French doctors warn lack of staff may scupper Macron promise of more ICU beds

French health workers were on Thursday asking how President Emmanuel Macron intends to follow through on promises to increase the number of intensive care beds to 10,000 “in the coming days” as France battles a third coronavirus wave. They're warning that such a feat is easier said than done, and will come at the expense of non-Covid patients.

A nurse treats a coronavirus patient in the intensive care unit of the Melun-Senart hospital, near Paris, France, March 8, 2021. REUTERS - BENOIT TESSIER

With many hospitals in virus hotspots – including Paris – struggling to cope with an influx of critically ill Covid patients, Macron on Wednesday outlined plans for an “extraordinary mobilisation” of the health sector that would double France’s usual capacity of 5,000 ICU beds.

Since the start of the pandemic, the number of ICU beds has been brought up to 7665. Of those, 7053 are now occupied.

Radically ramping up that number to cope with Covid infections, while feasible, would mean putting off other medical interventions such as surgeries, said Dr Bruno Mégarbane, head of the intensive care unit at Paris’s Lariboisière Hospital.

Atteindre 10.000 lits de réanimation: une promesse sous condition de renforts et déprogrammations https://t.co/ojZ7dDWgYK pic.twitter.com/pPWOamICt0

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“It can be done by transforming recovery rooms, operating theatres, or other sectors of medicine into new, temporary intensive care beds,” Mégarbane told French news channel LCI. 

“Doctors, nurses and anaesthetists would need to be redirected from operating theatres to these new beds.” 

So far 40 percent on non-Covid related surgeries have already been “deprogrammed”, Mégarbane added. 

• Paris hospitals to cut non-Covid procedures by 40% as ICU admissions rise

'Not enough staff'

Increasing ICU capacity also brings the parallel issues of equipment and training. ICU beds need to be equipped with a high-flow oxygen supply and artificial respirators, and the staff who monitor them must be familiar with resuscitation procedures. 

Health workers argue there won’t be enough “armed beds” to meet Macron’s target – because there is not enough time to train personnel in the complicated task of using resuscitators.

"When we talk about ‘arming beds', it means we have to find men and women to do the job,” said Dr Alain Ducardonnet, a health consultant for BFM TV. 

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“That's why there is the medical reserve – which has melted away – there are military personnel, students at the end of their studies, and retired doctors.

“The problem is the level of competence for resuscitation is not acquired in eight days … In normal times, we could supervise people who were less trained, but here we can't because everyone is at maximum capacity.”

Appeal to private sector

Poaching medical staff from private clinics and hospitals has been mooted as one way to help meet overwhelming demand.

Jean-François Timsit, head of the medical and infectious resuscitation department at the Bichat Hospital in Paris, has called for volunteers from the private sector to step forward.

"It doesn't seem feasible to increase the number of beds [in Paris] by 30 percent; our room for manoeuvre is almost zero at the moment," he told France Info radio. 

"All that’s left is to get staff who do scheduled surgery in the private clinics … and have them run some resuscitation beds.”