2023-12-22 15:07:59
The triple epidemic affecting France could quickly put pressure on emergency services in the coming weeks.
A tense situation. The entire metropolis is in an epidemic situation for bronchiolitis, five regions (Provence-Alpes-Côte d’Azur, Occitanie, Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté and Grand Est) are placed on alert level epidemic for flu and Covid-19 is progressing, according to the latest bulletin from Public Health France. Why fear that hospitals will be overwhelmed during the holidays?
In certain regions, this triple epidemic is starting to put emergency services in difficulty. Particularly in the Grand-Est. The Regional Health Agency (ARS) thus activated the white plan last week in Haut-Rhin and Bas-Rhin. In Occitania, the situation is also complicated. The Regional Emergency Observatory (Oru) in this region has placed its 43 emergency services in red.
Covid, flu: will we all be sick before the holidays?
In detail, Oru Occitanie produces a “weather forecast” of the region’s emergency services every week. A weekly evaluation which takes into account the number and duration of visits to the emergency room, but also the number of hospitalizations, available or closed beds and even regulatory activity.
“For several weeks, we have been witnessing a growing increase in the number of visits to the emergency room,” observes for BFMTV.com Hervé Mourou, coordinating doctor at Oru Occitanie. In this case: +2% last week. “It doesn’t seem like much but it’s on top of the increases in previous weeks. And that’s a lot of patients.”
“Last week we surpassed 2022 activity at the same time. That’s significant.”
The “superposition” of epidemics
Epidemiologist Mircea Sofonea points to the conjunction of these three epidemics. “The overlap (Covid-19, bronchioloitis, flu, Editor’s note) is relatively strong,” he explains on BFMTV. What will the situation be in the coming days or weeks? “It’s very difficult to plan ahead.” A vagueness which comes in particular from the active circulation of a sub-variant of Omicron: JN.1, considered to be much more transmissible than the flu.
“There are still, four years after the start of the pandemic, several waves of Covid-19 each year,” points out Mircea Sofonea, researcher and lecturer in epidemiology and evolution of infectious diseases at the University of Montpellier. “We are far from what was said, at the time of the arrival of omicron, about the fact that the situation would normalize.”
Which, potentially, puts even more pressure on hospitals during the holiday period, points out Bruno Mégarbane, head of the intensive care unit at Lariboisière hospital (AP-HP).
“It’s a time when the mixing of the population is more important,” he explains on BFMTV. “The risk of transmission of viral infections, particularly respiratory infections, is therefore higher.”
6,700 bed closures
If this configuration is relatively common every winter, the situation could however become critical this year due to the reduction in the number of beds in hospitals, Bruno Mégarbane still worries. “We are once again approaching these epidemics with difficulty.”
The former Minister of Health, Aurélien Rousseau, had promised to “reopen several thousand beds by the end of the year” but their number has continued to decline. More than 6,700 bed closures for 2022 alone, according to the results of the Directorate of Research, Studies, Evaluation and Statistics (Drees).
The collapse in capacity has been almost constant since the beginning of the 2000s, according to data from the Institute for Research and Documentation in Health Economics. Caregivers regularly denounce these bed closures, which saturate services, put pressure on teams and increase tensions in emergency services.
In total, nearly 29,800 beds were eliminated over the period from the end of 2016 to the end of 2022, mainly corresponding to the presidency of Emmanuel Macron. This is much more than under his predecessor François Hollande (-15,000 between the end of 2012 and the end of 2017) but significantly less than during the five-year term of Nicolas Sarkozy (-37,000).
The peak of bronchiolitis has passed
The Committee for Monitoring and Anticipation of Health Risks (Covars) warned on Thursday of the resurgence of respiratory diseases In France. Its members therefore recommended intensifying the campaign to prevent Covid-19 and respiratory infections and the return of barrier measures.
This is also the call from Bruno Mégarbane, the head of the intensive care unit at Lariboisière hospital (AP-HP). Because if some 5 million people have been vaccinated against Covid-19, “this only represents 27% of the target people”, laments this doctor. The public concerned is made up of people aged 65 and over, people with comorbidities, immunocompromised people and their loved ones as well as pregnant women.
“These viruses are not going to disappear,” warns Bruno Mégarbane. “We are fortunate to have effective means to prevent risks, to avoid developing a more serious form, ending up in hospital and increasing pressure on caregivers, reducing the quality of care. “
A positive element all the same in the current context: an asynchrony of epidemics compared to last year. Because if the whole of France is in an epidemic situation for bronchiolitis, the peak has passed. On the other hand, with regard to the flu, “we are entering the epidemic”, warns Bruno Mégarbane. Two regions (Normandy and Brittany) are not yet in the pre-epidemic phase.
“The unknown is to what level the flu will spread this year,” concludes the specialist.
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