AFP, published on Wednesday 29 July 2020 at 20:32
MP LR Eric Ciotti, rapporteur for the commission of inquiry into the coronavirus crisis, believes that elderly people have been “deprived of access” to hospital, especially in intensive care, but this claim is rejected by the ministry of Health, which denounces a “fallacious use” of figures.
“Yes, the hospital has adapted, but at what cost? First there was a massive deprogramming of non-Covid care, the consequences of which we will measure later. Then there was a form of regulation which, without saying it, deprived of access to the hospital for the elderly, in particular residents of nursing homes, “points out Mr. Ciotti in an interview with Le Monde on Wednesday, halfway through the work of the commission of inquiry.
“At the peak of the crisis, at the beginning of April, the number of people over 75 admitted to intensive care fell sharply. We fell from 25% on average (at the same period, in previous years) to 14% during the crisis, and even at 6% in Ile-de-France, “he points out, relying on data transmitted by the General Directorate of the Care Offer (DGOS).
“Our system was therefore well and truly overwhelmed. We reduced the chances of the elderly. Many could probably have been saved. It is serious,” accuses the elected right.
“Patients who required hospitalization in intensive care were taken care of,” replied the Ministry of Health, questioned by AFP.
According to the ministry, to compare the admission figures in sheaves of this year and of previous years proceeds from a “fallacious use of the data provided” by the DGOS.
On the one hand, the number of patients in shifts, at the peak of the epidemic, was much greater this year (2,700 in Ile-de-France against 1,200 the previous year), which “makes comparisons difficult”.
On the other hand, the profile of these patients “was totally different” from that of 2019: “the impact of the deprogramming of non-urgent surgical activities (deprogramming made necessary by the situation, note) on the profile of patients received in intensive care is of legal age “, argues the ministry.
– Criteria –
In addition, the criteria for hospitalization in sheaves depend on “rules developed by learned societies and are also nourished by knowledge of pathologies that can evolve” during an epidemic, adds the ministry.
“The choice of hospitalization in intensive care always results from an analysis by the doctors who follow the patient and must assess the benefits and risks for the patient”, he explains.
This is a point on which specialist doctors had already insisted on Tuesday during their hearing by the committee.
They stressed that even in normal times, the decision to admit a patient to intensive care depended on his ability to withstand this very heavy treatment, whether because of his age or a poor health condition related to other pre-existing diseases.
“The criteria have not changed, on the other hand it is the disease that has changed,” said Eric Maury, president of the French language intensive care company (SRLF).
“When you’re ventilated for a Covid, it lasts 2, 3, 4, 5, 6 weeks,” which is a lot longer than the “4 or 5 days” that classic pneumonia requires, he said.
“At the beginning, we took patients like that, patients of 75/80 years old”, but they hardly survived “this marathon”, he continued. In this case, “maybe it wasn’t reasonable to offer them resuscitation.”
“We did not have the feeling to change our sorting procedures,” said Agnès Ricard-Hibon, president of the French Society of Emergency Medicine (SFMU). According to her, it is according to “the capacity of people in nursing homes to withstand the intensity of care that we made our decisions”.
In Germany, a study published on Wednesday covering 10,000 patients showed that nearly three-quarters (72%) of Covid-19 patients over 80 years old who were placed on an artificial respirator died (compared to 53% all age groups combined, and 63% among 70-79 year olds).
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