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HEALTH

‘Half our Covid patients are under 43’: How the third wave has left a Paris hospital struggling to cope

As Covid-19 rips through the impoverished Paris suburb of Seine-Saint-Denis, doctors are struggling to find beds for critical patients and teachers are walking out over a spike in infections in schools.

'Half our Covid patients are under 43': How the third wave has left a Paris hospital struggling to cope
Staff treat a critically ill Covid patient in the Delafontaine hospital in the Paris region. Photo: Thomas Samson/AFP

At the Delafontaine hospital, in the heart of mainland France’s poorest region, the ravages of France’s third wave of coronavirus infections are plain to see.

A 30-year-old man, who had no prior medical condition before being struck down by Covid-19, wakes up after three weeks in intensive care.

“This one has to get better,” one nurse says to an orderly. “But I’ve learned not to have too much hope,” she adds, after a moment’s reflection.

As the number of critically ill patients across France soars past 5,000 – more that at the height of the second wave last autumn – Delafontaine has had to add eight more beds in intensive care, taking the total to 26.

With doctors in the Paris region warning they will soon have to start deciding who to save, two patients have already been transferred from Delafontaine to other facilities.

Daniel Da Silva, the head of Delafontaine’s intensive care unit, is hopeful he will never have to turn patients away.

But he is worried about the profile of people now presenting severe symptoms in an area of densely-inhabited high-rise housing estates with a large immigrant population.

Half of the hospital’s Covid-19 patients are under 43 years of age, who are far down the waiting list for a vaccine being administered in descending order of age.

And in a first for the hospital since the pandemic began, pregnant women are winding up in intensive care.

“We had to intubate and carry out an emergency Caesarean on a young woman aged 23,” Da Silva says, calling it “unprecedented”.

Seine-Saint-Denis currently has the second-highest incidence rates of Covid-19 in France, with 783 per 100,000 people, more than twice the national average.

Last week, around 30 teachers at a high school in the town of Drancy walked off the job saying they were in “imminent danger” of falling prey to a pandemic that has killed 20 people among its students’ families in a year.

On Wednesday evening President Emmanuel Macron, who has so far resisted imposing a third countrywide lockdown, will address the nation to announce further restrictions.

READ ALSO What can we expect from Macron’s TV announcement

Da Silva says his biggest concern is how to keep his unit staffed, with more and more carers getting written off work for stress or anxiety.

“People are exhausted and the issue of post-traumatic stress from the first wave is far from being resolved,” he said.

Alice Auroux, a nurse who said she had not had a proper holiday in a year, gave voice to the despair that many healthworkers have expressed in the face of the government’s failure so far to impose a stay-at-home order.

“It feels as if we’re not getting on top of it,” she said.

Mathilde Azzi, a young doctor who has cancelled her holidays and doubled her shifts to remain on the frontline, expressed particular concern for non-Covid patients.

Like all hospitals in the Paris area, Delafontaine has been ordered to cut back surgery to make space for Covid patients.

“They (non-Covid patients) are the ones who will pay the price,” Azzi said, noting a decline in the number of patients being admitted for heart attacks, a trend she believed was caused by people failing to see a doctor on time.

As France girds for a further curtailment of freedoms, Da Silva said he understood the toll on the economy and nation’s psychological wellbeing under stay-at-home orders.

“But at the same time I see what we’re dealing with here. One thing is certain – with lockdowns, we saved more lives than we can count.”

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HEALTH

Essential guide for travelling with allergies in France

Whether you have an allergy or travel with someone who does, dealing with unfamiliar foods and not knowing what you can eat can be a stressful experience. Hopefully this guide will help you get by in France.

Essential guide for travelling with allergies in France

Travelling in France can be a bit intimidating for people with food allergies, especially if you do not know how to speak French.

You may find that servers casually place a bowl of peanuts in front of you while sipping a glass of wine at a café, and plenty of French dishes use lots of butter and other dairy products.

Luckily, France is subject to EU rules that requires all restaurants inform customers if the food contains known allergens, such as nuts, milk, or gluten. 

If a dish contains any of the 14 common allergens (listed below), then there must be a warning label of some form.

List of allergens, French government website Service-Public

When it comes to gluten products, the rules differ slightly.

The label may say ‘low gluten’ (Faible teneur en gluten) as long as the gluten content does not exceed 100 mg/kg, and the ‘gluten-free’ (Sans gluten) label can only be applied if the gluten content is less than 20 mg/kg.

How will I be informed?

It depends on the product.

Packaged products must indicate the presence of allergens on the packaging. For products bought in bulk (en vrac), such as fruits and vegetables, or cereal and granola, there must be some visible signage close to the product informing the customer of the presence of allergens.

As for prepared dishes – meaning the ones you would get at a restaurant, canteen, bakery or take-out stand – allergens should be clearly indicated near the listing of the products on offer or near where they would be consumed.

In all cases, the information should be very clear and stand out from the rest of the writing, potentially in bold, italics, underlined, or using a different font than the rest of the label.

The specific allergen itself (ie nut products, or produits à base d’arachides) should also be visible, instead of just writing the word ‘allergens’ (allergènes).

Informing restaurant staff

Even though allergy information should be clearly visible, it is still important to make staff aware of your allergy, especially to avoid cross-contamination.

Before ordering, be sure to inform them of your allergy. You may also want to call in advance or send an email.

Here is a sample email;

Bonjour,

Je me permets de vous contacter. Je souhaite visiter votre restaurant mais je souffre d’une grave allergie à ___. J’aimerais vérifier qu’il y a des produits sur votre menu qui ne contiennent pas de traces de ___ …

(Hello, I am reaching out because I am interested in visiting your restaurant but I have a serious allergy to ___. I would like to verify there are items on your menu that do not have any traces of ___.)

Another option would be to write up your own ‘allergy card’ to show to restaurant staff when you visit the restaurant. This may save you some time and trouble trying to explain your allergy in French.

You will need to clearly explain that this is an allergy, not merely a preference or small intolerance. 

Factcheck: Do French waiters really tell customers what they can order?

Here are some phrases you might use;

Je souffre d’une allergie alimentaire grave et potentiellement mortelle. – I have a serious and potentially life-threatening food allergy.

Je suis allergique à… – I am allergic to…

Je peux manger… – I can eat…

Il ne s’agit pas d’une intolérance [au gluten/lactose]. – It is not due to an intolerance of (gluten or lactose)

Il ne s’agit pas d’une préférence, mais d’une allergie grave. – It is not a preference, it is a serious allergy.

Je voudrais vérifier que vous ne mélangez pas les produits dans la cuisine. Je suis gravement allergique à… – I would like to verify that you do not mix products in the kitchen. I am seriously allergic to…

You may also want to inform them of affiliated products that you cannot eat. For example, if you are allergic to milk, you may list some other dairy products. Beware that lots of French dishes use dairy products, even soup or other sauces you might not expect.

Je ne peux pas manger de produits laitiers, comme le beurre, la crème, la crème fraîche ou le fromage, par exemple. – I cannot eat dairy products, like butter, cream, sour cream, or cheese, for example.

You would want to do the same for other allergies, especially for nuts. You should be sure to specify which nuts you are allergic to.

Essential allergy phrases and vocabulary 

  • Cereals containing gluten (Céréales contenant du gluten)
  • Wheat (Blé)
  • Rye (Seigle)
  • Barley (Orge)
  • Oats (Avoine)
  • Gluten (Gluten)
  • Crustaceans/shellfish (Crustacés)
  • Crabs (Crabes)
  • Prawns (Crevettes)
  • Lobster (Homard)
  • Eggs (Œufs)
  • Fish (Poisson)
  • Groundnuts (Arachides)
  • Peanuts (Cacahuètes)
  • Soy/soybeans (Soja)
  • Milk (Lait)
  • Almonds (Amandes)
  • Hazelnuts (Noisettes)
  • Walnuts (Noix)
  • Cashews (Noix de cajou)
  • Pecans (Noix de pécan)
  • Pistachio (Pistache)
  • Celery (Céleri)
  • Mustard (Moutarde)
  • Sesame seeds (Sésame)
  • Sulphur dioxide and sulphites (Anhydride sulfureux et sulfites)
  • Lupin (Lupin)
  • Molluscs (Mollusques)
  • Mussels (Moules)
  • Oysters (Huitres)
  • Squid (Calmar)
  • Snails (Escargots)

What to do in the event of an allergic reaction

If you believe someone is having a serious allergic reaction, you should call emergency services. 

If you are having an allergic reaction, you can say…

  • Aidez-moi ! (Help me!)
  • Je fais une grave crise d’allergie (I am having an allergic reaction)
  • Appelez les secours d’urgence (Call for emergency help)
  • J’ai de l’épinéphrine dans mon sac (I have an epipen in my bag)
  • Je suis allergique à ___ et j’ai mangé __ (I am allergic to ___ and I ate ___)
  • Je n’arrive pas à respirer (I cannot breathe)

You can either call 15 to alert the SAMU (service d’aide médicale urgente), this is the number for critical health and medical situations which require urgent medical attention, or you can call 18. This number connects to the fire services (Sapeurs Pompiers) who provide rapid medical intervention and rescue.

Call 112 if in doubt (or 114 for people with hearing and speaking difficulties, who are also able to communicate by text or fax). This is the Universal European Emergency Services who can direct you to the correct line.

The number is available free of charge everywhere in the EU from all phones including mobiles and does not require prepaid credit or a valid SIM card. The operators speak over 40 languages including English.

READ MORE: Emergency in France: Who to call and what to say

What if I go to the hospital?

If you end up visiting a French emergency room (urgences), then you may be faced with a bill. 

Calls to SAMU are free but you will be billed for their services, with prices for consultations and call outs varying greatly according to department as well as how long you need to stay in hospital and the treatments you receive.
 
In some areas, the price can be as high as €2,400, anyone registered in the French health system will be reimbursed via social security (at the 70 percent rate) and the remainder covered by their mutuelle, or complementary health insurance scheme, if they have one.

Travellers from within the EU are covered by the European Health Insurance Card (EHIC) in which EU governments basically agree to refund each other for healthcare their nationals receive while visiting other countries.

Brits used to benefit from EHIC but since Brexit, do not. However the UK government does provide a card known as GHIC (Global Health Insurance Card) which, if you are travelling to France, works in basically the same way as EHIC.

The crucial point, however, is that both GHIC and EHIC only reimburse a proportion of the cost – in most cases around 70 percent. 

If you do not have either travel insurance or separate health insurance, the remaining cost will come out of your own pocket – and this can easily run into hundreds or thousands if you have a serious illness or accident. 

For non-EU travellers, it is highly recommended to pay for supplemental travel insurance to cover the cost of any accidents.

READ MORE: CEAM: How to get a French European health insurance card

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