Covid-19 – Martinique: Special “covid-19” units reactivated at the CHU – All the news from overseas in 360 °

In order to prevent the acceleration of the number of confirmed cases of Covid-19, the Martinique University Hospital has reactivated its special “Covid-19” units.

After the white plan launched last week by the CHU of Guadeloupe, the CHU of Martinique reactivated its special Covid-19 units, faced with the acceleration of the number of cases in the department (340 cases identified during this month of August. A decision taken by “precautionary measure” but also of anticipation “, indicates the CHU of Martinique.” We reactivated the device which was in place last March. That is to say that specialized units for the least seriously affected patients were opened. We also reactivated the covid sector in intensive care for the most serious patients, ”replied André Cabié, head of the infectious diseases department at the CHUM to RCI Martinique.

If the intensive care services are far from saturation (3 patients currently hospitalized against 20 patients at the beginning of April), the health authorities are continuing the calls for vigilance. This circulation of the virus in Martinique is the consequence of the circulation of many people, family or friendly reunions. We see that the oldest people are starting to be affected. We really have to take these precautions vis-à-vis the oldest and most fragile people, such as people suffering from chronic diseases or obesity ”, declared Professor André Cabié. As a reminder, Martinique was placed in the list of departments classified red for active circulation of Covid-19 by the Government last week.

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Good kisses from Guyana (with a mask)

At the age of 27, in order to get a change of scenery and to leave the hospitals of the metropolis for a while, Arthur (1) had chosen a medical internship in Guyana for the summer of 2020. It was just before the pandemic:

“I chose my period well, you will tell me: after the first deluge of patients in metropolitan France, the Guyanese wave. Without being a journalist myself, I will try to follow this quote from Albert Londres: “Our job is not to please, nor to do harm, it is to carry the feather in the wound.” This testimony will therefore necessarily be unique to me, with my vision as a caregiver, my bias as a metropolitan and the inherent bias in preserving anonymity while trying to remain faithful to what is happening away from cameras and institutional social networks. I will mainly talk about hospital and territorial management but will not address the issue of city medicine due to ignorance of the subject.

Read alsoIn Guyana, caregivers “keep their fingers crossed so that nothing goes wrong”

“Before talking about Covid, I would like to paint a quick picture of the health situation here: Guyana is currently suffering from a dengue epidemic, and for a long time that of HIV. And that’s without counting the problems that are much more frequent than cardiovascular disease or cancer. Take Saint-Laurent-du-Maroni for example, for a population pool of several tens of thousands of people, the number of hospital beds in acute medicine outside the Covid-19 period is … 30. It is not to sink into the miserable but it is certain that 30, that calms down … In total, there are three hospitals on the coast distributed in the big cities (Cayenne, Kourou and Saint-Laurent-du-Maroni) and centers of health dispersed in land and along waterways. We all know that the investment and skills of caregivers are very heterogeneous in the hospital… but here we can say that it is pushed to its climax. Before detailing the dysfunctions in the management of this crisis, I would like to greet some incredible caregivers: those who have been pillars of care in this department for several years, those who have set up services, those who allow the hospital to stand up. But alongside these staff, we find jumbled mercenaries who don’t care, those who don’t have the skills but don’t realize it, and those who feed their ego. In such a difficult environment, the contrast is striking.

Staggering lack of communication

“You have to adapt in Guyana all the time. We have to adapt to patients: to a sometimes exacerbated precariousness, to the different language barriers, to their paperwork problems, to their life outside the big cities of the coast. We have to adapt to the means: digestive endoscopies are Cayenne, urology is Kourou, ophthalmology is Saint-Laurent-du-Maroni. Certain biological examinations… it is the metropolis. So I can understand that we cannot work as I am used to in metropolitan France, that we have to juggle and make compromises. But some situations are just indecent. Not in France, not in 2020: we do not refuse to take a patient in his thirties in intensive care under the pretext that he is HIV and Brazilian. We do not die after having an epidural for childbirth. We are not saying that we do not care if we made a mistake because the patient speaks poor French and will not file a complaint. You cannot be unreachable when you are on call… I think that in metropolitan France, no one would accept some of the things that I have seen here. And that can be brushed aside with the back of the hand since “It’s that or nothing, there is no one else”. It is not acceptable, it is indecent. And still I’m lucky in my medical practice, I’m a guy, people listen to me. It sucks, but that’s how it is. This is clearly not specific to Guyanese hospitals: more than once when I was a student I was spoken to instead of my boss. But here it is exacerbated, I am ashamed to have to repeat what my female colleagues say so that less competent men listen to them. It is blatant, it is shameful.

Also read, the previous episodes of the Epidemic JournalEpidemic Journal, by Christian Lehmann

“The patients, at least as far as I have come across, have illnesses made worse by many social problems. Two like that in your room in metropolitan France, it burns you out for the day. Here it is everyday. Illnesses as in the books and patients who do not fit into the administrative framework. I don’t want you to imagine the Wild West by reading this, but there are so many great projects to strengthen or create, I think our fellow citizens deserve to be done better. So inevitably, when a pandemic emerges, we are not serene. We had two major advantages: a young population and a few weeks ahead of the mainland. We quickly forget the weeks in advance, they were squandered by internal quarrels between hospital management, crisis management and the ARS. It was almost as if we were discovering the problems day to day, with a beautiful ball of hypocrites constantly parading in the media and on social networks. I am very happy to see the director of ARS Guyane, Clara de Bort, pose on the tarmac of the airport with her staff and congratulate herself on carrying out Evasan (medical evacuations) in a beautiful cooperation with hospitals. Unfortunately, it has happened several times that some of these evacuations were announced on television or on the Internet… before warning the doctors who directly took care of the patients concerned. The first time it was a family who came to ask us at what time their loved one would be evacuated when we had not been informed …

Read alsoIn Guyana, endless confinement

“Finally, I would have had the right to the same speech here as at the start of the wave in metropolitan France:” No, but France is different, it will not be like Italy “,” No, but Guyana, that will be fine, it won’t be like in the metropolis. ” One day you will explain to me which part of “pandemic” you did not understand. I don’t know, honestly, how we could confidently say that everything was ready, that we didn’t need help and that everything was going to be fine. I feel like I heard Macron say that we never ran out of masks. Nobody one day could assume to say “It’s shit, but we will adapt as quickly as possible, everyone is on the front”? Must always put everything under the carpet? Fortunately, we had help, a lot of help, a lot of people who came to give a helping hand whether it was on their leave, on an agreement between hospitals, via the army or the health reserve. However, I would still like to underline the astounding lack of communication between hospitals, ARS and health reserve. You try to round up your friends to fill in the holes, put on the patches to keep it going and you finally discover that a whole team is arriving but no one has seen fit to warn the staff. You may even hear the phrase “There are too many reinforcements” while services are still understaffed. I know that in the end the whole technostructure will congratulate itself on the excellent management and will go with its little comment, but it is the caregivers who make it possible to hold on.

Infernal mixture of care, public opinion and political interests

“The health reserve I still have a few complaints. Throwing in the room retired general practitioners who have not done hospitality since their start of their careers and putting hospital workers in town, doesn’t that sound like a bad idea? I have no desire to be ungrateful to my colleagues, more than courageous, who volunteered to come, but maybe estimating the needs and positioning the reinforcements accordingly would be a good start. So inevitably when by ego we say that all is well in the services, we find ourselves hearing that a pulmonologist or infectious disease specialist is not necessary in Guyana. Anyway, we are no longer close. Ah and I greet you dear resuscitator colleague who did not want to see respiratory distress because you were eating. I do not forget you. Same for the reinforcements who complained about not being able to tour, I do not forget you either.

Read alsoIn Cayenne, unwelcome hunger: insufficient humanitarian aid

The climax of this infernal mixture between care, public opinion and political interests was the trial planned for plasma therapy (with plasma from patients who had developed antibodies). If we summarize the situation, a trial concerning the interest of plasma therapy in Sars-CoV-2 infection had started in metropolitan France and was to continue in Guyana. There are two advantages to this: to provide patients with a potentially useful treatment and to succeed in including enough patients to reach a robust conclusion. In a context of mistrust of health authorities, media hubbub and the habit of this department being left behind, announcing this news from Paris was very clumsy. Let us add to this that this was done not by a PUPH (university professor-hospital practitioner) but by a PUPH, Karine Lacombe, and it was gone. Everyone has gone there from their affiliations to promote themselves, deputy, local collectives, close to Didier Raoult’s IHU. And in this mess, in the end, people were therefore pushed to demonstrate to refuse the help of an infectious disease specialist and her team in a territory that badly needed it. Admittedly, the announcement was awkward, but we saw people chanting loud and clear that they refused therapeutic help. I thus saw a good number of messages passing to say that the Guyanese patients were not guinea pigs. It’s such a no-brainer: no one is ever forcibly included in an essay if they don’t want to. This is the very basis of our ethical principles. But obviously to say it would do a disservice to the conspiracy discourse. On the other hand, promoting the use of hydroxychloroquine without any proof of its effectiveness in Covid, that was to use patients as guinea pigs. Associations have been calling for the creation of a university hospital in Guyana for years… and when a university team comes to do research, the door is vehemently slammed in its face.

“All this reflects a profound ignorance of clinical research and its functioning. So I hope that some people’s political agenda was worth it. In all of these ego bickering, whenever politics take precedence over caregivers and scientists for the wrong reasons, it is the patients who drink. While the Guyanese are worth it that we are interested in their territory, that we invest in improving access to healthcare here and that it be worthy of France. ”

(1) The first name has been changed.


Christian Lehmann doctor and writer

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Germany: Christian Drosten, a very discreet “mister corona”

“Which virologist do you trust the most?” asked the tabloid Bild to its readers, on April 3. The 60,000 participants in the survey did not hesitate: Christian Drosten is the undisputed champion, the favorite of the public. At 48, the director of the virology department of the Berlin University Hospital of Charity already has an impressive career behind him, just crowned with an award from the German Research Foundation. Drosten was recognized for his “exceptional achievements for science and society in the face of a dramatic evolution of the pandemic ”.

He is one of the most listened to scientists in Germany. By the government, but also the general public. He intervenes several times a week in a very popular radio program, covering all types of subjects : Does the virus spread through the air? Are children as contagious as they say? Begun on February 26, the show is at its 34e episode, and always

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Johanna Luyssen correspondent in Berlin

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Coronavirus: the ultras “say no to a premature resumption of football”

“The ultras are the trade unionists of popular football”, explained to Release sports historian Sébastien Louis. In this health crisis, they also seem to be the guarantors of the health of spectators as much as the guardians of temples who only make sense with people in their spans. In a press release published on Monday, about fifty associations of supporters, ultras or not, and supporting around thirty clubs “Say no to a premature resumption of football” : “France has experienced its worst health crisis for several generations. Many people are dying in hospitals more in demand than ever. […] Everywhere, collective interest prevails. “

Under these conditions, they write, “It is urgent to wait. It is not conceivable that football will resume prematurely. It is not possible that it will resume in camera. It will resume in due course when the health and social conditions are met. ” While the season is far from over, the football league has offered to resume L1 and L2 on August 22 and 23. Between the end of the season, the players’ vacations and the preparation, it is difficult to imagine such a scenario possible, except to want to resume quickly and behind closed doors. From Lille to Montpellier, from Brest to Strasbourg, the ultra groups then castigate these “” Thinking heads “of football who quarrel”, “far from these harsh, concrete realities, far from this capillary and anonymous solidarity” symbolized by these caregivers and ultras who decided to participate in the collective effort.

Read also Sports: ten scenarios (more or less eccentric) for the end of the season

Masks and pizzas

Because on the ground, a number of supporters deprived of their passion have decided to mobilize their forces for charitable, social actions or in favor of hospitals. As in Toulouse, where the Tolosa Indians harvested more than 11,000 euros from 500 people to buy coffee, fruit juice, cakes or cookies for the Purpan and Rangueil teaching hospitals. A little further north, the Ultramarines also bring boxes overflowing with food at four Bordeaux hospitals. And, taken in Tenon or La Pitié-Salpêtrière, Massy (Essonne) or Chelles (Seine-et-Marne) – and even as far as Seine-Maritime or in Burgundy – the photos of hospital staff and firefighters are increasing daily, Collectif Ultra Paris scarf in hand and in medical combat uniforms, posing in front of boxes of foodstuffs financed by members or sympathizers of the CUP as well as pizzas offered by restaurateurs and delivered by members of the group.

Even if not all of them are signatories to the press release, all of the associations organize its actions, rooted in their city and in solidarity with their hospital staff. Like the ultra Marseille people who, in addition to the banners hung in the stadium or in the streets in support of the mobilized staff and Professor Didier Raoult, the South Winners distributed some 3,000 protective masks collected from their members for hospitals, the IHU and seafarers.

“Football torn from its roots”

An altruism that does not stop at supporters of elite clubs since those of FC Rouen, resident of National 2 (4e division), also collected 900 euros while the Rouen Fans hung a banner of support in front of the CHU “Strength and honor to our caregivers”.

Read also Coronavirus: European football on the brink of a crash

Even though football clubs have often displayed their support for hospital staff, with money or simple messages, the actions of ultra groups, in terms of their means, contrast with the will of directions giving the impression of wanting resume as soon as possible, so as not to see the windfall of TV rights escape them. Everyone, however, believes that they are defending the best interests of the club: some talking about financial survival, others about spectator health or the ridiculous nature of matches behind closed doors for months. “This football is dying of being torn from its roots and not being able to see more than a fiscal year, a window of transfers or a multi-year contract for television broadcasting. […] [Le football professionnel] must take advantage of this break time to rethink “, explain the associations in their press release. Who conclude: “Football” at all costs “is a football of shame, which will have no future.”

Damien dole

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WHO: a first role undermined by “every man for himself”

Wash your hands, maintain social distance, and above all “Test, test, test”. There are three of them, every day at 5.30 p.m., two meters apart, lined up behind a desk at the end of a very long meeting room, which is deserted because it is forbidden to access. There is the director general, the Ethiopian Tedros Adhanom Ghebreyesus, patron of the institution for three years, flanked by the Irishman Michael Ryan, executive director for health emergencies and all-terrain veteran of virological crises, and the American epidemiologist Maria Van Kerkhove, technical director of the emergency program. The three of them are giving the same injunctions to 300 journalists from all over the world, taped by videoconference. Welcome to the World Health Organization (WHO) virtual press point, the only way now to access officials of the UN agency, at the heart of the most serious global health crisis since the Spanish flu of 1918-1919.

The Covid-19 th

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Serge Enderlin Correspondent in Geneva

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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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Nathalie Raulin

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Arnaud Vaulerin

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Sabrina Champenois

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Sibylle Vincendon

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Catherine Mallaval

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Fabrice Drouzy

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Clementine Mercier

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Sarah Finger

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Coralie Schaub

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Virginie Ballet

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Hala Kodmani

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Kim Hullot-Guiot

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Frantz Durupt

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Jérôme Lefilliâtre

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Eva Fonteneau

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caregiver health at the challenge of continuity of care

When the pressure subsides after the epidemic, the management of front-line staff by hospitals will be another area of ​​health concern.

Through Guillaume Mollaret

Wetsuit, gloves, mask and glasses: the work clothes of a nurse from the Lenval pediatric hospital in Nice.
Wetsuit, gloves, mask and glasses: the work clothes of a nurse from the Lenval pediatric hospital in Nice. ERIC GAILLARD / REUTERS

This is a taboo subject at the Regional Health Agency (ARS) Occitanie. Asked by Le Figaro for the cases of nursing staff affected by the Covid-19, the administration has been silent for two days. However, the protection of healthcare personnel constitutes a major issue of continuity of care. Tuesday, the positive diagnosis with the coronavirus, of a doctor of the service of infectious and tropical diseases of the CHU of Nîmes, a service precisely in charge of patients affected by this same virus, resulted, according to our information that the ARS did not not wish to confirm or deny, screening by nasopharyngeal swab of all staff having been in direct contact with this doctor.

On paper, such an approach seems relevant. However, it involves a risk: that of seeing the hospital empty of its specialists, whether they are doctors, nurses or nursing assistants since the fortnight or hospitalization, depending on the severity of the symptoms,

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