“At the end of the roll”, “one knee on the ground” … The hospital fears a 5th wave of Covid at Christmas

Expected at the turn of the year, the fifth wave of Covid-19 will sweep over a hospital wrung out by the first four, dried up by a shortage of caregivers and already on the line as the holidays approach.

«
Everyone squeezes their buttocks, it can’t last for months and months
“: The alert launched Monday, November 22, 2021 by Martin Hirsch does not apply only to the Hospitals of Paris (AP-HP) that he directs. Whether it is pediatric resuscitation overwhelmed by the early epidemic of bronchiolitis, or emergencies closed at night for lack of doctors like in Draguignan (Var), the “recurring” difficulties of winter ”
are met this fall
“, Indicated last week the Ministry of Health.

A chilling observation in the preamble of a “DGS-Urgent” message with the air of a commotion, calling for “
immediately engage all the levers to keep open the services in critical situation
», Increased overtime until requisitions as a last resort. All means are therefore good to face the backlash from the Covid, which risks rocking the ship again. Because after the summer “little wave”, ”
the real wave of Delta variant is coming
», Warns Professor Jean-François Delfraissy. The president of the Scientific Council expects to see it “go up to 1,000, even 1,500 hospitalizations per day” – against approximately 500 currently on average weekly – and predicts “not easy weeks around Christmas”.

Already, the number of hospitalized Covid patients rose to 8,525 on Tuesday, or 2,200 more in a month. In critical care, a real barometer of the health crisis, they are today 1,455, against a little more than a thousand in mid-October.

For the moment, that “is not increasing too quickly”, observes Martin Hirsch, also predicting that “the strong increase, if it is to occur, would rather occur at the end of December or in January”.

The government on its guard

«
The situation is still relatively contained in the hospital and the models at our disposal, if they predict a significant increase in hospital pressure over the next few weeks, believe that we can avoid submersion.

“, Assured Wednesday, November 24 the spokesman of the government, Gabriel Attal.

“On condition” however ”
to continue and increase our efforts in vaccination, in barrier gestures and in the health pass
», He continued during his report of the Council of Ministers.

” The situation is tense ”

The contaminations curve does not wait to take off: the threshold of 30,000 daily cases has just been crossed, for the first time in three months. But this time, the hospital leaves with an additional handicap. At the AP-HP alone, a thousand of the 18,000 nursing positions are not filled, forcing the institution to keep 13% of its beds closed.

This is less than the 20% advanced by the Scientific Council at the beginning of October on the basis of feedback from “large hospital structures”, but significantly more than the 6% or 7% identified by the French Hospital Federation (FHF), even if its president Frédéric Valletoux underlined that “the phenomenon mainly affects Île-de-France” and three other regions.

On this subject, Olivier Véran commissioned his own investigation, while acknowledging that “the situation is tense” and that it will “last in the coming weeks”. No doubt until January, since the Minister of Health asked private clinics and liberal doctors to “do their part” to ensure the continuity of care “at the end of the year”, in particular in “the emergency, pediatric and maternity services ”. “The hospital will face the 5th wave”, but “it will be complicated”, worried Mr. Valletoux Wednesday on Radio Classique: he has “one knee on the ground”, is “at the end of the roll” and his staff is “wrung out”.

Social demonstration and white plan

To make matters more difficult, it will also be necessary to deal with ongoing social movements in key hospital professions. Like the nurse anesthetists, who will demonstrate Thursday in Paris and in several other cities, the culmination of a “dead block” mobilization that began in early November.

Or like midwives, some unions calling for a “black weekend” from Friday – the third since the start of the school year – and are already preparing for a “black week” between Christmas and New Year, despite the salary agreement just signed by other organizations.

Unless once again, the waltz of “white plans”, deprogramming and transfers of patients brings the hospital back into line.


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