Open letter from 41 French hospital doctors to French government
“The Covid-19 epidemic is again in constant progression in all the Regions, and the Île-de-France is unfortunately found among the Regions on the front line. In the next two weeks, the contaminations having already taken place, we are almost certain about the number of critical care beds that will be necessary and we already know that our care capacities will be exceeded at the end of this period.
It is too early for the vaccination campaign to significantly improve the course of the epidemic during this critical period. We recall, if it were necessary, that vaccination remains the essential weapon in the medium and long term. All the indicators agree that the current measures are and will be insufficient to quickly reverse the alarming curve of contaminations.
For the purpose of informing and legitimately alerting our fellow citizens, our future patients and their families, we want to transparently explain the situation we are going to have to face and how we are going to face it. In this disaster medicine situation where there will be a glaring mismatch between needs and available resources, we will be forced to triage patients in order to save as many lives as possible. This sorting will concern all patients, Covid and non-Covid, in particular for the access of adult patients to critical care.
We have never experienced such a situation, even during the worst attacks in recent years. Before arriving at this painful but imminent period, we will do everything possible to delay the deadline by using all available human and material resources, by carrying out medical evacuations as much as possible even if these are reduced. day by day because of the progression of the epidemic in all the other regions.
We will use all innovative solutions that could limit the progression to severe forms and reduce the length of stays in intensive care. This sorting will be done with the permanent objective of guaranteeing the availability of critical care resources in a collective, equitable and homogeneous manner throughout our territory.
The triage of patients has already started since major medical and surgical deprogramming has already been imposed on us and we know full well that these are associated with loss of opportunity and non-access to care for some patients. These deprogramming will have to intensify in the days to come, soon sparing only vital emergencies. For several days, we have already been forced to carefully weigh the indications of certain exceptional techniques such as circulatory assistance.
We, the doctors involved in the care of serious victims of the pandemic, affirm that we will be present with all patients and their families to take care of them regardless of the difficulties of our working conditions because it is our mission. We know that we can count on the unfailing mobilization of all caregivers, whatever their weariness and despite working conditions that they never imagined they would one day know. We cannot remain silent without betraying the Hippocratic Oath we once took.