During a patient transfer to Tours, in November 2020 (archives) -

GUILLAUME SOUVANT / SIPA

  • There is hardly any room in intensive care in Ile-de-France so, a year later, the ball of transfers of patients and patients between regions resumed this weekend.

  • Air transfers for the moment, but which will not be enough to relieve congestion in the Paris region.

    It will be necessary to use medical trains.

  • Evacuations are not a miracle solution, however, because the less stressed regions do not have unlimited reception capacities.

These images were among the most striking of the first confinement: those of the transfers of patients with Covid-19, from one region to another, by plane, medicalized TGV or even military ship.

At the worst of the first wave, some regions with saturated resuscitation services had to send patients to areas less "in tension".

These images are back in March 2021, just a year after the start of the first lockdown.

If the government is to be believed, the pace should even accelerate in the coming week, probably not good news from the point of view of exiting the crisis, but from a logistical point of view, how does this feat work?

"It's extremely heavy logistics", recalled on BFMTV Frédéric Adnet, the medical director of the Samu of Seine-Saint-Denis.

This is to ensure the safety of people transferred, of course we cannot transfer just any patient who, if she is in intensive care, is therefore in serious condition.

There are medical criteria: the person must be stable from a ventilatory point of view and a cardiac point of view.

You also need the agreement of relatives, and it is not necessarily easy to obtain.

“It’s extremely difficult, because it’s seeing someone from your family with a vital prognosis moving away to the other side of France.

Of course, we have a certain number of refusals and we respect the wishes of the family, ”explained Frédéric Adnet to our colleagues.

Air evacuations will not be enough

This weekend, the first six people left the hospitals in Ile-de-France for the province, especially New Aquitaine.

Gabriel Attal, the government spokesman, announced this Sunday from the tarmac at Orly airport three other air evacuations each day from Monday.

The government, which is trying to avoid a reconfinement of Ile-de-France, the region where the health situation is most worrying at the moment, would like to transfer around a hundred patients next week.

This objective represents around 10% of people currently in intensive care in the Paris region.

If "it is time for general mobilization" and "every bed counts", as Gabriel Attal says, transfers by plane or helicopter will not be enough.

"We may have to renew what we did during the first wave, that is to say transfers by TGV" medicalized, said Frédéric Adnet on Saturday.

“We have experience of it,” he added.

In this case, several dozen people can be transferred at one time each time.

However, this is not done by snapping your fingers: "We know that the establishment of a health TGV with 24 patients requires forty-eight to seventy-two hours", details at the microphone of Europe 1 François Braun, president of the Samu emergency France.

Tight timing to avoid re-containment

However, the "railway situation" in France is, at this time, not that of the first confinement.

In April 2020, almost no train was running on the network.

Today, the situation has not returned to that before the pandemic, but a place will have to be found on the trans-sanitary tracks in the middle of passenger trains.

All this will take time: BFMTV has learned from the ARS of Ile-de-France that these TGVs capable of transporting 24 to 48 people will only be available at the end of the week.

The timing will be tight in a region where 95% of resuscitation beds are already occupied by Covid-19 patients.

Last problem and not the least, the reception capacities of regions not yet under tension are not infinite.

Far from it even.

First, if we are to believe the data from the CovidTracker site, only two French regions have an occupancy rate of resuscitation beds by Covid-19 patients of less than 50%.

They are 46% in New Aquitaine, and even only 40% in Brittany.

The Pays-de-la-Loire are not so far away, at 52%.

And above all these figures do not count the other patients, who must go through an intensive care unit for other reasons, planned or emergency.

With perhaps a hundred more beds occupied in a few days, these areas will also likely have to deprogram planned surgeries soon.

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