Coronavirus: the triage of patients has started

The Covid-19 epidemic is moving into a third wave. The situation in some regions leading to sorting of patients in hospitals. What does this mean in concrete terms?

On Sunday March 28, 2021, 41 doctors signed in the Sunday newspaper a forum to alert on the situation in hospitals in the regions most affected by the coronavirus. The caveat is clear: “It is too early for the vaccination campaign to significantly improve the evolution of the epidemic during this critical period. We would like to remind you, if it were necessary, that vaccination remains the essential weapon in the medium and long term. ” The signatories warn: “In the next fortnight, they say, we have virtual certainty on the number of critical care beds that will be needed, and we already know that our care capacities will be overwhelmed. “

This means that an emergency practice will have to be accentuated: the triage of patients, whether they are Covid or not, and an arbitration in the access of adults to critical care. What does this imply concretely?

What is the sorting of patients in the hospital?

The sorting of patients is a necessity in the hospital and intensive care professions. Asked by 20 minutes, Professor Elie Azoulay, head of the intensive care unit at Saint-Louis hospital in Paris, explains: “Prioritization is already in the identity of resuscitators, it is a medical decision taken in the best interest of the patient”, this in order to avoid harsh therapy on people “for whom resuscitation has nothing to offer”. The sorting is carried out according to objective criteria which are balanced: the age but also the co-morbidities, the autonomy of the person or his life expectancy in good health after resuscitation. Two people must be there to make such a decision: a resuscitator and a person who is not directly in contact with the intensive care unit, such as an emergency physician or an attending physician.

Today, however, a critical threshold has been reached. Doctors denounce a catastrophic medical situation which accentuates the practice of sorting patients. Why that ? Because hospital pressure, that is to say the lack of space, requires optimizing care resources. This is in order to save as many lives as possible and to guarantee the availability of care resources throughout the territory, and that the most affected regions do not saturate the others. The issue of sorting patients has therefore shifted today from the interest of the single patient to the material resources available.

Sorting already in progress

This is what the forum of the JDD : the sorting of patients is in fact already in progress. Indeed, resuscitation services do not only welcome people affected by the coronavirus. Other patients need this care. However, given the hospital pressure due to the increase in Covid-19 contaminations, major medical and surgical deprograms were required. Only vital emergencies are treated. It affects people who have chronic illnesses, for example. With serious consequences, since these deprogramming are associated with loss of opportunity and the impossibility of accessing care for some patients.

To read also: “I could die of my cancer because of a lack of care linked to the Covid”

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This is the whole problem with these epidemic waves: they do not only affect those who have caught the disease, but have an impact on the entire healthcare system and its patients as a whole. After a year of health crisis and more than a year of hospital crisis, all the patients are affected, warns Professor Azoulay : “Cardiovascular diseases, cancers, infectious or inflammatory diseases: we are missing out on all of this and falling behind schedule for the months and years to come. Today, we are allowing diseases to emerge for which we will still have repercussions in five years. “

Mathilde Wattecamps

Missions: Mathilde is an expert in subjects related to women’s rights and health. Addicted to Instagram and Twitter, never stingy with a good …