A patient transfer between Paris and Rennes during the first wave, illustration -

Mathieu Pattier / SIPA

  • With an occupancy rate of over 90% and more than 1,000 patients in intensive care, hospitals in Ile-de-France are on the verge of saturation.

  • To avoid local re-containment, health authorities plan to transfer hundreds of patients to other regions.

  • Is this solution viable?

Night and day, every twelve minutes on average, a patient is admitted to intensive care in Ile-de-France.

A particularly worrying situation, with more than 90% of beds occupied and 1,080 patients in intensive care, or more than a quarter of French cases (3,918 patients are in intensive care nationwide).

And the situation is only getting worse.

As of February 23, they were "only" 805 patients in intensive care in Ile-de-France.

900 on March 5.

"If the pace continues to be the same, we will exceed 1,500 covid patients before the end of March in intensive care, which corresponds to a critical threshold," the Minister of Health Olivier Véran warned this Thursday evening.

As a result, the French health authorities are preparing to transfer patients to other regions, as was the case in particular during the first wave, in order to avoid saturation of Ile-de-France hospitals.

"There could be 300 to 400 transfers," said a close friend of Emmanuel Macron on France Inter.

The idea of ​​the government being to desaturate the hospitals in the region in order to avoid a local confinement of Ile-de-France.

A possible solution?

An action far from trivial

Patient transfers have already been used in the first and second waves.

In the spring, the transfer of 660 Covid patients in intensive care from Ile-de-France and Grand-Est had been orchestrated, in other French regions and abroad.

Mathias Wargon, emergency doctor in Saint-Denis, nevertheless recalls that the operation is far from trivial: “All patients in intensive care cannot be transferred, they must be transportable, in a stable condition, that the families accept… and above all, find beds available elsewhere ”.

Because unlike the first wave, it is the whole of France that is massively affected - slightly except for the southwest.

“Covid patients represent 80% of the initial capacities of our French intensive care units.

The pressure should increase further in the coming weeks, ”Olivier Véran recalled on Thursday.

However, 300 to 400 patients transferred for the Ile-de-France alone, "it is more than during the whole of the first wave", underlines Mathias Wargon, "it requires enormous work, exceptional logistics, and a lot of efforts.

"

Push back the problem… to sink better?

On the optimistic assumption that this happens, the impact would obviously be clear, at least initially.

400 fewer patients in Ile-de-France, this would desaturate the region of more than a third of its patients.

But for how long ?

For Hélène Rossinot, doctor of public health, we must not oppose confinement and patient transfers.

She says: “Transfers are inevitable now, but they are emergency measures, not curative.

It's a tourniquet on a hemorrhage.

It works for a while, but very quickly, either we repair the bleeding, or it necroses the leg or the bleeding starts again.

»To stop the bleeding is to reduce the circulation of the virus in the region.

Ile-de-France has a current incidence of 353.1 cases per 100,000 inhabitants, i.e. the metropolitan region with the highest average, for a national average of 222.84 cases.

"This is not an anti-Ovid measure, it is a consequence of the policy pursued until today", supports the doctor.

However, if nothing is done, with a British variant largely in the majority and likely to lead to a passage in intensive care more easily than the classic strain, nothing says that even with these transfers, the resuscitations are not again saturated in some cases. weeks.

Hélène Rossinot does not go four ways: “In Ile-de-France, it's shit, and it will be even more shit.

The urgency is to reduce the circulation of the virus, but it's been weeks and weeks that this is the case and that nothing more is done… ”She also notes that measures have been taken. taken in less affected areas.

The solution would therefore not be to desaturate hospitals so as not to re-define, but to re-limit while desaturation of hospitals.

For Mathias Wargon, it is clear that the circulation of the virus must slow down in the region.

“We can always hope for a miracle,” he notes without being totally ironic.

There are certain variations in contagiousness that we cannot control, regions where we do not yet fully understand why it is declining, etc.

But doing nothing would still be a gamble.

And if that doesn't work, we won't always be able to transfer patients elsewhere ”.

The same bet that led Ile-de-France to this situation.

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