The Saint-Joseph intensive care unit normally has 14 beds.
It rose to 36 in March 2020 and it is currently at 24 intensive care beds to accommodate Covid patients.
-
O. Gabriel / 20 Minutes
In the intensive care unit of the Saint-Joseph hospital group, in Paris 14th arrondissement, the end of the second wave is not yet relevant.
If the entries have fallen for two weeks, the service, which has doubled the number of beds, is still full.
And must, this time, take care of Covid patients and other pathologies.
The caregivers, tired by these two very tense periods, hope that with the deconfinement and the end of year celebrations, the barrier gestures will not be forgotten by the population.
Room 6019, five caregivers, in gowns, charlotte and masks, help each other to turn an unconscious patient onto his stomach.
This Friday morning, in the intensive care unit of Saint-Joseph hospital, a private health establishment of collective interest (Espic) in the 14th arrondissement of Paris, everyone is at their post, calm and concentrated, the phone in their pocket or by hand to handle heavy patients.
Two entries on the counter: one Covid patient, one non-Covid.
"A rising tide"
Normally, this sheave has 14 beds.
This week, they are managing 24. Each patient is isolated in a room where we can see from the door pipes and infusions.
Some are intubated, some on the stomach.
"Are you not dressed?"
», Asks, surprised, Cédric Bruel, the head of the service against two nurses in the room of a Covid patient.
"We just received the negative PCR," replies one of them.
" It suits me !
Breathes the doctor.
With a pain au chocolat and coffee for all breakfast and lunch, he takes a quick tour of the ward before answering our questions in his office.
The Saint-Joseph intensive care unit normally has 14 beds.
It rose to 36 in March 2020 and it is currently at 24 intensive care beds to accommodate Covid patients.
- O. Gabriel / 20 Minutes
“In March, it was a real wave, we were overwhelmed.
We had 36 beds, we refused 20 patients a day, he recalls.
But in October, it was rather a rising tide with a more gradual arrival and a smaller volume of patients.
By the first wave, all non-Covid patients were gone.
This time, we also have to deal with the other patients.
Today, around two-thirds of patients followed in the department are suffering from the coronavirus.
The other change concerns the care, knowing that there is still no treatment against Covid-19.
"The airtight pipes protect caregivers from infection, but we try to use less mechanical respiratory assistance," continues the department head.
With the new protocol, there is more risk of aerosolization, so we expose caregivers more.
So no one laughs with the hygiene measures.
In the rooms, nurses and caregivers are covered from head to toe, charlottes, glasses, gloves… which can give the emerging patients the impression of having landed on another planet.
Hydroalcoholic gel everywhere, gowns to throw away as soon as you leave, cellphones avoided to limit the risk of contagion… “Our great anxiety would be to create a cluster in the service, admits Cédric Bruel.
In July, four caregivers fell ill at the same time.
Fortunately, nothing since.
Entrance to the Saint-Joseph hospital, an Espic in Paris, 14th.
- O. Gabriel / 20 Minutes
More experience, and more fatigue
Since September, the service has seen patient arrivals rise.
"We were shaken especially as the epidemic was spreading throughout the country," recalls the department head.
Morally, it was difficult but not impossible, we knew the mission.
And the disease a little better.
Rearming the beds, reorganizing the service, resuming the right reflexes was therefore quick.
“Now we know how to dress, how to react,” explains Morgane, a nursing assistant.
“We expected it, adds Justine.
We all took our leave before September 15th ... The difficulty is that the epidemic returned when we were all exhausted.
"
“During the first wave, the limiting factor was the beds, but now it's the number of caregivers,” sums up the department head.
Many have invested themselves without restraint.
And lived a disillusion when at the exit, we realized that the model was not going to change.
For example, the doctors of foundations like ours, where patient care is not increased, have not benefited from the advances made by Ségur de la Santé.
In addition to the fatigue and anxiety of falling ill (and bringing the virus home), these caregivers must find the time and energy to train backups.
What has also changed is the relationship with families.
During the first wave, no loved one could step inside these walls.
This time they are accepted, drop by drop and one hour a day.
"This limits misunderstandings and aggressiveness," says Marc Tran, resuscitator.
Marc Tran is a doctor in the intensive care unit at Saint-Joseph hospital.
- O. Gabriel / 20 Minutes
"I have had families who had to do a bibliography session because they knew better than I how to treat the coronavirus ...", quips Cédric Bruel.
A service still full
Is the drop in incidence felt in the privacy of this front-line service?
“We keep our fingers crossed,” admits Justice.
But they are far from being able to relax their efforts ... "The admissions have decreased for two weeks, but the problem is that Covid patients remain in intensive care for a very long time", explains Marc Tran.
“In general, a patient is treated there for a maximum of two weeks,” says Justine, nurse.
For the Covid, it is sometimes more than a month.
She is interrupted by an intern, who warns her that one of her patients has just woken up.
“This patient has been in the service for a month, for example… and he has not come out of the woods!
»Of the 24 beds, only one is available.
“It's Friday, and at the weekend, we often have a lot of entries, worries Marc Tran.
So, no, we are not wide at all.
"
Between the contradictory injunctions of the government, the contrary opinions of the doctors, the heated debates in particular on hydroxychloroquine, more recently the conspiracy theories disseminated on the Internet, not sure that all the French take the measure of the reality of the resuscitations.
“It's a roller coaster ride, so it's complicated for families to understand that things were going better yesterday but that last night, he plunged back, justine justifies.
We have to watch the lungs, kidneys, neurology, it's very heavy.
We have patients who are 50 or 60 years old and who do not always have comorbidities.
"It is not because we are in good health that we are protected," adds Morgane, a nursing assistant.
Don't minimize the risks
This is why the members of the service remind that lowering the guard would be a bad calculation.
"This summer, a waitress, the mask under her chin, explained to me" it makes it difficult for me to breathe and that's okay, today there is room in hospitals, "" says Cédric Bruel.
An opinion that this resuscitator would like not to see resurface in the population, now that the signals are turning green.
"If this waitress had seen the 10th, even the 100th, of what I've seen here, she wouldn't sound like that," he sighs.
I don't want to position myself as a lesson giver.
But the goal is to put an end to this epidemic.
And it is only with barrier gestures that this is possible.
"
As France is gradually coming out of confinement, do they fear a third wave?
“What worries me is not the reopening of stores,” continues Cédric Bruel.
I have been taking the metro since March, as long as people wear a mask, there is no problem.
The risk will increase from December 24 to January 1, when people go to party with family and friends.
I understand this need well, but that's when they expose themselves.
The majority of patients we have in intensive care are family transmissions.
It is around January 15 that we will see if the epidemic has returned or not.
"
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