“If you feel sick, wear a mask», states a poster at the entrance to the emergency department of the Nantes University Hospital, rather calm on this freezing afternoon. Since January 6, the establishment has activated its blank plan to deal with the flu epidemic which was clogging up the emergency rooms. «It is more intense than last year but not more virulent than two years ago», comments Professor David Boutoille, specialist in infectious and tropical diseases at Nantes University Hospital, adding that the hardest hit patients are mainly elderly people suffering from health problems (unbalanced diabetes, obesity, heart failure, pulmonary pathology, etc.).
The white plan makes it possible to activate three measures: opening of beds downstream of emergencies, cooperation with follow-up care in the territory to distribute those leaving the CHU and deprogramming of non-urgent surgical interventions. “We are talking about operations whose postponement has no impact on health”, specifies David Boutoille. It is the surgeons who, department by department, revise their operating program. Vital interventions (cancer, transplants, etc.) are maintained and postponements concern, for example, bariatric surgery (gastric banding), ophthalmology or the installation of non-urgent joint prostheses.
81 operations postponed
The first week of the white plan, 24 beds were opened on the two hospital sites (14 in the city center and 10 north of Nantes) and 65 operations were postponed. The following week, 16 interventions were canceled but this week, none. Only 8 beds remain open on the North hospital site. “We have passed the epidemic peak, the situation has improved, notes Ségolène Lebreton, director of the platform which supervises emergency management. But the flu is still circulating a lot, so we must remain cautious. »
These measures have in any case made it possible, in the eyes of management, to «unclog emergencies » and reduce the duration of patient care from fifteen to eight hours. Since January 13, the regional health agency (ARS) has also introduced the regulation of access to emergencies at night, between 8 p.m. and 8 a.m., throughout the department. «The first three nights went well,” greets the platform director. Of the 96 patients who requested access to the emergency room via the 15, reinforced for the occasion, 56 entered, 14 received medical advice and 26 were taken care of by community medicine.
“A simple adjustment variable”?
Shouldn’t recourse to the white plan be reserved for exceptional circumstances, such as a serious road accident, an attack or a health crisis? “These white plans should not become commonplace and become a simple adjustment variable,” warns Olivier Terrien, general secretary of the CGT at Nantes University Hospital, who emphasizes that, during this period, agents are required to work overtime and cut back on their rest or leave to provide care.
-“No lessons have been learned you Covidhe laments. We continued to close beds and professionals deserted the profession. Result: we risk triggering a white plan every year at the slightest winter epidemic, due to lack of personnel…”
Low vaccination coverage
The hospital is suffering from a scissors effect due to long years of bed closures and a medical demographic at its lowest, depriving more and more patients of an attending physician. «But awareness is there, and new beds will be opened to cope with aging and the increase in the population in our area”assures Professor Boutoille.
Another necessity according to him, is to increase vaccination coverage for the most vulnerable and those around them to create a “cocoon effect”. However, this year, only a third of the target people took the plunge. «I have patients who died of the flu when they were very fragile, but they preferred not to be vaccinatedhe regrets. We pay very heavily for disinformation on social networks…”
