Confinement puts the French economy “in a state of anesthesia”

France is “Like an organism placed in a state of anesthesia” who “Only performs its vital functions”. In its last note published on April 23, INSEE confirms that the French economy is largely at a standstill, after five weeks of confinement.

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The organization estimates that the general level of activity in France has been cut by a third since mid-March. In the market sector (the one that produces goods and services that are sold), the drop in activity is even half, with some differences according to the branches.

Hotels and restaurants are logically among the most affected with a fall of 91%; automotive construction is down 72%; 80% refining; 55% trade. Compared to the last INSEE note, at the end of March, the situation is improving slightly in industry (- 39% instead of – 43%) and in construction (- 79% instead of – 88% ).

Some restaurants reopen for take-out

“Right now, a lot of companies are not even allowed to work,” regrets Alain Griset, president of the U2P, the Union of local businesses, who cites aesthetics and hairstyle … They want to reopen. But even for those who are licensed, activity is low. On average, we are barely 50% and in the building, not even 20% ”.

The construction sector itself is very diverse. “The building ranges from the craftsman alone to large public order sites. Small businesses are more agile and many of them have maintained their activity, which was not possible on larger sites. “, observes Vincent Frayssinet, director general of the French Building Federation for the Ile-de-France East.

As for the restaurants, some of those that were closed have been tentatively trying to open their doors for the past few days. Not for terrace service; only so customers or couriers can wait for takeout. ” Some establishments have gone on take-out for the past few days, admits an employer manager in the sector. But it is a very marginal and essentially urban phenomenon. “

Public services work

On the other hand, certain branches are still little affected by confinement. This is the case of finance, which is at its usual level of activity, or of food production, which only drops by 5%. In agriculture, the decline is 13%. The drop also remains limited in services “Non-merchants”, reflecting the fact that most public services, from health to police to education, continue to operate.

This calculation is based on an analysis of the value produced. INSEE also compared these figures with data on the conditions of employment of employees collected from companies with 10 or more employees and figures on partial unemployment. Today, nearly one in two private sector employees, or ten million people, are affected by partial unemployment measures. This device was requested by 820,000 companies, more than 6 out of 10.

In private companies with more than 10 employees, we observe a distribution in four equal parts: a quarter of the employees goes to work, a quarter is in telework, a quarter in partial unemployment and a quarter in sick leave or paid holidays.

No sign of massive short-time fraud

The situation is of course very different depending on the sectors and the size of the companies. “Today, out of the 77,000 employees of Engie in France, 32% are teleworking, 18% are on site, 31% on miscellaneous leave and 19% on partial unemployment “, Says Pierre Deheunynck, the group’s human resources director. For staff placed on partial unemployment, the group has committed to ” maintenance of purchasing power By encouraging its employees to take time off and RTT.

INSEE tried to verify that the data on activity, on conditions of employment and on partial unemployment do not present a contradiction. The organization concludes that they “Are consistent with the assumption of an economy turning at around two thirds of its capacity, all sectors included, with a more marked fall for the merchant sector”. This tends to show that there is no massive partial unemployment fraud, despite some testimony that has shown that companies here and there may have taken advantage of the windfall.

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The eurozone at a standstill

Private sector activity in the euro area collapsed in April at an “unprecedented” rate, as a result of measures taken to halt the spread of the coronavirus, according to the first estimate, Thursday, April 23, Markit firm composite index.
The monthly index is 13.5 points, compared to 29.7 points in March, which constitutes “By far the largest contraction in overall activity recorded in more than twenty years of surveys.” “In comparison, the index fell to 36.2 in February 2009, the height of the global financial crisis,” emphasizes the cabinet.

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Shortages extend to drugs

Faced with the unprecedented scale of the crisis and the influx of patients, stocks are running out. First those of protective masks. Then reagents used in diagnostic tests from Covid-19. And the respirators, whose production is struggling to keep up with demand. Little by little, everything necessary for hospitalization and treatment of patients is running out. Even the most common equipment, the most common drugs.

“Hospital stocks of muscle relaxants, sedatives and painkillers are consumed quickly”, is alarmed by the European Alliance of European University Hospitals, and “At their current rate of consumption, stocks will be empty within a few days in the hospitals hardest hit, and within two weeks for those with the largest reserves.” In their press release published on Tuesday, forty doctors and directors of establishments in France and other European countries call their respective leaders to coll

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Camille Gévaudan

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Resuscitation drugs: “We fear a shortage of stocks”

Damien Roux, university professor and hospital practitioner of intensive resuscitation medicine, works in the medical and surgical resuscitation department of Louis-Mourier Hospital (AP-HP), located in Colombes, in the Hauts-de-Seine. As of last weekend, this doctor was responsible for reflecting – in collaboration with other colleagues from the Public Assistance taking care of Covid-19 patients – on the means of optimizing the use of drugs in the services of resuscitation, due to the ever increasing number of serious patients. “The aim was to anticipate the overconsumption of certain drugs in the same way that we have been trying to increase the number of nurses for the past month»He explains. Except that a week later, the fear of an imminent shortage of certain molecules became a reality in Ile-de-France. “Despite our prospects and our vigilance on the issue, it is clear that suppliers and manufacturers are no longer able to monitor the consumption of drugs or certain medical devices in our hospitals.He warns.

AP-HP Director General Martin Hirsch acknowledged at a press conference on Friday that “stocks are very short on certain drugs.“This Saturday evening, it’s Edouard Philippe who admits the existence of”supply tensions here and there” “We regulate them by ensuring the circulation of these products throughout the territory, because there are stocks. We guarantee it by making sure to encourage increased domestic and global productionAdded the Prime Minister. Update with Professor Roux.

What is the situation of Louis-Mourier resuscitation service today?

We fear the beginning of a stock shortage for the end of the weekend. We have visibility over two days. That is to say, we are not sure that our internal pharmacy will be able to supply us with all of the drugs necessary for optimal patient management. There is great concern because it is very likely that the AP-HP central pharmacy, despite all its efforts, may not be able to meet the demands of all hospitals and that we will end up with shortages during the restocking. This shortage situation is new but ultimately quite logical. Instead of having a variety of patients who require very different treatments, resuscitation services are currently finding themselves with a majority of Covid + patients who need the same molecules. It is this quantity of identical patients, hitherto unknown in our units, which causes the drug shortage.

Which families of molecules are likely to be lacking?

There is a strong tension on hypnotics. These are the molecules we use to keep patients in sleep in intensive care. The equation is therefore simple: if we run out of stocks, we will no longer be able to take care of new patients. It’s a real danger. We also fear a rapid shortage of curares, which allow the patient, once asleep, to prevent him from moving and therefore consume less oxygen. Curares are necessary because they allow these patients with acute respiratory distress syndrome (ARDS) to be completely ventilated by the ventilator. The last other concern concerns antibiotics. As we speak, I do not believe that an AP-HP hospital is lacking. But there is a risk of overconsumption in the days and weeks to come, because these serious patients in intensive care are at high risk of nosocomial infection. As you can see, the supply of these three groups of molecules is essential to save lives.

Your working group’s mission was to think of new protocols to save your stocks. A summary of your recommendations is currently being sent to all AP-HP hospitals. What does it contain?

At this stage, we propose an optimization of the sedation protocols in order to limit any use which is not absolutely necessary. A close relationship between the pharmacy and the resuscitation service is also necessary in order to anticipate any shortage of a molecule to refer to another close molecule. We also underlined the interest of associating other molecules making it possible to reduce the quantity of usual molecules to be administered. More specifically for sedation, one of the recommendations would also be to use the usual method of anesthesia in the operating room. It is a procedure that uses halogenated gases to put people to sleep and that we never use in most resuscitation services. This technique would also limit the use of curares.

At Louis-Mourier Hospital, where are you with your stock of syringe pumps, which allow the infusion of treatments? Some hospital structures already seem to be lacking…

We did the drawer bottoms and requisitioned all the units a little to find as many as possible. But indeed, faced with the impressive influx of resuscitation patients, we had to resolve to work with fewer electric syringe pumps per patient. For the moment, it does not degrade the quality of care but it causes discomfort in work for nurses who must regularly move this type of equipment from one room to another. Unless suppliers, especially Chinese, can quickly send us a large quantity of electric syringe pumps, we will have to modify the way we administer treatments to patients using less precise techniques.


Anaïs Moran

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Coronavirus: caregivers “head in hand”

For three days now, around 8 p.m., the confined French have been applauding them from their windows. These thanks and encouragement, to say the least welcome, undoubtedly put a balm on the hearts of hospital staff. The fact remains that at a time when the Covid-19 is deploying in France and mobilizing more and more beds in the intensive care units, it is the certainty of the time to come which is particularly tense and difficult which imposes itself on all these caregivers.

This apprehension stems from the unprecedented nature of the current epidemic and is increased by the lack of protective means (masks, gloves, hydroalcoholic gel) and equipment (artificial respirators). This maximum stress is added to the fatigue that preexisted Covid-19, in personnel already in tense flow because of budgetary savings. This is what the caregivers of the hospitals say: Release collected testimonies, across France.

Some are already hard, confro

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Anesthesia, sedation, hypnosis: which anesthetic helps the dentist?

WORLD: When painful treatment is due, dentists resort to local anesthesia – it prevents you from feeling anything during the procedure. Why do patients want to be sedated even more when the pain is turned off?

Dietmar Austria: Of course, the fear of the intervention plays a role. The mouth, jaw and face area is one of the most sensitive areas of the whole body. Pain or changes are perceived much more intensely there than in other places. If, for example, you have hair in the oral cavity, you will notice it immediately and it will be terribly disturbing – because the tactile sensation is very pronounced there. In this respect, the perception of pain and manipulation in the oral cavity is an unpleasant topic for many people; We know from surveys that roughly one in two people have a bad feeling or fear when it comes to dental treatment. Sometimes there is even a real anxiety disorder: five percent suffer from dentist phobia.

WORLD: Does it often happen in your practice that you do more than one local anesthetic?

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