Wednesday’s defense council meeting is expected to assess the results of 10 days of increased restrictions in the 16 departments where they were first imposed, and consider whether additional measures are needed to “slow” the spread of the virus.
Some of the options being considered are imposing additional lockdown rules and closing schools, reported FranceInfo.
A minister said: “If we don’t take action, the risk is that the schools will close anyway.”
Schools could close for a total of three or four weeks, it is suggested. This week, new rules went into effect in schools that state that a single confirmed case of Covid is enough to close a class, up from three cases previously.
Health Minister Olivier Véran said last week: “We will only close [schools] last resort. ”
Read more: Class to close if a student has Covid in the most affected regions of France
Saturation of hospitals and “selection” of patients
A source close to the president said: “Emmanuel Macron’s ‘red line’ is patient selection [meaning that staff will have to choose which patients receive intensive care and which do not]. »
At the end of October 2020, Mr Macron said he viewed such a ‘triage’ – including the need to ‘choose between a Covid patient and a road accident … or two Covid patients’ as ‘unacceptable’.
But hospitals and doctors have already started warning of over-saturating intensive care units, which they say will effectively lead to patient selection and could mean some patients cannot receive the care they would have. other.
In two separate letters published at the end of last week – in The world et en the Sunday Newspaper (JDD) – Hospital doctors have warned against “triage of patients” in intensive care units.
The signatories called the current pressure on hospitals a “catastrophic medical situation”.
The large Parisian hospital group L’Assistance Publique-Hôpitaux de Paris (AP-HP) held a crisis meeting on Saturday March 27 to discuss “unpublished” figures in Ile-de-France, reported France Inter.
The meeting concluded that if a full lockdown is not imposed from April 1, 230 people will be hospitalized per day in Ile-de-France, double the current figures.
Professor Bertrand Guidet, head of intensive care at Saint-Antoine hospital in Paris, said: “If we wait a bit – imagine that we do not force childbirth until April 8 – the peak will be reached. April 19, and we’ll see numbers skyrocket. .
“We will not be able to cope with such a demand. As professionals and intensive care workers, we do not want to tackle such extreme situations on our own.
A source close to Mr Macron said: “There is still some leeway [such as] transfer patients or postpone other operations. ”
But open letters in Le Monde and JDD contradict this, saying that even canceling all possible operations, they will still have to set up a “triage” system for the intensive care units, and will have to deny some patients a bed in. care intensive care.
The letter from the JDD read: “Major medical and surgical cancellations have already been imposed on us and… we know very well that this means lost opportunities and non-access to care for some patients.”
Doctors of the World wrote: “When hospitals are asked to cancel or postpone 40% – and up to 70% – of surgeries, the government approves a prioritization strategy under another name, which consists in favoring Covid-19 patients at the expense of others.
Triage: how it works
Critical care physicians are required to make such decisions regularly, but not on the scale seen due to Covid.
Dr Anne Geffroy-Wernet, president of hospital union the enlarged Syndicate of hospital anesthetists-resuscitators (SNPHARE), explained to FranceInfo: “In intensive care, our job has always been to choose the patient who will benefit the most.
“A 20-year-old who has little chance of survival after a serious motorcycle accident has a lot to gain from intensive care, if he does. While a 110-year-old patient with metastatic cancer and dementia, will see no benefit from a stay in intensive care.
As an emergency doctor in Colmar, Haut-Rhin, Told France 2 last year: “Intubate, put [the patient] in a coma; it can just lead to [increased] suffering, for nothing.
In this case, the doctor was referring to a patient in his 80s, who was in respiratory distress, but had many other medical conditions. It was therefore decided not to admit him to intensive care.
French law requires two doctors to make such a decision, including “an intensive care doctor and one who has no direct contact with the intensive care unit”, explained Professor Lila Bouadma, resuscitation doctor at Bichat-Claude Bernard hospital in Paris.
“We always have to call someone from the outside, so that the decision is not made by one team.”
But in the open letter to The world On Sunday, nine AP-HP intensive care doctors said those decisions are not the same when doctors are faced with two patients who could benefit as well.
They wrote that this situation means that “only one intensive care bed is available, but … two patients could benefit.” We decide who will be admitted (and will likely survive) and who will not (and will likely die).
“Restrict access to intensive care to patients who could benefit from it [is a choice] far from basic ethical rules. ”
Dr Geffroy-Wernet said: “The more we have to triage, the more the choice becomes.”
Leaders discuss ‘international pandemic treaty’
The results of the Defense Council meeting and President Macron’s expected speech come as European leaders seek to deal with possible future health crises.
In one open letter in The world, the leaders of 26 countries, as well as the President of the European Council Charles Michel and the head of the World Health Organization Tedros Adhanom Ghebreyesus, called for an “international treaty against the pandemic”.
The leaders represent countries from five continents, including President Macron, German Chancellor Angela Merkel, British Prime Minister Boris Johnson and Presidents Moon Jae-in of South Korea, Cyril Ramaphosa of South Africa, Joko Widodo of Indonesia and Sebastián Pinera from Chile.
The letter reads as follows: ” [Covid-19] take advantage of our weaknesses and divisions [so]“Such a renewed collective commitment would be an important step in consolidating pandemic preparedness at the highest political level.
“There will be other pandemics and other large-scale health emergencies. No single government or multilateral body can face this threat on its own, ”we read.
This could include increasing the ‘resilience’ of countries to pandemics and ‘strengthening international cooperation to improve, for example, warning systems, common information, research, production and distribution. [of vaccines, medicines, tests, and protection equipment]The letter continues.
He says: “We are committed to ensuring universal and equitable access to safe, effective and affordable vaccines, drugs and tests for this pandemic and the future. Immunization is a global public resource. ”
Such a treaty would “lead to a broader and shared responsibility” and “allow transparency and cooperation on a global scale”, requiring “time and a commitment over several years”, “global leadership”, the letter concludes.
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