“A strong circulation of the virus”: the flu epidemic is accelerating, Occitanie hospitals are under pressure

Des patients qui attendent sur un brancard d’être pris en charge. Midi Libre – RICHARD DE HULLESSEN

Débordés, la plupart des établissements publics ont été contraints, ces derniers jours, de déclencher un plan d’adaptation. Et pourtant, le pic de l’épidémie n’a pas encore été atteint.

The flu is gaining ground in France. In its latest weekly bulletin, Santé Publique France speaks of an “exceptionally high” level of intensity even though the epidemic peak is far from being reached. The return of children to school last Monday should cause a new outbreak until the end of January.

Occitanie is no exception, appearing, like all the other regions, in red on the health authorities' map. The regional health agency (ARS) even mentions “high circulation”. With an incidence rate of 353 cases per 100,000 inhabitants, last week we were already very close to the epidemic peak of last winter (395) and the curve follows the same trend as that of 2023, the year in which the epidemic reached the record incidence rate of 695 cases per 100,000 inhabitants.

First consequence: hospitals are under pressure. From one department to another, the percentage of visits to emergency rooms due to influenza reflects overactivity: 4.31% in Hérault, 4.64% in Lozère, 3.37% in Aveyron, 2.7% in Gard as in Aude or Pyrénées-Orientales. “There were 1,003 emergency room visits for flu last week in Occitanie, 228 of which required hospitalization,” specifies the ARS. That is a 16% increase in emergency room visits compared to the previous week and 26% more hospitalizations related to flu.

A type A flu

The figure can explain the virulence of this flu. Indeed, 85% of positive samples in the first week of January were type A (H1N1), considered more contagious, especially among young people who are less immune. According to some specialists, this is also a derivative of the 2009 epidemic, which remains the last flu pandemic. It is therefore advisable to to protect themselves.

330 patients in Nîmes, compared to 150 usually

In hospitals, the alarm is therefore being sounded. “Sunday, it was almost Beirut”, indicates the CGT union of the Carémeau University Hospital in Nîmes, which mentions a number of 330 people treated daily, compared to an average of 150-170 patients. “For three days, there were not enough beds to accommodate them. And the peak of the flu epidemic, particularly virulent this year because it immediately affects the lungs, has not yet been reached”, the CGT is still worried, which says it deplores “that the private sector is not playing the game by not taking its share” or that Carémeau must also contribute to the night regulation of reception at the emergency rooms of Alès and Bagnols-sur-Cèze, due to a lack of staff in these establishments.

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The Nîmes University Hospital has therefore triggered level 1 of the “Hospital under pressure” plan, both to obtain reinforcements in human resources, but also to allow the installation of a second bed in certain rooms or to modify the organization of care.
In Bagnols-sur-Cèze, where the influx of patients, “mainly elderly people”, has more than doubled the waiting time in the emergency room, “from 3 to 8 hours” according to the director Jean-Philippe Sajus, and where no more beds are available for full hospitalization, the same measure has been taken. “This is an internal capacity readjustment to support this large number of patients, up to 80 visits per day.” The mask is not mandatory, “but recommended”, Jean-Philippe Sajus also indicates.

A report of “serious and imminent” danger

The situation is even more complex, in Hérault, at the Montpellier University Hospital, in any case according to the CGT which says it has noted“up to 17 hours of waiting in the emergency room”. An observation that prompted him to file a report of “serious and imminent danger” with his management on Wednesday, which has not yet responded but has asked patients, via social networks, to first contact their doctor or the 15 center before going to Lapeyronie. A meeting is to take place next Tuesday, the CGT estimating that, beyond the epidemic, it is “the consequence of successive austerity policies” which is breaking out with this severe flu episode. However, measures have already been taken, including the establishment of a daily crisis unit.

At the Sète University Hospital, we are not there yet, only “a slight peak” activity was noted last weekend. However, the establishment anticipated its organization, in particular with a reinforcement of the emergency reception service or an increase in hospitalization capacities. The Béziers University Hospital, which compares its activity to that of the summer on the number of patients, also declared itself under tension.

Vigilance in Ehpad

Since the start of the epidemic, the ARS Occitanie has recorded 46 episodes of grouped cases of influenza, including 43 in residential care homes for dependent elderly people (Ehpad). Vigilance is therefore required in these residences, especially since studies carried out on the most serious cases of influenza have shown that 46% are 65 years or older and 90% have a comorbidity. “Fortunately, indicates Didier Jaffre, the director of the ARS, we have a higher vaccination rate in these establishments. However, efforts must continue, particularly among staff, in order to best protect this vulnerable population”.

Vaccination and barrier gesture

In Aude and Pyrénées-Orientales, the figures indicate a less intense circulation of the flu. However, hospitals are also recording an influx of patients. “49 hospitalizations in a single day compared to 20 to 30 on average”, illustrates Dr. Alain Peret, head of the emergency department at Narbonne hospital.“Patients over 90 years old have stayed in an emergency room bed for more than 24 hours before a place became available in the right department”, denounces François Sanchez, representative of the Force Ouvrière union at the Perpignan hospital, who is also calling for the activation of a tension plan.

This is already the case in Toulouse, in Haute-Garonne, where the 450 daily visits to the emergency room in recent days (an increase of 15%) prompted the CHU to trigger its white plan this Thursday. A measure that should become widespread, at the request of the regional health agency, to anticipate the effects of the epidemic peak. The ARS is also inviting the population to get vaccinated and to get back into the habit of barrier gestures. These, in 2020 and 2021 to prevent the spread of Covid-19, had made it possible to limit the circulation of the flu to 40 cases per 100,000 inhabitants.

Covid, bronchiolitis, gastroenteritis… It's getting better!

According to data from Public Health France, other epidemics are fortunately not increasing. For bronchiolitis, in the region, there has even been a decrease in cases for the second consecutive week with 288 visits to the emergency room (-6.5%) which required 97 hospitalizations (-16.4%). The same observation applies to gastroenteritis with 331 emergency room visits (-7.8%) which resulted in 50 hospitalizations (-16.7%) and an incidence rate of 33 cases per 100,000 inhabitants (-13.2%). It is stable for Covid with 35 hospitalizations, however, here too, vigilance remains required in nursing homes where 95 grouped cases have been reported since the fall.

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