The Paca region is the leading region in France in terms of incidence rate.
The low vaccination coverage is felt in hospitals, which find themselves totally saturated.
Staff shortages are felt, and caregivers are exhausted.
From the introduction, the tone is set.
"The Provence-Alpes-Côte d'Azur region is in an even more worrying situation than elsewhere in France", launches the director of Public Assistance of Marseille Hospitals (AP-HM) François Crémieux.
This Wednesday morning, during a press conference, the main executives of the AP-HM drew up an alarming situation, to say the least, of the epidemic situation in the region, in particular in Marseille.
How to explain that the fifth wave of coronavirus is so virulent in the region?
20 Minutes
takes stock.
A significantly higher incidence rate
With a figure reaching 892, the Paca region is currently the leading region in terms of incidence rate, ahead of the Auvergne Rhône-Alpes region and the Île-de-France region.
"This rate flirts with 1,400 or even 1,500 in certain age groups, especially in 40-55 years, and in certain territories", laments the director of the AP-HM François Crémieux.
In the Bouches-du-Rhône, the most recent incidence rate recorded is currently 890, which places it seventh among the most affected French departments.
"For an equivalent week, in 2020, this rate was 170", specifies Noémie Ressiguier, epidemiologist at the AP-HM.
"The positivity rate is on average 7%, that is again a rate higher than the national average, and reaches 12% in certain territories", agrees François Crémieux.
And the rise in power of the Omicron variant risks "not distributing the cards in the right direction", to use the words of Noémie Ressiguier.
“We test 2,000 people a day,” explains Dr Pierre-Edouard Fournier from the IHU.
To date, 167 cases of the Omicron variant have been detected, which represents a positivity rate of 14%.
What should be noted is that it is increasing relatively rapidly.
Last week, we were in the order of 5% prevalence.
"
A considerable delay in vaccinations
One of the explanations, according to the AP-HM, for this explosive situation is found in the particularly low vaccination coverage. “The vaccination situation in Marseille is serious, deplores Professor Rémi Charrel, medical referent for vaccination against Covid-19 within the AP-HM. Today, in France, the general population is vaccinated up to 77%. In the Bouches-du-Rhône, no agglomeration reaches these 77%. On average, this rate is at least 10 points below the national rate. As for Marseille, the situation is even worse. All the districts of Marseille have 60% vaccination coverage. There are four arrondissements that are 30% below national coverage: the 3rd, 14th, 15th and 16th. This situation is very worrying. "
Low vaccination coverage in the northern districts which is felt in the intensive care units.
"We find largely the inhabitants of these districts of Marseille the most deprived in conventional hospitalizations for cases of Covid-19" reports Professor Jean-Luc Jouve, director of the establishment medical commission of the AP-HM.
"86% of patients admitted to intensive care are not vaccinated or have only received a single dose," points out Professor Lionel Velly, head of the intensive care unit at Timone.
This means that 86% of intensive care hospitalizations are preventable!
"
A saturation of the beds
Faced with this particularly virulent fifth wave, hospitals in the region are struggling to accommodate the growing flow of patients, especially in intensive care units.
“The hospital pressure rate is over 90% in the Paca region, worries François Crémieux.
We are in a situation where almost all of the available beds, including critical care beds, are being used.
"
"We have been in a phase of increase since the beginning of November," notes Noémie Ressiguier.
We are currently in the seventh consecutive week of increase in the number of patients arriving at the hospital.
For the last week observed, in the Paca region, 1,440 new patients arrived at the hospital and at the same period in 2020, we were at 846. All the signals are red.
"
Currently, 300 of the 500 intensive care beds are occupied.
Within the AP-HM, 60 patients with Covid-19 occupy intensive care beds.
"In the region, we have already passed the peak in August," says Professor Velly.
And we know that we have an increase of nearly 10% of Covid-19 patients roughly every week.
"
To cope, deprogramming of non-urgent operations is underway.
In addition, new medical evacuations are being studied.
“We had five in the Bouches-du-Rhône and Vaucluse departments and two are still scheduled tomorrow from Avignon, announces Professor Laurent Papazian, in charge of coordinating resuscitation.
These patients will go to Normandy.
And there will likely be more medical evacuations from Marseille by the end of the week.
"
However, a solution that is increasingly difficult to implement, according to Professor Papazian.
"All regions are affected," recalls the professor.
And we had greater possibilities of medical evacuations, but we opposed many family refusals to be able to carry out these evacuations, even explaining that this reduces our capacity to welcome new patients.
We have to face what we can qualify as a certain selfishness.
"
A totally bloodless hospital
This umpteenth wave, which marks the health crisis over a long period of time, is sweeping over a hospital increasingly weakened by the situation, and in a state already worrying before the epidemic. For months, the AP-HM has had to deal with a lack of personnel, despite repeated calls for recruitments. "We would need 150 paramedics," said Karen Inthavong, general coordinator of care at AP-HM. Many caregivers have indeed thrown in the towel over successive waves. “The doctors are exhausted, laments Antoine Roch, responsible for adult emergencies within the AP-HM. More and more of them are deserting our services and no longer want to work in emergencies. "
The increase in patients with Covid is therefore supported by the staff who remain.
"We manage this without reinforcement, only with overtime," notes Professor Velly.
“On December 1, we exceeded 40,000 overtime hours,” explains Elsa Blanc, deputy director of human resources within the AP-HM.
This effort corresponds to the hiring of 100 full-time equivalents in one month.
“At present, 8,000 caregivers work in the AP-HM, the third public hospital in France.
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Hospital
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