Coronavirus in France: evidence of tension in hospitals in the Grand-Est

Text by: Caroline Paré Follow | Ophélie Lahccen

The peak of the coronavirus epidemic has not yet been reached in France. However, in certain regions of the country, the evolution in terms of cases as of death is very important. This is the case for the Grand-Est region. Cross interview with two health professionals.

Publicity

In France, the Grand-Est region is particularly affected by the SARS-CoV-2 coronavirus pandemic. Hospitals and nursing staff are in a situation of extreme tension.

Cross-interview with two health professionals on site: Doctor Éric Thibaud , head of the emergency department and SMUR of the Civil Hospitals of Colmar and France , nurse at the Mulhouse hospital. They were on Wednesday March 25 in the morning the guests of the program Priorité santé , on RFI .

Do you feel that the wave of the coronavirus epidemic is coming back?

Dr. Éric Thibaud: No, unfortunately that is not yet the case. Currently, we welcome around ten patients every day who require intensive care. We have a relatively limited overall patient flow, thanks to the containment measures that have had their effect, since we no longer receive cases of road accident or sports trauma. On the other hand, there are still very many coronavirus patients and suspected cases. We receive between 30 and 40 per day, including almost a quarter of serious cases, requiring intensive care.

What are the symptoms of these patients who are being resuscitated in your home today?

Dr. Éric Thibaud: The complete inability to breathe. The lung no longer fulfills its role, so people suffocate. Before that, the symptoms are quite varied. The frequent symptom remains cough, usually accompanied by fever. We now know that some people have digestive problems (diarrhea) at the start. It has also been described a loss of taste and smell or a change in these senses. The clinical picture remains primarily respiratory. There are no predictors of cases requiring or not resuscitation.

Among people in intensive care, do you observe a profile, a particularly vulnerable population?

Dr. Éric Thibaud: No, we cannot define a standard profile. Patients in intensive care are between 30 and 80 years old. On the other hand, we have identified risk factors: the problems of overweight and obesity, sleep apnea, chronic respiratory pathologies ... We do not yet have enough perspective to be able to affirm what really constitutes a factor of risk. It's more of a trend, an impression that we have.

France: With us, in Mulhouse, it's a fairly mixed population. I share the opinion of Dr Thibaud. We also have patients between 30 and 80 years old. Some have other pathologies such as high blood pressure, diabetes, sleep apnea or other respiratory diseases. But for some patients, there is no other major pathology associated

Are all your resuscitation beds occupied in Colmar?

Dr. Éric Thibaud : Yes, very widely. In recent days, we have sent patients to Germany , Switzerland, and neighboring regions. Usually, our capacity in Colmar is 30 intensive care beds. At present, it has been increased to 50 beds. In the Haut-Rhin department, capacity is increased to 130 beds. While we have almost doubled our usual capacity, this is not at all sufficient. A resuscitation stay in a coronavirus situation lasts two to three weeks. If we receive a dozen patients and it is the same for Mulhouse (also ten) it means that we have about 25 patients a day in the department. These patients stay two or three weeks. You can imagine that 130 beds are absolutely not enough at such a rate.

These stays in intensive care are therefore longer than those you receive than in normal times?

Dr. Éric Thibaud : Indeed, in normal times, intensive care stays are generally much shorter. In the case of the coronavirus, the lung lesions are so severe that it takes time to heal. Unfortunately, there are also sometimes complications that arise ...

We know the highly contagious nature of this virus. France, how do you protect yourself from the risk of transmission, you who are extremely exposed as a nurse?

France: On a daily basis, we wear an over-blouse that tears very easily, gloves, a charlotte, a mask, glasses and overshoes.

Is all this material available in your Mulhouse hospital?

France: Yes, but the FFP2 masks were given to us very late. They were initially reserved only for invasive care such as intubation. We also missed the hydroalcoholic solution. You have to beg daily to get equipment.

As a nurse, what is your state of mind today ?

France: At first, I felt a certain annoyance since we had been waiting for this confinement for a long time, as well as preparation beforehand… We were caught off guard in our services. Currently, the state is in exhaustion.

Is this feeling of exhaustion shared by your colleagues from Mulhouse today?

France: Completely! We were in a crisis, long before this coronavirus. We were in great difficulty, we lacked beds. The premises are not suitable. In terms of personnel and equipment, we had needs. The situation was unmanageable. We were already in great difficulty before, to this is now added this health crisis. Exhaustion is therefore shared by all my colleagues.

This situation of confinement has another dimension for you caregivers: the loneliness of the sick, including those in extreme distress.

France: Absolutely, patients arrive at the emergency room with firefighters, paramedics ... They do not have their families by their side, their bearings. They are delivered to us, to us the caregivers who are disguised, whom they do not recognize. They are frightened when they arrive at our house. They can be hospitalized, intubated without even perhaps seeing their families one day.

The eyes of the media are focused on Mulhouse because the President of the Republic, Emmanuel Macron, was to go there on Wednesday, March 25. The reason for this visit is the installation by the army of a field hospital, which has been in operation since yesterday. What is your view on this situation?

France: This military hospital will be able to unclog our resuscitation services, but the 30 beds will be occupied as quickly as they were installed ... We have transfers every day to Switzerland, Germany, Brittany ... Our services resuscitation are constantly engorged.

Do you have a message for Emmanuel Macron?

France: Before, we were forgotten. Today we are considered superheroes. And tomorrow, what will we do with us?

We are talking about solidarity and recognition of the population towards caregivers. Is it important to you ?

Dr. Éric Thibaud : Obviously, it is heart-warming and it is essential for team morale to have this support. Unfortunately, I also have more negative personal experiences and echoes. We also scare the population. We are seen as potentially contaminating, as are our children. I had difficulty looking after my children. Fortunately, there are people who are really willing to make an effort for us. The songs, the applause on the balcony are important for morale, but what matters even more are the people who will do a little more for the caregivers. It can be a delivery of food, the sending of material found at home or agree to welcome our children, whatever the risk ... I think the risk is before us. If we are not in good working conditions, we will not be able to work.

France: My feeling is divided. This solidarity warms our hearts and we need it during this difficult period. It cheers us up. I cry every night when I hear the neighbors cheering. On the other hand, I have the impression that we only notice our work today, because this crisis is there. It's too bad.

Do you have a message for those who are not yet in an epidemic situation?

Dr. Éric Thibaud: What we are experiencing today was unimaginable. We are in a completely surreal situation. The worst catastrophic scenarios have not predicted what will happen to us. It is imperative that the places that have not yet been touched prepare. The priority is to be ready to face the epidemic, by putting in place the means. Here in the Grand-Est, we are fortunate to have very complete technical platforms. This is not the case everywhere, but what matters is the preparation and the awareness that what we are going through is much more than a flu, as some people can say. in the beginning. We are in a dramatic situation.

Do you think containment is essential?

Dr. Éric Thibaud : Containment is essential, as long as there is nothing better. You have to respect it. The best way to show support for caregivers is to respect the measures put in place.

France: People have to understand that containment is essential. I know that it is difficult for the French, that they need to go out, to see people. Choosing between that and getting treatment, being in intensive care or maybe never seeing your family again, I think that confinement must be respected. It just takes a little discipline ... Think of us, the caregivers! If you want the flow of patients with Covid-19 to decrease, you just need a little discipline and respect: stay home!

Our selection on SARS-CoV-2 coronavirus

• Listen to Infos coronavirus , our daily column on the Covid-19

• An infographic: The coronavirus in 7 points

• Practical questions:
→ What is the lifespan of the virus?
→ Who are the vulnerable people ?
→ What should you do when you think you are contaminated ?
→ Quarantine, what are we talking about ?
→ What treatments ? The effectiveness of an antimalarial drug in question
→ The advice of a psychiatrist to live well confinement

Find all our articles, reports, chronicles and programs on the coronavirus by clicking here .

Newsletter With the Daily Newsletter, find the headlines directly in your mailbox

Download the app

• Coronavirus
• France
• Health and Medicine
• our selection

On the same subject

Coronavirus: the advice of a psychiatrist to live well confinement

Coronavirus and diabetes: why you need to be extra careful

Against the coronavirus, the effectiveness of an antimalarial drug in question