• Two regions of France have launched the “white plan” in hospitals to remind caregivers on vacation and increase the number of hospital staff in the face of the increase in Covid hospitalizations.

  • Several unions point the finger at the lack of resources available to nursing staff who are understaffed.

  • More than this fourth wave, the global context of the sector strongly impacts the psychological state of health professionals.

This Wednesday, the Paca region was forced to trigger the "white plan" in its hospitals in the face of the resumption of the coronavirus epidemic.

The day before, Corsica had taken the same decision, thus allowing its health establishments to deprogram certain interventions deemed non-urgent or to recall caregivers on vacation in order to guarantee the continuity of care in the services.

Other regions could soon follow suit due to the increase in the number of Covid patients hospitalized in recent days, but also because of the current particularly tense situation in hospitals according to several unions who are sounding the alarm.

"20 Minutes" takes stock of the situation.

How many people with Covid are currently hospitalized?

At the national level, according to figures from Public Health France, critical care services had 1,331 patients on Tuesday (including 218 admissions in 24 hours) against 1,232 patients on Monday and 978 a week ago. An increase linked to the outbreak of the Delta variant and which is also generally observed in hospitalizations since the number of Covid patients in hospital is now 7,974, or 134 more than on Monday and 837 more than a week ago. 818 patients have been admitted in the past 24 hours, the highest figure since the end of May.

The Regional Health Agency also observes disparities according to the regions of France.

Thus in the Paca region, Covid hospitalizations have increased by 56% in one week and resuscitation care by 46%.

Tuesday, in Corsica, the share of Covid patients in intensive care was 77.8%.

Are there enough beds to accommodate this new influx of patients?

Depending on the level of people hospitalized, some regions could run out of places in the hospital in the coming days. The Public Assistance of Marseille Hospitals (AP-HM) indicates, for example, that its 32 intensive care beds are already all occupied. And summer vacation does not help matters. “In August, between 10 and 30% of beds are closed to allow agents to go on vacation,” explains Thierry Amouroux, spokesperson for the National Union of Nursing Professionals (SNPI).

The latter also points to the Social Security financing law passed last December "which provides for 1.4 billion savings on hospitals in 2021", which according to him inevitably leads to cuts in beds and positions.

As recently as Tuesday, several unions have called for an indefinite strike at the Nord Franche-Comté hospital, in particular to denounce the bed closures.

Will there be enough caregivers to handle this fourth wave?

The departures on vacation of hospital workers reduce the workforce in the summer, but another wave of departures could affect them in the much longer term. “Nursing professionals and caregivers are leaving hospitals because they are tired of the deterioration in working conditions month after month,” sums up Thierry Amouroux. It is the same everywhere: in the private sector, the public, whatever the size of establishment and in all regions. "If for the moment no figure has been communicated on this subject by the management of establishments, the spokesperson of the SNPI recalls that already" in June 2020, we had gone from 7,500 vacant nursing positions to 34,000 in September " .

Even without data, several clues suggest that hospitals are still facing a wave of resignations this year.

"Everyone advertises to try to attract nurses and nursing aides who are lacking everywhere," remarks Thierry Amouroux.

At the end of June, the APHP launched a major recruitment campaign that was much more resounding than in previous years.

What is the risk of this shortage of staff?

“When the head of the Lariboisière sheave in Paris announces that 40% of the nurses in his department leave the hospital, we understand the problem that will arise,” says Thierry Amouroux, recalling that for a service as specialized as intensive care, particularly mobilized in times of Covid, it takes between six months and a year to be operational.

The lack of staff could therefore affect the quality of patient care in certain departments.

"In intensive care, during the first wave, there were six Covid patients per nurse, in recent months, we have increased to eight Covid patients per nurse on average, or 30% more workload", gives as example Thierry Amouroux.

What state are the healthcare teams in?

If the Covid waves represent a peak of activity for all nursing staff in the CHU, over the rest of the year, the teams face an overload of work linked to all the chronic patients deprogrammed during a wave for lack of square. “So it's been a year and a half that the teams are over-revving and they can't take it anymore,” summarizes Thierry Amouroux.

“At the same time, we see the government making decisions going against common sense,” he continues, referring for example to the fact that people with a health pass can remove their mask in nightclubs.

"It's an aberration from a health point of view and it shocks us," he says.

Finally, the vaccination against Covid-19 made compulsory for caregivers by the government is not unanimous among caregivers.

The risk of seeing unvaccinated employees suspended at the start of the school year could deal a further blow to the morale of the troops, and generate even more understaffing.

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