“Warning, here is the first non-Covid patient in weeks! “, quips Damien Roux in front of a room in the intensive care unit. It’s 9 a.m. on Monday morning, and the deputy head of the intensive medicine and resuscitation department of the Louis Mourier Hospital (
Assistance Publique Hôpitaux de Paris), in Colombes (Hauts-de-Seine), transmits the files.
In front of the twelve rooms, about fifteen green pajamas and blue masks hastily note the pathologies, the saturation, the treatments of the people taken care of. All suffer from Covid-19 except one patient, therefore, admitted for malaria. A proportion that shows that the Delta wave, coupled with
‘Omicron, has not finished overloading the resuscitations.
“We manage everything, here, in reality! »
For each patient, the intern specifies the state of health, the position (on the stomach or on the back), but also the relationship with the relatives. A patient refuses to let her family visit her. “And for his dog, we found a solution, he will be at the SPA for nine days”, adds Edwige Touré, the service manager who had to find a solution quickly. “We manage everything, here, in reality! “, laughs Damien Roux.
After the round of resuscitation, head for the continuous monitoring unit (which is part of critical care), where the situations seem less extreme. In a room, a 26-year-old young woman survived Covid-19. “She self-extubated,” warns the intern. “She is anxious, but should be out soon,” reassures Damien Roux. A precious bed soon released. Because the hunt for vacant places has become a headache. “We work on nine beds instead of twelve for lack of nurses, justifies Jean Damien Ricard, head of the service. Last week, we were turning away five to ten patients a day! »
For how much longer ? On a national level, some good news invites optimism. Omicron takes precedence over the Delta variant and causes fewer hospitalizations. Intensive care admissions are beginning to stagnate. According to official figures from Sunday evening, these services have 3,852 serious patients with Covid-19, like the day before, against 3,895 on Friday and 3,939 on Thursday.
Martin Hirsch, boss of the AP-HP, spoke in an internal email of “encouraging signals on the Covid front”.
“The horizon exists, but it is not for now”
“This thrill seems to be confirmed at the AP-HP, but it fluctuates from one hospital to another, nuance Jean Damien Ricard, head of division. Three days is a bit early to say that the hardest part is behind us…”
Because for the moment, the Covid-19 continues to wreak havoc in hospitals in general, and in intensive care in particular. “We hope for an improvement, but not before a fortnight or three weeks, puts Jean-Damien Ricard into perspective. Even if there are fewer admissions, we have to be able to treat the patients currently hospitalized. However, with Covid-19, intensive care treatment lasts two to three weeks, compared to six days on average for other pathologies. We know thatOmicron sends less to intensive care, but it is not known if the duration of support in this service will be shorter. The horizon exists, but it is not for now…”
“They should come and see the reality in our service”
Nevertheless, these caregivers, who have seen a number of colleagues leave, their sweet holidays and overtime multiply, hope to see the end of the tunnel soon. Because to the fatigue is added the frustration of seeing young patients arrive, without comorbidity, who could have done without the sheave box. And all the rehabilitation that follows.
Of the eight Covid patients in the rea, seven are not vaccinated and one is immunocompromised. Figures that stick to national statistics. Room 12, a 48-year-old man, without comorbidity, unvaccinated, has been intubated for ten days. He is receiving extracorporeal respiratory support (ECMO), a machine that does the job of the lung, namely oxygenating the blood. “Afterwards, there is nothing left,” warns the department head. Gloves, FFP2, staring at the beeping machines, six caregivers grab the sheet and meticulously turn the patient over to place him in prone position. “By putting the patient on his stomach to oxygenate his lungs well because his organs do not press on his back, explains Stéphane, intern. At least, this treatment is not expensive… It’s such a shame to see patients like this one in reality. »
“The weariness is indisputable in the face of misinformation about vaccination which leads to avoidable hospitalizations, adds Jean Damien Ricard. People imagine things, but they should come and see the reality in our service. Some feel they have been cheated by this vaccine because it decreases but does not eliminate transmission of the virus, and because its effectiveness declines over time. Except that we are faced with a micro-organism that we did not know two years ago and which is mutating. “What discourages him are also the consequences on other patients, “unhappy to see their operations deprogrammed. When the Samu makes 20 phone calls to settle a patient, there is a loss of chance. »
An impression of waste shared by Charlenne, a caregiver who arrived two and a half years ago. A few months before the storm. “You could say that I ate!” she quips. This fifth wave is not the worst. But there is physical and moral fatigue because it lasts. »
And because it sometimes wipes the invectives of relatives not vaccinated. “Families do not always understand why we ask for the health pass, why visits are limited. Sometimes we have to call security, but we’re not security guards! Some patients, when they wake up, claim that he is going to get vaccinated and try to convince their relatives”. Not all. And Charlenne shares a striking memory: “a patient, aggressive, said to me “anyway, you want to fool me!”. I replied “no, just intubate you”. »
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