As Europe reopens, ICU teams stick with the sick and dying

Student nurse Soraya Ngin Tun, left, Dr. Atanas Sabahov, center left, nurse Rim Omrani, center right, and student nurse Landry Nzoyem, right, rest at Bichat Hospital, AP-HP, in Paris, Thursday, April 22, 2021. France still had nearly 6,000 critically ill patients in ICUs this week as the government embarked on the perilous process of gingerly easing the country out of its latest lockdown, too prematurely for those on pandemic frontlines in hospitals. President Emmanuel Macron’s decision to reopen elementary schools on Monday and allow people to move about more freely again in May, even though ICU numbers have remained stubbornly higher than at any point since the pandemic’s catastrophic first wave, marks another shift in multiple European capitals away from prioritizing hospitals. (AP Photo/Lewis Joly)Student nurse Soraya Ngin Tun, left, Dr. Atanas Sabahov, center left, nurse Rim Omrani, center right, and student nurse Landry Nzoyem, right, rest at Bichat Hospital, AP-HP, in Paris, Thursday, April 22, 2021. France still had nearly 6,000 critically ill patients in ICUs this week as the government embarked on the perilous process of gingerly easing the country out of its latest lockdown, too prematurely for those on pandemic frontlines in hospitals. President Emmanuel Macron’s decision to reopen elementary schools on Monday and allow people to move about more freely again in May, even though ICU numbers have remained stubbornly higher than at any point since the pandemic’s catastrophic first wave, marks another shift in multiple European capitals away from prioritizing hospitals. (AP Photo/Lewis Joly)
A Covid-19 patient under ECMO (Extracorporeal membrane oxygenation) remains unconscious, at Bichat Hospital, AP-HP, in Paris, Thursday, April 22, 2021. France still had nearly 6,000 critically ill patients in ICUs this week as the government embarked on the perilous process of gingerly easing the country out of its latest lockdown, too prematurely for those on pandemic frontlines in hospitals. President Emmanuel Macron’s decision to reopen elementary schools on Monday and allow people to move about more freely again in May, even though ICU numbers have remained stubbornly higher than at any point since the pandemic’s catastrophic first wave, marks another shift in multiple European capitals away from prioritizing hospitals. (AP Photo/Lewis Joly)A Covid-19 patient under ECMO (Extracorporeal membrane oxygenation) remains unconscious, at Bichat Hospital, AP-HP, in Paris, Thursday, April 22, 2021. France still had nearly 6,000 critically ill patients in ICUs this week as the government embarked on the perilous process of gingerly easing the country out of its latest lockdown, too prematurely for those on pandemic frontlines in hospitals. President Emmanuel Macron’s decision to reopen elementary schools on Monday and allow people to move about more freely again in May, even though ICU numbers have remained stubbornly higher than at any point since the pandemic’s catastrophic first wave, marks another shift in multiple European capitals away from prioritizing hospitals. (AP Photo/Lewis Joly)

Cradling the head of the deeply sedated COVID-19 patient like a precious jewel in his hands, Dr. Alexy Tran Dinh steered his intensive-care nurses through the delicate process of rolling the woman off her stomach and onto her back, guiding the team like a dance instructor.

They moved only on Tran Dinh’s count, in unison and with extreme care, because the unconscious patient could die within minutes should they inadvertently rip the breathing tube from her mouth.

“One, two and three — onto the side,” the doctor instructed.

His next order quickly followed: “Onto the back.”

“Perfect,” he concluded when the move was done.

Pulling in three nurses and a burly care worker from another section of the Paris hospital, the series of co-ordinated movements was just one of thousands of medical interventions — big and small, human, mechanical and pharmaceutical — that were maintaining the 64-year-old retired waitress on the threshold of life, while she fought to heal her diseased lungs.

And she was just one of nearly 6,000 critically ill patients still in French intensive care units this week as the country embarked on the perilous process of gingerly easing out of its latest lockdown — too prematurely for some frontline workers in hospitals.

French President Emmanuel Macron’s decision to reopen elementary schools on Monday and allow people to move about more freely again in May — even though ICU numbers have remained stubbornly higher than at any point since the pandemic’s catastrophic first surge — marks a shift away from prioritizing hospitals that is taking place in multiple European capitals.

In France, Greece and elsewhere, the cursor is moving toward other economic, social and educational imperatives. Governments are using ramped-up vaccinations to bolster arguments to ease restrictions, although just one-quarter of adults in Europe have received a first dose.

With record-high numbers of COVID-19 patients in critical care, Greece announced the reopening of its tourism industry from mid-May. Spain’s prime minister says the state of emergency that allowed for curfews and travel bans won’t be extended when it expires May 9, in part because vaccinations are allowing for a safe de-escalation of restrictions. This despite more than 2,200 critically ill COVID-19 patients still occupying one-fifth of Spain’s ICU beds.

Beginning Monday, in low-risk zones, Italy’s schools can reopen for full-time, in-person learning, and restaurants and bars can offer sit-down, outdoor service. The Netherlands is ending a night curfew and reopening the outdoor terraces of bars and cafes for the first time since mid-October, even as hospitals scale back non-urgent care to increase ICU beds for COVID-19 patients.

In France, Prime Minister Jean Castex said the latest infection surge that pushed the country’s COVID-19-related death toll beyond 100,000 people has begun a slow retreat, allowing for all schools to reopen and day-time travel restrictions to end starting May 3. Castex also raised the prospect that stores and outdoor service at restaurants and cafes closed since October could reopen in mid-May.

“The peak of the third wave appears to be behind us, and the epidemic’s pressure is lifting,” Castex said Thursday.

That’s not how it feels to Nadia Boudra, a critical care nurse at Bichat Hospital in Paris. Her 12-hour shift Thursday started with the unpleasant job of sealing the corpse of a 69-year-old man who died overnight with COVID-19 in a body bag, just hours before his daughter flew in from Canada hoping to see him alive.

“We have our noses in it. We see what’s happening, we see that people are dying — a lot,” she said. For her, reopened schools and, possibly, outdoor eating and drinking in May are “too soon” — a misleading message that “things are getting better.”

“Clearly,” she said, “that is not the case.”

After sending the man’s body to the hospital morgue, Boudra tended to the critically sick retired waitress, now the solitary occupant of the makeshift ICU set up for COVID-19 patients in what had been an operating room. The tender care, expertise and technology poured into keeping this one woman alive offered a micro-level look at the momentous national efforts — human, medical, financial — that France and other countries are still expending in ICUs as healthy people now plan May getaways and drinks with friends.

As the woman lay unconscious, 5,980 other gravely ill patients were also being kept alive with round-the-clock human and mechanical devotion in other critical care units across France. Automated drips supplied sedatives, painkillers and drugs to prevent deadly blood clots and leaks from the woman’s veins. Enriched oxygen, first bubbled through water to warm and humidify it, pumped mechanically into her lungs. The ICU team also took a call from the woman’s daughter, who telephones morning and night for news. It was bad on Thursday morning: Tran Dinh told the daughter her mother’s breathing had deteriorated.

“If you took away the machines, she would die in a few minutes, perhaps less,” the doctor said. “There is no room for error.”

Yet this patient wasn’t even the most fragile. An artificial lung, a last resort for patients with lungs ravaged by the disease, was keeping a 53-year-old man alive. Costly and resource-intensive, the state-of-the-art treatment is reserved for patients thought strong enough to have a chance of surviving. About 50% still die, said Dr. Philippe Montravers, who heads the surgical ICU department at Bichat, run by Paris’ hospital authority, AP-HP.

His unit has four of the ECMO machines — all of them used for COVID-19 patients. The man has been hooked up to his for over a month but “is not improving at all,” Montravers said.

“This machine only buys time,” he said. “It’s a life buoy, nothing more.”

Nurse Lea Jourdan said tending to someone so fragile is physically and mentally wearing.

“You have to be careful about everything, all the tubes, not ripping anything out when you turn him over,” she said. ”It’s tough to see the positive and say to oneself, ‘He will survive.’”

___

AP writers Mike Corder in The Hague, Netherlands, Nicole Winfield in Rome, Aritz Parra in Madrid and Elena Becatoros in Athens, Greece, contributed.

___

John Leicester, The Associated Press


Like us on Facebook and follow us on Twitter.

CoronavirusEuropean UnionHealthcare

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Creston Town Hall. (Photo by Kelsey Yates)
Ellen Tzakis resigns from Creston Town Council

Council is preparing to hold a by-election later this year

RCMP are searching for Philip Toner, who is a 'person of interest' in the investigation of a suspicious death in Kootenay National Park last week. Photo courtesy BC RCMP.
Man sought in suspicious Kootenay death found in Lake Country

Philip Toner is a person of interest in the death of Brenda Ware

A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine at a COVID-19 vaccine clinic in Toronto on Thursday, January 7, 2021. THE CANADIAN PRESS/Nathan Denette
65 new cases of COVID-19 in Interior Health

Overall, B.C. is seeing a decrease in COVID-19 cases

School District 8 employees Shannon Tetz, Cheryl Rendek, and Janet Wall officially began their retirement with a COVID-friendly send-off outside of Prince Charles Secondary School. (Photo by Kelsey Yates)
School District 8 employees Shannon Tetz, Cheryl Rendek, and Janet Wall officially began their retirement with a COVID-friendly send-off outside of Prince Charles Secondary School. (Photo by Kelsey Yates)
Three women retire from School District 8 with COVID-friendly celebration

Shannon Tetz, Cheryl Rendek, and Janet Wall shared 87 years of service collectively

Two Creston Schools have reported potential COVID exposure. (Submitted photo)
Two Creston schools report potential COVID-19 exposure

Those who tested positive on May 3, 4 are now self-isolating at home

A bullet hole is seen in the windshield of an RCMP vehicle approximately 4 km from Vancouver International Airport after a one person was killed during a shooting outside the international departures terminal at the airport, in Richmond, B.C., Sunday, May 9, 2021. THE CANADIAN PRESS/Darryl Dyck
Homicide team IDs man in fatal YVR shooting as police grapple with spate of gang violence

Man, 20, charged in separate fatal shooting Burnaby over the weekend

Keith MacIntyre - BC Libertarian
Penticton’s Keith MacIntyre new leader of the B.C. Libertarian Party

The Penticton businessman was voted in by members of the party on May 8

Vernon North Okanagan RCMP reported to 287 mental health calls between Jan. 1, 2021, and May 1. (Black Press files)
‘It’s not the police’s responsibility to deal with mental health calls’: Vernon RCMP

RCMP remind public to take care of mental health and well-being, while better solutions are sought

Thompson Rivers University campus is in Kamloops, B.C. (KTW file photo)
Thompson Rivers the 1st B.C. university to supply free menstrual products

The university will offer the products this September

Fraser Health is using ‘targeted’ vaccination clinics in high-risk areas of the Lower Mainland. (Fraser Health photo)
B.C.’s COVID-19 decrease continues, 515 new cases Tuesday

426 seriously ill people in hospital, up from 415 Monday

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

The site of Sunfest, Laketown Ranch, will be open for camping this summer. (Citizen file)
Sunfest country music bash won’t be shining on B.C. in 2021

Annual Vancouver Island Festival cancelled due to COVID-19, along with Laketown Shakedown

Tla-o-qui-aht First Nation elected chief councillor Moses Martin, who was also Chantel Moore’s grandfather, speaks to media in Port Alberni on Aug. 16, 2020, during a visit from NDP leader Jagmeet Singh following the police shooting of Chantel Moore. (Elena Rardon photo)
Mother of 2 shot by police in critical condition, says B.C. First Nation chief

Community ‘devastated’ by third member of 1,150-person Vancouver Island nation shot in less than a year

B.C. Agriculture Minister Lana Popham promotes the government’s BuyBC food program in 2019. (B.C. government)
Money running out for fresh fruit, vegetables, milk in B.C. schools

‘Looking at ways to support this type of program,’ minister says

Most Read