- It is not only the coronavirus in this period that weakens and kills.
- Patients suffering from chronic diseases, cancers, but also psychiatric disorders have, in part, interrupted or alleviated their course of care during confinement.
- To the point that caregivers and patient associations fear an embolism in health services, due to the arrival of patients other than Covid, but also of healthy people who have developed physical and psychological problems.
"What really scares me in deconfinement is the second cool kiss effect: many patients have refrained from consulting and will come back to the hospital, anticipates Carla, a nurse in Val-de-Marne. What will represent, again, a colossal workload ”. A concern shared by many caregivers, who have warned of the dramatic consequences of a renunciation of care for patients other than those who suffer from Covid.
On this fourth day of deconfinement (very gradual), the government's warnings continue. The risk of a second wave of the coronavirus epidemic is not a pipe dream and our German neighbors are already experiencing it. But even if this new disease does not start to rise again, it is likely that the healthcare system will be tested by a second wave, made up of chronic patients who interrupted their treatment, but also of patients suffering from disorders. psychiatric and for whom confinement was a terrible ordeal.
A second wave, Covid or not
“A second wave is to be feared, regrets Gérard Raymond, president of France Asso Santé, national union of approved associations of users of the health system. Will it be a catastrophic peak or will it be manageable, the question is there. "
Why these worries? "The renunciation of care was a big concern for us during confinement," says Gérard Raymond. Unfortunately, we now see patients arriving with complications of chronic pathologies arriving at the hospital because for two months, some have practiced self-medication, interrupted their treatment, or the fear of Covid has slowed their follow-up. According to a survey carried out by France Asso Santé among its members, two thirds of those who interrupted their care pathway did so for fear of being contaminated in a medical office or hospital, and a third because 'They felt that their caregiver had more urgent things to do ...
But for about a month, doctors, patient associations and even Emmanuel Macron on Easter Monday have alerted to this risk. Were there any effects? Yes, according to the doctors we interviewed. "We have seen a turn in our offices, patients are coming back and it's even truer since Monday," reassures Franck Duvulder, president of the CSMF Specialists, the first specialist union. "One might think that there is a return to care," adds the president of France Asso Santé. But what we see is that the damage is done. Certain decompensations or complications are already visible, mainly for diabetes and cardiovascular diseases. "
But for many observers, this exceptional period also allowed a reorganization of services, essential for better reacting in the future. “There has been a real revolution in the coordination of caregivers and an impressive response, reassures Gérard Raymond. If we want to be able to take on the second wave, whether Covid or not, we must continue on this path: listen more to the field teams, adapt the offer to the needs of the healthcare teams. And health care users will have to be listened to fairly quickly. "
Blocked blocks
If many patients have found the way to the hospital or a link with their general practitioner, there is a space that remains inaccessible: the operating room. Indeed, the enlarged white plan, which caused the non-emergency operations to be scheduled, is still valid, even if Olivier Véran allowed some flexibility, especially for operations linked to cancer. Learned societies, associations of doctors of all specialties, called last week to gradually lift this expanded white plan.
"All the blocks in France and Navarre work at less than 50%," explains Franck Duvulder, president of the CSMF Specialists. It is reasonable for the first fifteen days of deconfinement. What we are asking is that we put the conditions in place to go from 50 to 75% over the second half. And from June, which we resume normally, to allow catching up with people who could not be screened or operated. Because if, for example, a woman who had to have a hip replacement had to wait six months, she could fall, charge herself for a bone and become addicted.
What stocks for anesthetic products?
All with two major concerns. On the one hand, how do you really manage a second wave of the Covid epidemic? “The first time, we were all at full speed, and we showed that in less than 48 hours, we could empty our private clinics, retorts this gastroenterologist in Reims. Today, after this experience, we are able to react even faster. "
But the second brake may be more difficult. The shortage of anesthetics, necessary to put patients to sleep, necessarily slows down the activity of the operating room. “It is estimated that the increase in the use of these anesthetics reaches + 2,000% worldwide. It is therefore impossible to import this product during a pandemic. "Our request is to know where we are?" What products are missing? ", He insists.
Risk of psychiatric problems on the rise
For Gérard Raymond, of France Asso Santé, the study of the long-term consequences of this parenthesis on the chances of recovery and survival of chronic patients and people with disabilities will be fundamental. Several international and French studies have also been launched, notably that called Coclico. "We shouldn't realize that at the exit, peripheral illnesses at Covid have caused more deaths!" The other alert concerns the general population. Because this period may have delayed certain diagnoses, a dramatic loss of luck when it comes to serious illnesses, physiotherapy treatments that leave a legacy, dangerous self-medication…
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A concern that relates as much to physical as to mental health. Many psychiatrists have been warning for a few weeks about the risk of seeing the number of suicides, addictions, anxiety attacks multiply. Especially since some, diagnosed or not, have stood the time of confinement, but began to pour into psychiatric services since Monday. An international survey, in which the Institute for Research and Documentation in Health Economics (IRDES) participates, looks at the impact of containment policies on mental health in the general public. "It will be important to see the general state of health at the end of this crisis and in the future," says Gérard Raymond.
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Emergencies and medical offices deserted for fear of the Covid-19… Where are the “other” patients?
- Olivier Véran
- Hospital
- Disease
- Cancer
- Coronavirus
- Covid 19
- Society
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