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France records at least 884 coronavirus deaths in care homes for elderly

At least 884 elderly people have died in nursing homes in France since the start of the coronavirus epidemic, French health chiefs reported on Thursday. It is the first time that figures for non-hospital deaths have been revealed.

Published: 2 April 2020 21:14 CEST

France records at least 884 coronavirus deaths in care homes for elderly

Photo: AFP

France's Director General of Health Jérôme Salomon revealed on Thursday that at least 884 elderly people have died in the country's care homes for elderly, known as Ehpad (Établissement d'hébergement pour personnes âgées dépendantes) since the coronavirus epidemic began.

France's previous daily coronavirus death tolls had included only those who had died in hospitals, but it was known that the nursing homes, particularly in the east of the country, had been hard hit by the outbreak of the virus.

Salomon announced on Thursday night that at least 884 people had died in Ehpads around the country, while stressing that this is only an initial figure.

France's Director general of Health Jérôme Salomon. Photo: AFP

Separately Salomon reported that in the last 24 hours 471 coronavirus patients have died in hospitals, taking France's total number of hospital deaths so far to 4,503.

But the health chief stressed that the most important number to look at for predicting the direction of the epidemic is the number of people currently in intensive care units, saying “this is the major indicator of the future course of the virus”.

Currently there are 6,399 people in intensive care, up from 6,017 on Wednesday and 5,565 on Tuesday.

The huge numbers of patients in critical conditions needing intensive care treatment has put massive strain on hospitals, particularly in the worst hit areas in eastern France and the greater Paris Île-de-France region.

At the beginning of the epidemic, France had just 5,000 intensive care beds in total. This has now been increased to 9,000 with a target to increase again to 14,000.

In total 26,246 people are in hospital while 12,428 are listed as having recovered.

The operation to evacuate patients from overwhelmed hospitals continued, with the French military airlifting patients to Germany, Luxembourg, Switzerland and Austria. In total 163 patients from France have been transferred to hospitals in neighbouring countries.

Specially adapted TGV trains are also being used to take patients out of overwhelmed Paris hospitals to Brittany, Occitanie and Centre-Val-de-Loire regions, which have fewer cases.

Despite this, the Paris police chief on Thursday confirmed that police have requisitioned part of the Rungis food market on the outskirts of Paris to store bodies as local funeral homes also struggle to cope.

Around a third of all coronavirus deaths have happened in the greater Paris area, although this includes patients from other areas transferred to the specialist hospitals in the capital.

The death toll on Thursday was slightly lower than the 509 people who lost their lives on Wednesday, although Salomon cautioned that it was too early to say if this was a trend.

“I would be very careful, there is an incubation phase of a week and delay in severe cases appearing,” he said.

“The evaluation of the impact of the confinement can take place at the end of the week or over the weekend. We should start to have an impact on admissions to hospital and intensive care in particular.”

“When we have the good news from the ground so much the better. But let's be careful,” he said.

France's prime Minister Edouard Philippe has predicted that this week would be “extremely difficult” but after that the government hopes that the effects of France's struct lockdown measures, which began on March 17th, will begin to be felt.

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Explained: How dangerous are French heatwaves?

A recent report highlighted the potential risks to athletes’ health if this summer’s Paris Olympic and Paralympic Games take place during a heatwave. The report, backed by climate scientists and athletes, warned of the potentially fatal risks of high temperatures at this year’s Games.

While most people are unlikely to be trying to break a 100m record during a heatwave – or any other time in fact – high temperatures bring with them serious risks to health.

Mercury rising

Any temperatures in France are getting higher, the country has endured a series of record heatwaves in recent years.

The all-time temperature record for Paris is 42.6C, set during a heatwave in 2019. It’s entirely possible this record won’t last long – 2022 was the hottest year on record in France, with a record 33 days meeting officially defined heatwave conditions: five in June and 14 in both July and August.

Vérargues, in the southern Hérault département, holds the highest recorded temperature in France – 46C set on June 28th, 2019.

The highest national average temperatures in France were recorded later in the year: August 5th, 2003, saw an average national temperature of 29.47C, followed by July 25th, 2019, when the average daily temperature was 29.4C.

And remember – air conditioning is not standard in French homes.

Health risks

There is no question that heatwaves can be fatal – some 400 people died in France in a two-week heatwave in August 2023 when new local temperature records were set around the country, according to public health data.

Over the whole of last summer, some 5,000 excess deaths were recorded between June 1st and September 15th, 2023, of which 1,500 were attributed to the heat.

Over the same period, nearly 20,000 heat-related emergency calls were recorded, according to a report by Santé Publique France published in February this year, and 10,600 additional hospitalisations followed a visit to the emergency department during periods of high temperature.

The risk is highest among the elderly or people with chronic health conditions, but also at risk are outdoor workers and people exercising – including hiking – during the hottest part of the day.

The government issues weather warnings – ranging from yellow (be aware) to red (potential risk to life) during heatwaves and we would strongly advise people to take notice and follow the advice, even if you come from a hot country.

Climate trends

And it seems that the situation is not going to get better soon, even if the response has improved.

“By the end of the century, heatwaves will be more frequent, more intense, and spread over a period from May to October,” warned France’s Haut Conseil pour le climat (High Council for the Climate) in a report in 2021.

Around 80 percent of the French population will experience 16 to 29 abnormally hot days each year over the three decades to come, as climate change takes hold according to a 2022 study by national statistics institute Insee – with Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté and Occitanie the most affected regions.

It estimates that more than 9 million people will have to endure more than 20 extremely hot days each year in the years to come. Nighttime temperatures will also rise, with some areas seeing up to 19 abnormally hot nights each year, compared to seven between 1976 and 2005.

The phenomenon of ‘tropical nights’ – where the temperature does not drop below 23C even at night – is linked to sleepless nights and heat stress, as the body does not get the chance to cool itself.

Meanwhile, Santé Publique France’s figures underline the impact of high temperatures during heatwaves, it said, and confirmed the need for measures throughout the country, and for a reinforced strategy of adaptation to climate change, to reduce the impact of heat on health.

The unusual Pentecôte public holiday in France, when many people work ‘for free’ by donating that day’s salary a government ‘solidarity fund’ for the elderly, was introduced in 2005 following the disastrous 2003 heatwave, when more than 15,000 French people, most of them elderly, died in the sweltering temperatures.

Heat islands

The particular problem with Paris – and other major conurbations – is that it is a noted ‘urban heat island’, where temperatures can be up to 10C warmer than in the surrounding countryside, due to a combination of human activities, concrete surfaces that reflect heat, and heat pollution such as air conditioning units and cars.

The phenomenon also leads to significantly warmer nighttime temperatures, as heat accumulates during the day but cannot escape in the same way it might in a less dense environment – making for sticky nights that make it hard to sleep and increase the effects of heat stress, especially among the elderly or ill.

Emergency plans

One thing that has improved in recent years is how France deals with its heatwaves.

After 2003’s fatal summer, the French government introduced new protocols to protect the public whenever the temperature rises above a certain threshold.

Today, when the temperature soars, the government issues health advice on staying safe, which includes: drinking plenty of water to stay hydrated, staying indoors during the hottest part of the day (afternoon and early evening), keeping in the shade, exercising only during the coolest parts of the day (early morning and late nights) and eating regular meals.

Most cities now have heatwave plans. Parks stay open at night and ‘cool rooms’ open up to give those in at-risk groups a chance to be taken somewhere they can cool down.

Fire risk

Extreme temperatures and long periods without rain also increase the risk of wildfires.

The year 2022 was the worst on record for wildfires in France. In total 72,000 hectares, or an area seven times the size of Paris, burned over the summer.

Overall, 90 percent of fires are caused by humans – either deliberately or accidentally. But while casually throwing away a cigarette is objectively dumb, heatwaves can – and do – increase the risk of fires.

Where weather conditions do have a major effect is in turning what would perhaps have been a containable fire into a wildfire that devours thousands of hectares of ground and prompt evacuations.

High temperatures make it more likely that fires will start, but drought conditions cause these fires to spread – parched vegetation with no moisture catches extremely easily. In the height of summer, large parts of the south of France are particularly at risk of wildfires.

This is far from a new phenomenon. It’s why there has always been a wildfire ‘season’ in the hottest months of the year and why wildfires are much less common – though not unheard of – in winter.

In October 1970, 11 people died in a wildfire near France’s far southeastern border with Italy and in 1985 an inferno in the same area killed five volunteer firefighters.

Deaths are more unusual today, thanks to improved techniques and technology, but the fires themselves are getting more common, bigger and occur over a wider geographical area.

Poor air quality resulting from wildfire smoke can be a serious health risk to those with respiratory conditions.

If you live in an area where wildfires are common, make sure you sign up to the government emergency text alert system so you get the latest advice on whether you need to evacuate. You can also keep track of the risk of wildfire in your area by checking the government’s forest fire map, which is updated daily.

And you have legal obligations, too, relating to keeping your property as clear as possible of fire hazards during key wildfire periods.

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