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Dr Florent Bavozet, head of the intensive medicine and intensive care unit at the Victor-Jousselin hospital in Dreux, notes the same phenomenon: “We have 15 patients, 11 in intensive care and four in intensive care. We manage to make one or two outings per day, and we have one or two entries per day. So for now we are holding”.
If he also explains this turnover by decrease in average age – from 65/66 years old during the first wave to 59.6 years currently – he is also very worried about the condition of these increasingly young patients.
“A third is under 55 years old, which is not negligible. Above all, we have patients who have no risk factor (no diabetes, no overweight problem, no hypertension) and who end up with a very serious form of the disease.”He breathes.
“It’s hell”
“For the moment we don’t have to do it, but if it continues, we will have to make choices among patients, and patients who are young.”, Warns the head of the intensive care unit. This is what any doctor fears: if you have a bed left and you have to choose between two patients … It is hell.”
Our fear is having to choose patients.
Dr Florent Bavozet
It echoes on a column published in Le Monde by nine resuscitators from Assistance Publique – Hôpitaux de Paris who wave the red rag of sorting between patients.
The head of intensive care in Chartres, Dr Pierre Kalfon, also declared at the Republican Echo : “We were able to cope with all the requests, which are currently increasing, thanks to internal patient transfers. But I can’t guarantee [que] we do not have a situation as difficult as in Ile-de-France, within two weeks to three weeks.“
Staff “not extensible”
“They might end up making difficult choices. The challenge today is to avoid this and anticipate”, Abounds Yvon Le Tilly. Dr Florent Bavozet appeals to “civics”And hopes for his part“awareness” people.
The risk of having to sort patients is explained by the increase in contamination, the virulence of the variants, but also by the saturation of hospitals.
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If until then they have been able to create additional beds and reorganize the medical and paramedical teams, they are no longer able to do so. “The staff is not expandable, warns the head of the intensive care unit in Dreux. “In itself, we should not be able to manage so many beds.“A nursing staff imbued with a certain weariness and undeniable fatigue after a year of fighting the virus.
Transfers not excluded
As for the transfer of patients to other establishments in the region, it is not that simple. “When they are in an acute phase, the patients cannot be transported because they have to be put on their stomachs, they have excessively strong drugs, they have a maximum oxygen level., he explains. So we cannot take the risk that their condition deteriorates over a potentially long transfer. However, to go to Tours, it takes 1 hour to 1:30 by helicopter, 3 hours by road”.
He calculates that out of the 15 patients in the service, only one or two would be transferable.
On the side of the hospitals of Chartres, the transfer of patients “is not excluded, it is part of the planned adaptations”, Confides Yvon Le Tilly. But he assures us that the establishment still has a small “flexibility”To create a handful of additional beds. There are currently 24 compared to 18 normally; during the first wave, 29 places had been opened.
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