If, for the moment, the teams control the situation generated by the new wave of the Covid-19 epidemic, we will have to face the lack of nurses if reinforcements are necessary.
During a press point made by videoconference this Wednesday, November 24, the heads of the intensive care and infectious diseases departments took stock of the situation at the University Hospital of Angers.
Maine-et-Loire is particularly affected by this 5th wave of Covid-19, in a region, Pays de la Loire, which has an incidence rate (number of positive cases per 100,000 inhabitants) higher than the national average (197.8 at the regional level for 180 at the national level).
This Wednesday afternoon, the intensive care unit of Angers University Hospital welcomed 25 patients with Covid-19.
“Since the beginning of October, we have been witnessing an increase in the number of covid patients, notes Professor Alain Mercat, head of the intensive medicine and intensive care unit at the Angers University Hospital. We were between three and five a week until ten days ago and now it’s more like ten a week. The pressure is strong in the sheave, we have opened three additional beds. We are not overwhelmed but we remain vigilant. “
As for the conventional sector, excluding intensive care, therefore, it is not saturated either because patients do not stay there for long. Either their situation improves and they go home, or it gets worse and they are referred to intensive care.
“Middle age (covid patients in the conventional sector) is 74 years old, explains Prof. Vincent Dubée, head of the infectious diseases department. Half are vaccinated. There is a strong representation of people who are vaccinated and immunocompromised. ”
Same observation in intensive care where they are patients over 65 years of age and where, out of 45 patients admitted since early October, 28 are vaccinated but present either immunosuppression or comorbidity, obesity or diabetes.
In Angers, as elsewhere, we are realizing that after six months, complete vaccination is less effective.
“We were very surprised by the effectiveness of the vaccination, but here we are witnessing a drop in effectiveness” recognizes Professor Dubée. “The booster dose (3rd dose) protects extremely well but for how long? “
Will it be necessary to be vaccinated every six months? “It is not excluded” answers Alain Mercat.
The current situation is surprising in Maine-et-Loire, which had been relatively preserved by the fourth wave.
“We have no explanation, answers Prof. Mercat. There are clusters in belote tournaments, lotos, hunter meetings but that does not explain everything. These meetings also exist in Mayenne where the incidence rate remains lower. This particularity of Maine-et-Loire should fade. “
At Angers University Hospital, we hope that the situation will not worsen too much. The peak of infection should occur at the end of December and, consequently, the peak of hospitalization around mid-January.
“What’s boring, fears Professor Dubée, is that it is during this period that we record a peak for the flu epidemic (except last year). It may complicate our task and pose problems of support. “
For the moment it’s fine, we could summarize, but it may not last.
“We are not in tension, confirms the head of intensive care, but if the wave gains momentum, it cannot be done without deprogramming. We have less leeway than at the time of the first wave. “
Why ? Because caregivers have left or, exhausted, have requested availability. And, clearly, the nurse available to reinforce the teams or replace the absent has become a rare commodity.
The deprogramming of non-urgent interventions therefore points its nose.
“There is a certain weariness of surgeon colleagues, warns Prof. Mercat, who must call back their patients to postpone the procedure. “
The end of year holidays with family reunions or friendships Christmas and New Year will they not amplify this fifth wave? Not sure. We expected a strong rebound in early 2021 after the holidays but this was not the case. It is true that we were coming out of a curfew period.
The two department heads of the University Hospital of Angers recall for all intents and purposes the importance of vaccination and respect for barrier gestures, wearing a mask, disinfecting the hands, ventilating the rooms. Practices that we have somewhat forgotten but which could allow us not to have any unpleasant surprises at the time of the 2021 end-of-year holidays.