Strasbourg (AFP)

Four beds available out of 55: at a time when the curfew is decreed, the resuscitation services of Strasbourg hospitals, already very busy with the usual autumn activity, see the second wave of the epidemic arriving with apprehension, but also more experience.

On Thursday, ten Covid patients were on "shifts".

This figure is still modest compared to the peaks observed in April, but which represents a significant increase in activity and could increase sharply in the coming weeks.

"We are gradually seeing that we have more and more Covid patients, we feel that we will slowly fall back into a situation comparable to the first wave," says Armelle Fieuvet, intensive care nurse at the New Civil Hospital (NHC), equipped a charlotte, glasses and a protective overcoat.

Compared to spring, the seasonal activity is much more important.

"We are in the autumn period, and without counting the pandemic, our resuscitation services are already almost full", explains Professor Ferhat Meziani.

On the 4th floor, all the beds in the infectious diseases department are already occupied by patients with Covid-19.

In case of worsening of their condition, some will have to be transferred to intensive care.

Health executive, Florence Cionneau fears "the coming wave".

"The first time, it was trying hours, we over-solicited the caregivers, we asked them to return to the hours of rest to help. We say to ourselves that reliving that, psychologically, is complicated."

-"We learned"-

So, the Strasbourg CHR is anticipating: it has already planned a deprogramming plan for activities in other services, starting with pneumology, geriatrics and internal medicine, in order to free up staff as needed.

"It is all the more important that today, all regions are affected, so mutual aid between hospitals will be very difficult," said Ferhat Meziani.

Likewise, the CHR has acquired the equipment that it was sorely lacking a few months ago.

"There have been purchases of respirators, masks, gowns, drugs ... There is no longer a shortage, we have stocks at four months," says Emmanuel Andres, head of the internal medicine pole.

The medical teams also plan to use the lessons learned from the first wave to improve patient care.

"We learned from the previous episode. We know in particular that corticosteroids make it possible, in a number of cases, to prevent aggravation and the need for intensive care," says Vincent Castelain, head of the medical intensive care unit at Hautepierre hospital.

"We have fewer intubated patients, and when they are, it lasts less."

The use of anticoagulants has also reduced the number of pulmonary embolisms, although it has no impact on the virus itself.

In the end, the average length of stay for Covid-19 patients was thus reduced from 30 days "to about twenty", according to Ferhat Meziani.

- "Tsunami" -

But if the caregivers feel a little "better armed" now, they also concede having accumulated "lassitude" and fatigue over the past six months and say they are bitter after the meager salary increases obtained at the end of the Ségur de la Health.

"It has aroused a lot of hope, in particular for recognition of the specificities of the work of intensive care nurses," says Vincent Castelain.

"But all that was pschit, they were not recognized + nurses of advanced practices +, there is a deficit of consideration", he regrets.

So, rather than being possibly applauded every evening, nurses and doctors call for respecting barrier gestures, to limit the spread of the virus, and hope that flu vaccination campaigns will prevent overloading services.

Otherwise, the wave could turn "into a tsunami", worries Ferhat Meziani.

© 2020 AFP