Coronavirus in nursing homes (2/3): a director talks about his "crisis management"

After four weeks of isolation in the accommodation establishments for dependent elderly people (Ehpad), Pierre Gouabault is just beginning to raise his head. Currently in charge of three establishments in the Center-Val-de-Loire region, he has not yet identified any cases of coronavirus. But for the past week, he has also been managing the Covid-19 crisis management in a nearby establishment in Salbris.

The toll is heavy: ten deaths in a few days, including five related to the coronavirus, as well as 19 cases of suspicion. "It is not a wave but a tsunami which entered the Ehpad, it is a real drama", comments Pierre Gouabault.

"Even science fiction had never imagined such a scenario"

"No one is prepared for this. We may have implemented business continuity plans, we are close to chaos, comments the 37-year-old administrative manager. Even science fiction had never imagined such a thing. scenario." In France, more than 700,000 elderly people with loss of autonomy are accommodated in some 10,600 nursing homes, according to data from the Ministry of Health. According to an initial partial account announced on April 2, at least 884 died from the Covid-19.

In the Salbris establishment, more than 50% of the workforce was declared sick on March 23, including the establishment manager, himself affected by Covid-19. It is first of all the director of a neighboring Ehpad who replaces him at short notice. Pierre Gouabault, he comes in reinforcement 48 hours later, on his own initiative. "It's simply a logic of solidarity," he explains.

Within a few days, the director put together an operational team: 14 young people were recruited, mainly nursing students. "They are essentially in third year and have the equivalent of a nursing assistant position," he said. Then, the health reserve is also mobilized, with three nurses and three nursing assistants from all over France. "It is in real drama that the solidarity of the nation is revealed," he said.

Congratulations to the mom of my colleague from promo @ ED3S_ThClerc @EHESP @karelleherm who came to strengthen the # EHPAD #salbris # covid19 teams. Retired and united! Our pride our EHPAD, our pride solidarity @ARS_CVDL @FHFCVdL @ Departement41 pic.twitter.com/OUyFS5Jh5b

"The most vulnerable in society are entitled to the utmost attention"

For him, the "terrible" health crisis currently playing out in the world will have the merit of "taking a unique look at the question of solidarity", he comments. The general public thus discovers the middle of the Ehpad, where "the most fragile in society are entitled to the utmost attention".

As required by the protocol, a Covid-19 unit has been set up within the establishment. Located on the first floor, the dedicated service mobilizes three health professionals permanently. "They're all volunteers, but it's a heavy choice," he said. "This is what accompanies life. Life to the end, with dignity."

In case of respiratory distress of residents, the director can request a transfer to the resuscitation service of a nearby hospital. "We are lucky not to be a region where hospital services are saturated," he slips. One of the infected residents was hospitalized before dying.

The question of protective masks, Pierre Gouabault prefers not to drag on. "The prevention phase is behind us," says the director. The masks arrived a week ago, "and still not for everyone", he slips, before letting go: "It's almost too late."

Now is the time for patient management, says the director of Ehpad. We need single-use overcoats, "he says." The real challenge now is to strengthen personnel protection measures, "he concluded.

>> Read also: "Coronavirus in Ehpad (1/3): 'It is no longer work but survival'"

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