Tribune. Metropolitan intensive care has absorbed the wave of 7,148 patients with Covid-19 at the height of the crisis thanks to their extraordinary strength of adaptability. This was expressed on the structural level, with the ex nihilo creation of 4,260 resuscitation beds from adapted structures such as continuous surveillance units and recovery rooms in addition to 5,600 intensive care beds already existing; but also on the medical level, with the rapid redeployment in intensive care of 3,215 doctors and interns, 80% of whom were anesthetists.
This versatility of exercise in anesthesia and intensive care was essential to strengthen the 4,900 medical professionals already in place, at the non-medical level, with the use of 7,700 nurses, 45% of them from operating theaters and nurse anesthetists, and, at the managerial level, with the rebalancing of governance in medico-administrative tandem respecting the principle of subsidiarity.
This adaptability was the key element in maintaining a well-thought-out medical ethic in the care of patients and always providing appropriate care. Above all, it made it possible, in the metropolitan area, that the resuscitation capacities during this pandemic were not exceeded, making it possible to achieve mortality thresholds significantly lower than those observed in other European countries.
In the leading quartet
At the end of the crisis, the question that naturally arises for the public authorities is that of determining the optimal supply of critical care during “normal” periods, with a view to anticipating possible subsequent health crises. With a usual supply of nearly 5,600 intensive care beds and 5,800 intensive care beds, France is in the top quartet of Europe in ratio of the number of critical beds (16.3 / 100,000 inhabitants), occupied on average at 75%.
It would be damaging for politics to favor rigidity by directing precious funding towards the creation of beds, the number of which, by nature and even before they are created, will be exceeded during the next crisis.
Likewise, with an average of one doctor for two hospitalized patients, the number of resuscitators, composed of 60% of anesthetists-resuscitators and 40% of intensivists, is consistent with the functional needs of resuscitation in particular to maintain a qualified medical presence around the clock.
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