Doctors fear worst of Covid-19 wave still to come in France

In the Covid-19 intensive care unit of the Antony Private Hospital south of Paris, no bed stays free for long and medics wonder when their workload will finally peak.

Doctors fear worst of Covid-19 wave still to come in France
Nurses tend to a Covid-19 patient under respiratory assistance lying unconscious in a room of the intensive care unit of the Hopital Prive hospital in Antony, a southern Paris suburb on April 2, 2021. (Photo by Christophe ARCHAMBAULT / AFP)

As one recovered elderly patient is being wheeled out of the ward, smiling weakly, boss Jean-Pierre Deyme is on the phone arranging the next arrival and calling out instructions to staff.

Louisa Pinto, a nurse of nearly 20 years’ experience, gestures to the vacated room where a cleaner is already at work, scrubbing down the mattress for the next arrival.

“The bed won’t even have time to cool down,” she says as the patient monitoring system beeps constantly in the background. 

For now, everything is stable in the 20-odd beds around her where Covid-19 victims lie inanimate, in a silent battle with the virus.

Paris is going through a third wave of the pandemic, which risks putting even more strain on saturated hospitals than the first wave in March and April last year.

“With what’s coming in April, it’s going to be very complicated,” says Pinto, a mother of three who hasn’t had a holiday since last summer and like other staff will be cancelling a planned break this month.

Even with a new round of restrictions coming into force this week, Health Minister Olivier Véran predicts that infections in France will peak only in mid-April, while hospital admissions will continue climbing until the end of the month.

READ ALSO: Why the average age of patients in France’s intensive care units is getting younger

Alarming forecasts leaked to the French media from the Paris public hospital authority AP-HP last week showed anywhere from 2,800-4,400 people in intensive care in the Paris region by the end of April even with a strict lockdown. In the first wave, the number peaked at 2,700.

Intensive care capacity is increased but staff shortages threaten healthcare

The director of the Antony hospital, Denis Chandesris, says intensive care capacity has already been increased by drastically reducing all surgery except for critical cancer, cardiological and emergency cases.

Hospitals everywhere in the region have taken similar measures, re-deploying beds and creating new wards, but they are reaching their limits.

“The difficulty is not so much beds or material, it’s a question of finding medical and paramedical staff to be able to take in patients,” Chandesris explained.

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

Last Sunday, a group of emergency care directors in Paris warned in an open letter that the situation was so bad that medics would soon have to start “triage” – selecting patients for care based on their chances of survival.

This prospect horrifies staff – and President Emmanuel Macron has always promised to shield hospitals and avoid the sort of scenes witnessed in Italy last March when patients piled up in corridors. 

In a televised speech to the nation on Wednesday night, he promised to increase intensive care capacity nationwide from 7,665 beds currently to 10,000 – a jump of 30 percent.

“I want to thank medical students, retired people, the army health service and medical reserve volunteers. All of them will be mobilised in a larger way,” he announced.

Opposition politicians and some experts reacted with scepticism while an Ifop poll for the Journal du Dimanche weekly found only 35 percent of French people had confidence in their government “to deal effectively with the coronavirus”.

Pinto, the nurse, underlined how working in intensive care is “very technical”, requiring specialised training and knowledge.

French President Emmanuel Macron hopes new lockdown measures will curb the wave of Covid-19 cases. (Photo by BENOIT TESSIER / POOL / AFP)

French PM pins hopes on new restrictions

Macron is banking on a limited lockdown over the next month turning the rising tide of cases, which have roughly doubled to 40,000 a day compared with their level a month ago.

The sharp acceleration is down to the spread of the more contagious so-called British variant which has become dominant in France.

New measures include nationwide travel restrictions, which limit people to 10 kilometres (six miles) from their homes, and the closure of schools and non-essential shops.

Only a significant increase in the vaccination campaign – which started sluggishly but is now picking up pace – fills any of the medics at Antony Private Hospital with any hope.

A medical worker prepares a dose of the Pfizer/BioNTech vaccine, in France. (Photo by JEAN-FRANCOIS MONIER / AFP)

After months of lacking doses, the government is promising a major rollout this month and an increase in the rate of jabbing.

Samir Taik, a taxi driver from Paris, walked out of the Antony hospital last week as the 1,000th Covid-19 patient to have benefited from oxygen therapy in the Covid-19 intensive care unit.

READ ALSO: UPDATED: When will you be eligible for the Covid vaccine in France?

The 43-year-old, who enjoys boxing and sport, is still short of breath and reeling from the trauma of seeing his health deteriorate so fast.

He says he knows three or four people with a similar profile to him who have been hospitalised recently.

“Young people need to know that we’re not talking about 80-year-olds, it’s people who are 30, 40, 45-year-olds and have no health problems. The British variant is not like the old one,” he told AFP.

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Where in France are there concerns about pesticides in drinking water

An investigation has revealed that tap water supplied to some 12 million people in France was sometimes contaminated with high levels of pesticides last year.

Where in France are there concerns about pesticides in drinking water

Data from regional health agencies, and collated by Le Monde, found that supplies to about 20 percent of the population, up from 5.9 percent the year previously, failed to consistently meet regional quality standards. 

The study highlighted regional differences in tap water quality. Hauts-de-France water was the most likely to be affected, with 65 percent of the population there drinking water contaminated by unacceptable pesticide levels. In Brittany, that level fell to 43 percent; 25.5 percent in the Grand-Est, and 25 percent in the Pays de la Loire.

Occitanie, in southwest France, meanwhile, showed the lowest level of non-compliance with standards, with just 5.1 percent of the region’s population affected by high pesticide levels in their tap water. However, figures show that 71 percent of people in one département in the region, Gers, were supplied with water containing high levels of pesticides.

Regional discrepancies in testing, including what chemicals are tested for, mean that results and standards are not uniform across France. Tap water in Haute-Corse is tested for 24 pesticide molecules; in Hauts-de-Seine, that figure rises to 477. 

One reason for regional testing standards are differences in local agricultural requirements.

Part of the increase in the year-on-year number of households supplied with affected water may also be explained by the fact that tests in many regions now seek to trace more molecules, Le Monde noted.

Water quality standards in France are strict – with a limit for pesticide residues set at 0.1 microgramme per litre, so the “high” levels found in tap water supplies may not represent a danger to health.

The question of the level of health risk to humans, therefore, remains unclear. The Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses) has not defined a maximum safety level for 23 pesticides or their metabolites. Le Monde cites two metabolites of chloridazone, a herbicide used until 2020 on beet fields, for which only provisional safety levels in tap water have been set. 

Many of these molecules and their long-term effects remain unknown – and “the long-term health effects of exposure to low doses of pesticides are difficult to assess,” admits the Ministry of Health.

Michel Laforcade, former director general of the ARS Nouvelle-Aquitaine told Le Monde that health authorities have “failed” on this subject. 

“One day, we will have to give an account,” he said. “It may not be on the same scale as the contaminated blood affair, but it could become the next public health scandal.”

In December 2020, the Direction générale de la santé (DGS) recommended “restricting uses of water” as soon as the 0.1 micrograms per litre quality threshold is exceeded, in cases of residues for which there is no formal maximum health value.

But this principle is not always applied, according to France 2’s Complètement d’enquête programme.

In December 2021, the DGS asked the Haut conseil de la santé publique (HCSP) “for support on the management of health risks associated with the presence of pesticides and pesticide metabolites in water intended for human consumption.”

The HCSP, in response, said that “an active and urgent policy must be implemented to reduce the contamination of resources by pesticides”.