A tense situation. The entire metropolis is in an epidemic situation of bronchiolitis, five regions (Provence-Alpes-Côte d’Azur, Occitania, Auvergne-Rhône-Alpes, Burgundy-Franche-Comté and Grand Est) are at epidemic alert level 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 some regions, this triple epidemic is beginning to put emergency services in difficulties. Especially in the Big East. 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) of this region has placed its 43 emergency services in red.
In detail, Oru Occitanie prepares a “weather forecast” for the region’s emergency services every week. A weekly evaluation that takes into account the number and duration of emergency room visits, but also the number of hospitalizations, available or closed beds and even regulatory activity.
“For several weeks now, we have been witnessing a growing increase in the number of visits to the emergency room,” Hervé Mourou, coordinating doctor at Oru Occitanie, observes for BFMTV.com. In this case: +2% last week. “It doesn’t seem like much, but it adds to the increases from previous weeks. And that’s a lot of patients.”
“Last week we surpassed 2022 activity at the same time. That’s significant.”
The “overlapping” of epidemics
The epidemiologist Mircea Sofonea points out the conjunction of these three epidemics. “The overlap (Covid-19, bronchioloitis, flu, editor’s note) is relatively strong,” he explains on BFMTV. What will be the situation in the coming days or weeks? “It’s very difficult to plan for the future.” A vagueness that is due in particular to the active circulation of an Omicron subvariant: JN.1, considered much more transmissible than the flu.
“Four years after the start of the pandemic, several waves of Covid-19 still occur every year,” says Mircea Sofonea, researcher and professor of epidemiology and evolution of infectious diseases at the University of Montpellier. “We are far from what was said, at the time of Omicron’s arrival, about the fact that the situation would normalize.”
Which potentially puts even more pressure on hospitals during the holiday period, notes Bruno Mégarbane, head of the intensive care unit at the Lariboisière hospital (AP-HP).
“It is a time when the mix of the population is more important,” he explains on BFMTV. “Therefore, the risk of transmission of viral infections, especially respiratory infections, is greater.”
6,700 bed closures
While this configuration is relatively common every winter, the situation could become critical this year due to the reduction in the number of beds in hospitals, Bruno Mégarbane remains concerned. “Once again we are approaching these epidemics with difficulty.”
Former Health Minister Aurélien Rousseau had promised to “reopen several thousand beds before the end of the year,” but their numbers have continued to decline. More than 6,700 bed closures by 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 early 2000s, according to data from the Institute for Research and Documentation in Health Economics. Healthcare workers periodically denounce these bed closures, which saturate services, put pressure on teams and increase tensions in emergency services.
In total, around 29,800 beds were eliminated during the period from the end of 2016 to the end of 2022, which corresponds mainly 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 Nicolas Sarkozy’s five-year term (-37,000).
The peak of bronchiolitis has passed.
The Health Risk Monitoring and Anticipation Committee (Covars) warned this Thursday of the resurgence of respiratory diseases in France. For this reason, its members recommended intensifying the campaign to prevent Covid-19 and respiratory infections and the return of barrier measures.
This is also the call of Bruno Mégarbane, head of the intensive care unit at the Lariboisière hospital (AP-HP). Because if some five million people have been vaccinated against Covid-19, “this only represents 27% of the target people,” this doctor laments. The interested public is made up of people aged 65 years or older, people with comorbidities, immunosuppressed people and their loved ones, as well as pregnant women.
“These viruses are not going to disappear,” warns Bruno Mégarbane. “We are lucky to have effective means to prevent risks, avoid developing a more serious form, ending up in hospital and increasing pressure on caregivers, reducing the quality of care.”
A positive element in the current context: the asynchrony of the epidemics with respect to last year. Because if all of France is in an epidemic situation of bronchiolitis, the peak has already passed. However, when it comes to the flu, “we are entering an epidemic,” warns Bruno Mégarbane. Two regions (Normandy and Brittany) are not yet in the pre-epidemic phase.
“The unknown is to what extent the flu will spread this year,” concludes the specialist.
Source: BFM TV
