Many city carers are desperately waiting to receive protective masks to continue their activity, and fear a shortage. - SEBASTIEN SALOM-GOMIS / SIPA

  • While France lives confined to try to stem the spread of the coronavirus, the epidemic continues to progress.
  • City caregivers and hospital staff are on the front line to care for patients with Covid-19, but also all other patients who need care.
  • But the shortage of protective masks worries caregivers. Many of them are still waiting to be delivered, and fear that they will have to stop their activity if they no longer have the necessary protective equipment.

Where are the masks? They have been promised by the government, but many doctors, nurses, midwives or paramedics are still waiting to receive this essential tool to protect them, while they care for patients, some of whom are carriers of Covid-19. At the hospital, we fear the shortage when in town medicine, the absence of masks is already a reality.

“How did we get there in France in 2020? Ask caregivers, but also individuals. Who makes these coveted masks? Is there a state stock yes or no? And when will caregivers be delivered? 20 Minutes interviewed the caregivers and shed light on these questions.

No more strategic state stock in France

If protective masks are as rare as they are coveted - "a precious commodity is a scarce resource", as the Director General of Health Jérôme Salomon said on Thursday evening - it has not always been so . Today's lack contests with yesterday's abundance. In 2009, while France was shaken by another coronavirus (the H1N1 epidemic), the country had a state stock of more than 1.5 billion masks. About one billion surgical masks and more than 500 million FFP2 masks, according to a Senate report. Of the approximately 579,691,625 FFP2 masks identified at the time, 463 million belonged to the strategic state stock, and 116 million belonged to the stock of health establishments, according to a count made by the establishment of preparation and response to health emergencies (EPRUS), now dissolved.

In 2009, a Senate report expressed doubts about the need to keep a state stock. And in 2011, in the aftermath of the H1N1 flu crisis, which left France with tens of millions of doses of vaccine on their hands, it was decided not to keep a state stock of protective masks. Today, "there is therefore no stock of FFP2 masks", confirmed on March 3 the Minister of Health, Olivier Véran, at the microphone of the National Assembly.

"Plan and prepare, it is essential and necessary": @doorjean (LR) welcomes the prevention plan, implemented since 2004 and asks the Gvt what is the state of all FFP2 masks and the respirators ordered in 2006 #DirectAN #QAG pic.twitter.com/BLXSChdRgq

- National Assembly (@AssembleeNat) March 3, 2020

A decision in reverse of the recommendations of the High Council for Public Health, which nevertheless recommended keeping them for "the personnel directly exposed to a high risk", which include the carers, recalling that the risk of pandemic remained "unchanged", and that the nature of the infectious agent "could not be anticipated".

One million masks from China and five million masks from the army

At the beginning of March, President Macron announced the requisition of the stocks of masks available or being produced in France, and much of which has already been sold. And if it was then a question of distributing "to the French affected by coronavirus", this is no longer on the agenda.

We requisition all stocks and the production of protective masks. We will distribute them to healthcare professionals and French people affected by the Coronavirus.

- Emmanuel Macron (@EmmanuelMacron) March 3, 2020

And today ? A few million protective masks should be distributed to caregivers. This Wednesday, China sent a million medical masks to France, announced the official agency new China. This lot, donated by two Chinese charities, was flown to Belgium.

For its part, "the Ministry of the Armies delivers 5 million surgical masks" to make them available to the Ministry of Health, said on Wednesday the Minister of the Armed Forces, Florence Parly. They are therefore not FFP2 masks, the models that provide the best protection against the Covid-19.

The Ministry of the Armed Forces delivers 5 million surgical masks to @MinSoliSante.

Every effort counts. pic.twitter.com/78zovESoMI

- Florence Parly (@florence_parly) March 18, 2020

The world's leading producer of stationary masks

On the production side, the pace is far from keeping up with exploding demand. The reason ? China, factory of the world. But factory stopped. As the starting point for this coronavirus pandemic, the country has put a number of regions under control, setting up complete containment of the population. And placing its industry, which drinks the planet in goods of all kinds, at a standstill. However, masks, China is the world's leading producer. And production was halted at the most critical time, when the pandemic swelled and international demand exploded.

But France in all this? Does it produce masks? To date, there are in France "four manufacturing plants, replied Thursday evening Jerome Salomon. Their production capacity has been increased and they are now able to produce six million masks per week ”. But in practice, distribution is difficult to follow: at the rate of three masks per day per carer, the needs are exponential.

"I did not receive anything"

So, on the caregivers' side, we wait feverishly to recover the precious protective masks, delivered - when there are any - drop by drop. "For the moment, in the hospitals of the AP-HP, we do not yet have supply problems, we have surgical masks and FFP2 masks", reassures Professor Philippe Juvin, head of the emergency department of the Georges-Pompidou European Hospital, in Paris. "We have prioritized the areas most affected," says Jérôme Salomon. The hospitals consume a lot of masks because they have a lot of patients, and we react very quickly to requests from health establishments which call on us for direct deliveries. ”

"On the other hand, as far as city carers are concerned - general practitioners, dentists, nurses, midwives, but also staff in nursing homes and those working with dependent persons - the shortage is there, and it is a disaster, ”says Professor Juvin.

"I have almost no more, and I have received nothing," confirms Dr. Michèle Scheffler, gynecologist who continues to provide some face-to-face consultations in her office. The council of the Order indicated to us that from now on, we would have to ration 18 masks per week and per doctor, which is very complicated, since the secretary who welcomes patients must also wear them, and that we give them to any patient who arrives with a fever or a cough in consultation ”. In spite of this, the gynecologist "plans to have fabric masks made to continue the emergency consultations".

Same low stock which visibly reduces for Isabelle Fournier, president of the National Association of Liberal Midwives (ANSFL). “I canceled all the consultations that could be postponed, but in the follow-up of pregnancy and at the end of maternity, certain physical appointments remain essential. However, no delivery of masks is planned for midwives, with the exception of those located in the regions most affected by the epidemic. But they will only receive six masks per week! "

# COVID19 Very critical mask shortage for #women: only 6 units / week in risk areas.
Their activity is essential: the profession ensures continuity of care (pregnant women, postpartum ...).
This threshold must be raised https://t.co/6IoEtGJi4J pic.twitter.com/XUQ3siKnQV

- Midwifery Order (@CNOSF) March 19, 2020

"I just got a box from it"

A few rare “lucky ones” were able to obtain it. "I come out of the pharmacy, I just got a box, says Dr. Jacques Battistoni, general practitioner and president of the MG France union. But these are surgical masks, not FFP2. And we do not have enough to hold very long: with 18 masks per caregiver and per week, this prevents us from giving them to any patient who presents in consultation with symptoms of Covid-19. It is worrying for the future. The Minister of Health has promised us FFP2 masks that do not come. There are big logistics problems! I asked him the question of supply, but he simply replied that it was complicated ”.

So when will caregivers get their masks? "Several tens of millions have been distributed or are in the process of being distributed," replied the Director General of Health at 20 minutes during a press briefing Thursday evening. And the distribution should be finished this Friday evening ”. Without however specifying when the FFP2 would be available again.

"We have recovered some donations"

The few FFP2 he managed to gather this week, Yannick Janeiro, president of the National Federation of Emergency Ambulance Technicians (FNTAU), owes them to the generosity of Breton companies, where he works: “It is the fruit of donations of construction companies, he explains. On the other hand, I have received nothing from the health authorities, and no delivery is planned for the paramedics, whereas 80% of our activity in the last weeks consists in ensuring the medical transport of probable and confirmed cases of coronavirus , he confides. This means that we have an essential need for masks. ” Previously, "we get masks from the teaching hospitals we work with, but since they too are just in time and are starting to have inventory problems, they don't have enough."

This surge of corporate solidarity, Jérôme Salomon encourages it. “I appeal to solidarity. Many institutions, communities, companies have masks. Give them! Even individuals can go to pharmacies to donate their masks. ” But for Dr Jean-Paul Hamon, general practitioner and president of the Federation of Doctors of France (FMF), "getting there reveals the faulty management of the coronavirus crisis by our administration".

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