A caregiver talks to us from the « inside

 » I am a caregiver* with 20 years of experience in almost all Intensive Care Units (ICU) and Emergency Departments in Brussels. I quickly noticed that a large proportion of caregivers chose to ride the covid wave to take on a hero role that they were never given credit for. The temptation was strong and the media didn’t have to insist much to drag them into the dance. Where it was necessary to keep one’s composure, to calm down, to put things in perspective, we took the theatrical option and accentuated the stampede. Well… not all of them. Many remain centered, silent. These caregivers don’t panic because they only care about « now » and the person who is breathing less well now. But they are invisible: we shun the noise and cultivate appeasement. We don’t look at numbers, but one person at a time. We are appalled by what you are watching over and over again on the screens. This is not our reality. If there are shots, they are managed. Quiet is the norm and everything is VERY quiet. This covid is not ebola and the treatments are routine. We regret that you are not informed of health and immunity-boosting tips that would empower you and make you self-sufficient.  »

This is how the situation was presented by the person who gives us the information we share with you. Since the managements via their communication service do not answer us, it is the workers, those who are in the heart of the action, who inform us. And the reality is sometimes far from the media fiction.

On the side of the State « the drama », on the side of the hospital, the calm?

We received figures from an emergency service, covering the last few weeks. Below, they are presented over a 24-hour period, distinguishing influenza-like illness from covid tests and other emergencies. It is not possible to know whether those discharged from the emergency department with influenza-like symptoms were hospitalized or returned home with treatment.

Week 1

Monday

Influenza-like conditions: 10

Test covid for administrative reasons (tracing, travel) : 4

Other emergencies: 70

Total entries: 84

Tuesday

Influenza-like states: 11

Test covid: 5

Other emergencies: 60

Total entries: 76

Wednesday

Influenza-like states: 7

Test covid: 5

Other emergencies: 66

Total entries: 78

Thursday

Influenza-like states: 5

Test covid: 2

Other emergencies: 73

Total entries: 80

Friday

Influenza-like states: 3

Test covid: 5

Other emergencies: 62

Total entries: 70

Saturday

Influenza-like states: 3

Test covid: 5

Other emergencies: 57

Total entries: 65

Sunday

Influenza-like states: 3

Test covid: 1

Other emergencies: 63

Total entries: 67

Week 2

Monday

Influenza-like states: 7

Tests covid: 2

Other emergencies: 63

Total: 72

Tuesday

Influenza-like states: 8

Tests covid: 3

Other emergencies: 54

Total: 65

Wednesday

Influenza-like states: 1

Tests covid: 7

Other emergencies: 54

Total: 62

Thursday

Influenza-like states: 10

Tests covid: 7

Other emergencies: 74

Total: 91

Friday

Influenza-like states: 8

Tests covid: 8

Other emergencies: 58

Total: 74

Saturday

Influenza-like states: 2

Tests covid: 4

Other emergencies: 35

Total: 41

Sunday

Influenza-like states: 1

Tests covid: 1

Other emergencies: 48

Total: 50

Week 3

Monday

Influenza-like states: 2

Tests covid: 2

Other emergencies: 71

Total: 75

Tuesday

Influenza-like states: 2

Tests covid: 2

Other emergencies: 65

Total: 69

 » In the ICU of this hospital, there are 8 beds: 5 were occupied by covid between 65 and 80 years old, intubated, all with the usual comorbidity: obesity (some with a weight of more than 120 kg), arterial hypertension, diabetes. All of them will probably die in the unit: not young enough to recover from ICU stress, but not old enough to die quickly. One bed is occupied by a detubed covid but it is drawing air and may be re-intubated. One bed was occupied by another pathology, one bed was free « .

Those who come into the hospital with flu-like symptoms all go home ‚ » saysDr. G. G. G.auf if their saturation is below 95% with visible lung involvement on CT. Patients with mild symptoms are sent home with the same treatment for all: paracetamol, eucalyptus spray and 5 to 7 days off work « .

 » What makes the difference between a simple flu and a covid is the oxygen saturation, the gasometrice: an arterial blood test showing more precisely the PaO2 which is low in covid attacks; the CT scan of the lungs which determines if there is a pulmonary attack and of which percentage. One of my nursing colleagues estimates that about 4 out of 20 symptomatic patients remain hospitalized in a covid unit depending on the severity of the above examinations, in addition to age and co-morbidities which are always the same: hypertension, diabetes, obesity.  »

 » The activity of the emergency room resumes its normal course during the day. The attendance, at night, always slows down with the curfew, around 10 pm.  »

Emergency room registrations are lower than in normal times.  » Because of the curfew, there are fewer driving accidents,sprains, fractures, etc.wounds, wounds, alcohol impregnation. And as with the first confinement, we see much less chest pain (infarction, pulmonary embolismareas), renal colic, abdominal pain; it is really curious. Because then, either people come quickly to the hospital in normal times, or they don’t dare to come again believing that it is full of covid, or they condition themselves not to allow themselves to be in pain…? We don’t know. Well, at the same time it is also like that when there is a princely wedding, an attack or a match of European or world cup. But in any case, doctors as well as nurses, we enjoy these hyper-calming periods os where we can work well with the few patients who present. We become nice again, empathetic.  »

Several questions arise:

- What is the difference between these figures and those of previous years ;

- Sciensano and the government centralize the information, not allowing journalists and the public to consult the figures by hospital. So we can legitimately ask the question: what if it was the same in all hospitals?  » Oh yes! That’s for sure: it’s like that everywhere. Now, maybe in the large university structures, they concentrate younger patients with more complicated comorbidities to manage (autoimmune diseases, cancers,…). But it remains the exception (that everyone loves to repeat). This covid has a picturesque side because it is like the women who tell their childbirth: there are not 2 similar!  »

The Wilmès « case

Only Sophie Wilmès seems to have arrived in the Delta ICU under different circumstances:  » She arrived at Delta ICU on her own, on her own two legs, in a car with a driver. She did not go through the emergency room. So this is, at best, an arrangement between his treating physician and Delta management, or an arrangement between Wilmes and his connections. She was received directly in the ICU by several members of the hospital management, including El Haddad(1), with champagne and glasses for everyone. She didn’t need oxygen at all when she arrived and stayed in the ICU for about a week. She therefore occupied an ICU bed as a preventive stay where a simple private room would have been sufficient, if her condition warranted hospitalization « .

 » I would like to remind you that a patient who needs to go directly to the ICU without going through the emergency room is the decision of two intensivists. He always arrives in an ambulance, already perfused, intubated, ventilated, oxygenated to 100%, under cardiac monitoring, accompanied by a doctor.cin SMUR, an emergency nurse and a minimum of two firefighters. He is sedated and is no longer able to drink anything with anyone.  »

- These figures show that there is no saturation in this Brussels hospital. However, the political-sanitary measures (confinement, masks, curfews, « social » distancing) continue, with their array of side effects, of which we are only just beginning to see;

- The vaccine, presented as a panacea, is refused by the majority of the medical profession in the ICU and emergency rooms of this hospital, while the government told us that the medical profession would be the first to be vaccinated. It would be interesting to hear more about the opinion of the health care personnel on the vaccine;

- In addition to the low ICU occupancy rate of covid patients, there is a very low case fatality rate(2) (less than 0.5%), indicating that 99.5% of people who test positive for covid survive, even though no vaccine exists(3).

* The person testifying wanted to remain anonymous. 

Interview by Alexandre Penasse

Notes et références
  1. https://chirec.be/fr/le-conseil-executif-chirec
  2. La mortalité chez les personnes positives au Covid.
  3. https://youtu.be/991orOyxsMY ou https://twitter.com/do_officiel

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