All hospitals in Ile-de-France initiated a plan blanc on Wednesday, December 8th, following a rapid increase in cases, piling further pressure on the region’s healthcare system. This protocol will be rolled out across the entire country in the coming days.
In a statement, the regional health authority said that it had decided to activate the plan because of ‘a situation that has been clearly deteriorating since mid-November’.
What is a plan blanc?
It is an emergency device, enshrined in law in 2004, that allows the temporary mobilisation of additional personnel to deal with an exceptional health situation, such as Covid-19.
Once triggered, it allows hospitals to postpone non-essential surgeries and call-in staff who are on holiday. It is used in cases of a massive influx of victims following a major accident or disaster with numerous casualties, an epidemic or a deadly and lasting climatic event. It also allows for the mobilisation of a ‘health reserve’ to ensure healthcare levels are maintained.
It can be triggered by individual hospital bosses as required, as well as regional health authorities, prefects or the Prime Minister and is only lifted once the health situation has stabilised.
A back-up ‘extended plan’ – reserved for situations in which the organisation of the health system alone is not sufficient to deal with a health event, such as Covid-19 – allows departmental prefects to mobilise additional vital resources as necessary.
In the past, plans blanc have been triggered nationally during the influenza epidemic of 2017 and the deadly heat wave of 2003, and in six departments to deal with an outbreak of gastroenteritis in 2005.
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In the case of Covid-19, the first plans blancs were triggered on February 25th, 2020, in the hospitals of Creil and Compiègne to deal with the first clustering of coronavirus cases. On March 6th, all hospitals in the Grand-Est and Ile-de-France followed suit, then all hospitals in France were put on the emergency footing a week later.
A number of hospitals and regional health authorities have already unlocked their plan blanc. When Provence-Alpes-Côte d’Azur announced it had done so earlier on Wednesday, the deputy director of the Regional Health Agency said that “all hands were welcome”, and called on medical students, and self-employed and recently retired health professionals to offer their services.
On December 8th alone, health authorities in Auvergne-Rhône-Alpes, Occitanie, Pays de la Loire, Bourgogne-Franche-Comté and Île-de-France instructed all hospitals to trigger their plans blanc. The Regional Health Authority in Hauts-de-France asked hospitals in the Lille metropolitan area, Hainaut and Oise to activate their plans, and called on all hospitals to ready a total 114 additional ICU beds.
Over the past week, hospitals in Mulhouse, Colmar and Nancy, in the Grand-Est; Saint-Malo, Dinan and Cancale (Brittany); Le Mans, Alençon, Orléans; Tours (Centre-Val de Loire); and Bayonne and Bordeaux (Nouvelle Aquitaine) have all activated their plans.
Why the urgency?
Nationally, Santé publique France figures published on Wednesday revealed that more than 61,000 new cases of Covid-19 had been recorded in the previous 24 hours, compared to the figure of 49,610 published the previous Wednesday. A total 129 deaths were recorded.
Meanwhile, 13,044 patients were being treated in hospital for coronavirus infection, including 2,426 in intensive care. On December 1st, 10,558 Covid-19 patients were hospitalised, with 1,886 in intensive care.
“Regional plans blancs will be triggered in the coming hours in major regions of France due to the influx of covid-19 patients. A patient with a serious form of the disease enters the intensive care unit every 10 minutes,” Health Minister Olivier Véran warned in the Senate on Wednesday.