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HEALTH

How can France increase hospital ICU capacity to 10,000 beds?

French health professionals have greeted with scepticism President Emmanuel Macron's pledge that ICU capacity in the country's hospitals would increase to 10,000 beds to cope with rising Covid-19 hospitalisations.

How can France increase hospital ICU capacity to 10,000 beds?
Health personnel at the intensive care unit of the Andre-Gregoire Hospital in Seine-Saint-Denis, outside Paris, treat a Covid patient on April 1st. Seine-Saint-Denis is the area suffering the highest pressure from the epidemic on hospitals. Photo: BERTRAND GUAY / AFP

On Wednesday, Macron outlined plans for an “extraordinary mobilisation” of the health sector in the coming days. 

Since the start of the pandemic, the number of hospital intensive care beds has been brought up to 7,665 beds from its usual base of 5,000. Of those, 7,053 are now occupied – 5,109 by Covid patients, according to Covid Tracker.

Health Minister Olivier Véran said the number of patients in intensive care could peak at 10,000 at the end of April. In comparison, at the peak of the health crisis last spring, on April 8th, 7,148 people were being treated in intensive care units across France.

During the second wave, intensive care patients peaked at 4,919 on November 16th. 

Healthcare issues

Increasing the number of beds to cope with rising Covid infections comes at the expense of non-Covid patients who needed medical help, several senior doctors have said.

“Theoretically, it is feasible, but to achieve it concretely it would take at least three weeks or a month,” said Alain Ducardonnet, a doctor and health consultant for French TV channel BFM.

Bruno Mégarbane, head of the intensive care unit at Paris’s Lariboisière Hospital, told French news channel LCI: “It can be done by transforming recovery rooms, operating theatres, or other sectors of medicine into new, temporary intensive care beds.”

The issue is not finding the beds.

Mégarbane explained the cost to staffing: “Doctors, nurses and anaesthetists would need to be redirected from operating theatres to these new beds.” 

It is estimated that 40 percent of non-Covid related surgeries have already been postponed to allow treatment for the number of patients with the virus. The health minister said last week that the aim was to increase this number to 80 percent in the greater Paris region Île-de-France, where hospitals are struggling to cope.

REVEALED: Just how bad is the third Covid wave hitting France compared to previous spikes?

Thierry Amouroux, spokesperson for the National Union of Nursing Professionals and a nurse at Saint-Louis hospital in Paris, described the knock-on effect. 

“When you postpone 5 percent of the operations, it is only cosmetic surgery [that gets cancelled], but at 40 percent, it starts to get serious, and when the [regional health authority] posts a target of 80 percent deprogramming, it touches on oncology (cancer treatment),” he told French daily Le Parisien.

Staffing and training 

Mégarbane said that, as well as current staff, the health system in France would have to mobilise its healthcare reserve, a list of 26,000 retired doctors, military medics and students at the end of their studies to be able to care for the number of people requiring the level of treatment and monitoring involved in intensive care.

But, then there is a question of training. Intensive care is highly specialised.

“In normal times, we can take less trained people and supervise them. Here we cannot, everyone is at the limit of what they can do,” Nicolas Bruder, head of the intensive care unit at La Timone hospital in Marseille, told BFM TV.

“So we need fully-trained people from tomorrow and we do not have them.”

Jean-Daniel Lelièvre, head of infectious diseases at Mondor hospital in Créteil told Le Parisien: “It seems completely unrealistic. We have the equipment and the physical space in the hospitals, but what will be lacking is the staff. 

“The president seems to say that we will find reinforcements, but will he learn resuscitation himself in two weeks? It is not my habit to criticise, but you should not announce anything.

“Going to 10,000 beds is a third more than the peak of last year. We do not know how we did it [then] and today staff are exhausted, while patients with other diseases are in a much more serious state because of breaks in care.”

Others have been rather more direct. These medics at the CHU de Nancy demonstrated their professional opinion of Macron’s statement in a tweet:

“We obey our president:

 – we make the effort

 – we move the walls to accommodate 10,000 ICU beds”

 

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HEALTH

Macron announces free condoms for under-25s in France

French president Emmanuel Macron has announced that from the beginning of January, condoms will be available for free in pharmacies for young people.

Macron announces free condoms for under-25s in France

Speaking while on a visit to Vienne in south west France, the president said: “In pharmacies, condoms will be free for 18-25 year-olds. This will begin on January 1st.

He added: “It is a small revolution of prevention.”

Since 2019 condoms have been available on prescription from doctors and midwives, with the cost reimbursed via the carte vitale health card.

However, Macron’s announcement goes a step further and makes them available on an over-the-counter basis from pharmacies, without the need for a prescription or to obtain a reimbursement via the health card.

Since the beginning of 2022, women aged between 18 and 25 have been offered the contraceptive pill, IUDs, contraceptive patches and other long-term contraceptives for free, while all women can now access the morning-after pill for free. 

Under-18s are already entitled to free contraception, but there were concerns that some women were stopping contraception once they turned 18 because of the cost.

The French government also launched on December 1st a new advertising campaign around AIDS – reminding people that with correct treatment AIDS patients can end with an undetectable viral load and therefore be unable to pass on the virus.

The campaign, which is appearing on billboards around France, is a play on words on séropositif (HIV positive). 

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