In recent days, the situation has become more complicated in the northeast of Lot, at Saint-Céré, Bretenoux and Biars-sur-Cère, with the practice of testing within Ehpad (Accommodation facility for dependent elderly people) and Saint-Céré hospital, which revealed many positive people, among residents and among nursing staff. Dr. Slim Lassoued, president of the Medical Commission of establishment of the hospital of Cahors, answers our questions.
Actulot.fr: Why did the situation suddenly get complicated in the northeast of the Lot?
Dr. Slim Lassoued: What is happening in the northeast of the Lot, in Saint-Céré, Bretenoux, Biars-sur-Cère, concerns us for several reasons. Following tests carried out in particular in Saint-Céré, we find ourselves in front of a large number of “positive” people, including caregivers. As a result, we are dealing with a lack of staff insofar as the caregivers who test positive, are no longer operational; some of them are sick and confined. The director of the Saint-Céré hospital is asking for reinforcements because of this situation. From the moment it is tested positive, the staff can no longer go to work, at least for a fortnight. Hence this situation of staff shortages at Saint-Céré hospital.
Did the Saint-Céré hospital contact you?
Yes, Saint-Céré hospital would like us to take patients on Cahors. Due to their understaffing, they are requesting transfers, understandably. However, in Cahors, in light of our means, we are obliged to consider the situations of people on a case-by-case basis. Those who may require a little more intensive and specific care, we agree to take them. On the other hand, for the other people, we consider that they would be better to stay there, in particular because of their advanced age and the concerns of adaptation that this represents for themselves.
If there was no other solution for the north of the Lot, for lack of staff, how would the Cahors hospital manage this crisis?
We would be forced to open another patient admission unit, while asking Gourdon and Figeac hospitals to take part in the reception of patients who do not need resuscitation. It is also important to keep these elderly people as close as possible to their areas of origin.
There are limits that should not be exceeded in terms of pressure on staff.
In the end, the situation is tense, more than it seems?
Yes, the situation is tense, due to this cluster (area where a grouped number of people is contaminated by a virus, which is circulating) Saint-Céréen. However, this is not a case of so-called “heavy” patients, requiring resuscitation, but we are faced with a lack of staff, to receive new patients. I would remind you that for the past month our teams have been mobilized at full capacity. There are limits that should not be exceeded in terms of pressure on staff.
Have you been asked for other transfers?
Yes, it is the transfer of a rather young person from Gourdon to Cahors hospital, not in intensive care, but in the containment zone.
How many people are in this containment area?
This containment zone has entrances and exits varying between 7 and 10 people.
As for the resuscitation area, what about it?
At the moment, this late afternoon Saturday, it has seven people.
Do you think we have reached the peak of the wave in terms of the spread of the epidemic?
We are on the high plateau, with patients taken care of and a lot of work for the staff. We are not on the descent. In any case, it is not noticeable due to the problems mentioned above, concerning the north of the Lot. There are always hospital admissions, positive tests.
Being tested positive is a worrying factor, while it could very well go unnoticed!
Are you worried that the situation will worsen with the tests that continue at the start of the week?
At the start of the week tests are planned in Saint-Germain-du-Bel-air. Indeed, if there are positive tests among the staff, these are all people who will no longer be able to assume their usual work. Admittedly the test is good, in the sense that it makes it possible to measure the degree of penetration of the epidemic, but when it turns out to be positive it raises concerns among those concerned. You can be positive, without it changing anything in your lifestyle … But as soon as you know that you are positive, it may cause you anxiety that does not have to be, and that puts you on the sidelines on a professional level. Knowing that you are positive creates tension in people; we don’t talk about it much, but it’s a reality! Being tested positive is a worrying factor, while it could go unnoticed!
As soon as the test is positive, for a member of the nursing staff, is the separation automatic?
Yes. And this is how we find ourselves faced with a shortage of staff, which places us in a complicated situation which develops concerns at all levels, even in the family circle.
Today, 7 nurses and 15 nursing assistants are missing.
Is this not the application of the precautionary principle?
Yes. This is the principle of knowledge, of knowledge. We want to know and as soon as we know we change our behavior. It’s good to do tests to compile statistics.
However, indirectly, this generates fear, doubt, the demand for withdrawal … These are all elements explaining the difficulty of managing this health crisis!
Again, the difficulty we face is not related to the pressure of heavy care, but it is related to the fact that there are positive patients and also positive caregivers. Once the health care workers who test positive are removed, how can they be replaced? Today, 7 nurses and 15 nursing assistants are missing. The question for us is to find a sufficient number of caregivers to intervene serenely in the north of the Lot.
JEAN-CLAUDE BONNEMÈRE
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