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HEALTH

Doctors fear worst of Covid-19 wave still to come in France

In the Covid-19 intensive care unit of the Antony Private Hospital south of Paris, no bed stays free for long and medics wonder when their workload will finally peak.

Doctors fear worst of Covid-19 wave still to come in France
Nurses tend to a Covid-19 patient under respiratory assistance lying unconscious in a room of the intensive care unit of the Hopital Prive hospital in Antony, a southern Paris suburb on April 2, 2021. (Photo by Christophe ARCHAMBAULT / AFP)

As one recovered elderly patient is being wheeled out of the ward, smiling weakly, boss Jean-Pierre Deyme is on the phone arranging the next arrival and calling out instructions to staff.

Louisa Pinto, a nurse of nearly 20 years’ experience, gestures to the vacated room where a cleaner is already at work, scrubbing down the mattress for the next arrival.

“The bed won’t even have time to cool down,” she says as the patient monitoring system beeps constantly in the background. 

For now, everything is stable in the 20-odd beds around her where Covid-19 victims lie inanimate, in a silent battle with the virus.

Paris is going through a third wave of the pandemic, which risks putting even more strain on saturated hospitals than the first wave in March and April last year.

“With what’s coming in April, it’s going to be very complicated,” says Pinto, a mother of three who hasn’t had a holiday since last summer and like other staff will be cancelling a planned break this month.

Even with a new round of restrictions coming into force this week, Health Minister Olivier Véran predicts that infections in France will peak only in mid-April, while hospital admissions will continue climbing until the end of the month.

READ ALSO: Why the average age of patients in France’s intensive care units is getting younger

Alarming forecasts leaked to the French media from the Paris public hospital authority AP-HP last week showed anywhere from 2,800-4,400 people in intensive care in the Paris region by the end of April even with a strict lockdown. In the first wave, the number peaked at 2,700.

Intensive care capacity is increased but staff shortages threaten healthcare

The director of the Antony hospital, Denis Chandesris, says intensive care capacity has already been increased by drastically reducing all surgery except for critical cancer, cardiological and emergency cases.

Hospitals everywhere in the region have taken similar measures, re-deploying beds and creating new wards, but they are reaching their limits.

“The difficulty is not so much beds or material, it’s a question of finding medical and paramedical staff to be able to take in patients,” Chandesris explained.

READ ALSO: REVEALED: Just how bad is the third Covid wave hitting France compared to previous spikes?

Last Sunday, a group of emergency care directors in Paris warned in an open letter that the situation was so bad that medics would soon have to start “triage” – selecting patients for care based on their chances of survival.

This prospect horrifies staff – and President Emmanuel Macron has always promised to shield hospitals and avoid the sort of scenes witnessed in Italy last March when patients piled up in corridors. 

In a televised speech to the nation on Wednesday night, he promised to increase intensive care capacity nationwide from 7,665 beds currently to 10,000 – a jump of 30 percent.

“I want to thank medical students, retired people, the army health service and medical reserve volunteers. All of them will be mobilised in a larger way,” he announced.

Opposition politicians and some experts reacted with scepticism while an Ifop poll for the Journal du Dimanche weekly found only 35 percent of French people had confidence in their government “to deal effectively with the coronavirus”.

Pinto, the nurse, underlined how working in intensive care is “very technical”, requiring specialised training and knowledge.

French President Emmanuel Macron hopes new lockdown measures will curb the wave of Covid-19 cases. (Photo by BENOIT TESSIER / POOL / AFP)

French PM pins hopes on new restrictions

Macron is banking on a limited lockdown over the next month turning the rising tide of cases, which have roughly doubled to 40,000 a day compared with their level a month ago.

The sharp acceleration is down to the spread of the more contagious so-called British variant which has become dominant in France.

New measures include nationwide travel restrictions, which limit people to 10 kilometres (six miles) from their homes, and the closure of schools and non-essential shops.

Only a significant increase in the vaccination campaign – which started sluggishly but is now picking up pace – fills any of the medics at Antony Private Hospital with any hope.

A medical worker prepares a dose of the Pfizer/BioNTech vaccine, in France. (Photo by JEAN-FRANCOIS MONIER / AFP)

After months of lacking doses, the government is promising a major rollout this month and an increase in the rate of jabbing.

Samir Taik, a taxi driver from Paris, walked out of the Antony hospital last week as the 1,000th Covid-19 patient to have benefited from oxygen therapy in the Covid-19 intensive care unit.

READ ALSO: UPDATED: When will you be eligible for the Covid vaccine in France?

The 43-year-old, who enjoys boxing and sport, is still short of breath and reeling from the trauma of seeing his health deteriorate so fast.

He says he knows three or four people with a similar profile to him who have been hospitalised recently.

“Young people need to know that we’re not talking about 80-year-olds, it’s people who are 30, 40, 45-year-olds and have no health problems. The British variant is not like the old one,” he told AFP.

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HEALTH

The different ways you can make a doctor’s appointment in France

Booking a medical appointment in France can be time-consuming – especially if you are new to the country and are looking for an English-speaking doctor.

The different ways you can make a doctor's appointment in France

You do not need a carte vitale to book a doctor’s appointment in France – anyone who needs medical help while in the country is entitled to it, but you may not be entitled to any reimbursement if you are not part of the social security system.

Booking a GP’s appointment can be as simple as phoning up your friendly neighbourhood GP, or using an online service such as Doctolib. 

It helps a lot, if you have a médecin traitant – an attending GP, who adds you (and your family, if they can) to their list of patients. 

READ ALSO Explained: How to register with a doctor in France

It is not always easy to find one. Some parts of the country are short of GPs, which means doctors’ lists can fill up very quickly. But it is important that anyone who lives in France is registered with a named GP, especially if they have a carte vitale.

As well as being the main point of contact between patients and the medical profession in all its guises, it is financially responsible to be registered with a GP in France.

Reimbursement on consultations is typically 70 percent through the French healthcare system, but just 30 percent for anyone without a declared doctor. Meanwhile, top-up mutuelle health insurance companies usually require you to declare a médecin traitant and if you don’t, you may not be able to receive reimbursements on certain treatments.

Bear in mind, it is your responsibility to register with a local médecin traitant. But, even after you have done so, you can still make an appointment with any doctor, anywhere in France, and arrange specialist treatment, if you need it. 

READ ALSO 5 things to know about visiting a doctor in France

How do you go about making a GP appointment in France?

There are several options.

Some health centres – more often in larger towns and cities – operate a walk-in policy. But expect waits to be lengthy. Do not, however, assume that your GP operates a system like this.

You can phone for an appointment. This is another very common method. Your GP will have their own system for making appointments – which may even include something that looks, to the uninitiated, very much like a casual walk-in policy. 

Some may have an assistant to deal with booking appointments and other administration. Others may deal with appointments themselves, and may – for example – operate some sort of triage system based on voice messages from patients. 

What about online booking systems?

And many practitioners are now attached to websites, such as Doctolib. As of 2023, about half of all GP appointments in France were made using Doctolib.

READ ALSO How to use: French medical website Doctolib

Be aware that other online booking systems are available. Doctolib is one of the best known, but your GP may be attached to another system, like the health ministry approved site ‘LeMedecin.Fr’.

This website also has a feature where you can take an immediate online consultation with whatever doctor is available at that moment. By clicking ‘Consultez en vidéo maintenant’ you will be connected to the next doctor who is free. This option may involve an additional charge between €5-10 on top of the price of the consultation, and you will be expected to pay when booking.

If you have any trouble with either of these websites, you can go through the list of registered generalists per département on the ‘Ameli’ website. If you use this option, you will need to call the doctor to see if they are open or available for appointments.

In terms of wait times, online systems have helped to significantly reduce the delay between booking and getting an appointment.

According to a 2023 study by Doctolib, about half of all GP appointments were available within three days from the time of booking on their platform.

Similarly, you can use online platforms to check the medical professional’s qualifications and languages spoken, as well as filter based on the doctor’s English abilities. However, this should be taken with a grain of salt because not every medical professional with English listed on their Doctolib page speaks fluent English. 

An increasing number of doctorsoffer video consultations, known as télémédecine in France. This allows professionals – particularly those in more rural areas – to diagnose less serious conditions remotely. This type of consultation is usually only available from those medical practices that are attached to online booking systems. 

Some pharmacies have also begun offering walk-in télémedicine consults, using ‘Medadom’ machines. More information here.

What about specialists?

In France, you book your own consultations with specialists, even if you are referred by a doctor (your GP may offer a recommendation, but won’t always). The good news is that many specialists do use online booking services. Those that do not usually have assistants to take care of the appointments.

READ ALSO: Urgent care: How to get non-emergency medical treatment in France

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