How to explain the scale of the bronchiolitis epidemic this year?

For pediatricians interviewed by BFMTV.com, the crisis in pediatric services in France explains the saturation of public hospitals. On Wednesday, the Minister of Health launched the Orsan plan.

In its weekly bulletin relating to the bronchiolitis epidemic published on Wednesday, Santé Publique France underlined the unprecedented nature of the wave which is currently falling on France. The number of emergency visits and hospitalizations is “at levels higher than those observed at epidemic peaks for more than 10 years”.

Wednesday in the Senate, the Minister of Health François Braun indicated that the Orsan plan was going to be launched in French hospitals, to cope with the large number of hospitalizations. Still according to Santé Publique France, 6,891 visits to the emergency room linked to bronchiolitis were recorded from October 31 to November 6. This Orsan plan provides in particular for deprogramming and requisitioning of caregivers if necessary.

The hospital crisis

But how to explain this strong comeback of bronchiolitis, after a relative lull during the Covid-19 pandemic, which with its successive confinements and its barrier gestures protected the little ones? For the specialists interviewed by BFMTV.com, it is not so much an exceptional epidemic phenomenon that is responsible for the situation described by François Braun, but rather the inability of the French hospital system to absorb the requests for hospitalization presented to it. .

“Currently, the hospital is like a sinking boat. And the bronchiolitis epidemic is a bit of a storm that can sink it”, analyzes for BFMTV.com Véronique Hengten, pediatrician at the Versailles hospital center.

For the doctor, “10 years ago, we were able to take care of children. This is no longer the case, the hospitals are bloodless, and we also have to deal with a strong epidemic. The government has actually triggered the white plan to deal with the emergency”.

Words that resonate with the open letter sent on October 22 by more than 7,000 pediatric caregivers, to alert to the saturation of services.

The difficulties of city medicine

“We can wonder if there is a correct sizing of the hospital, if with each epidemic we start to trigger a white plan …”, abounds Yvon Le Flohic, general practitioner contacted by BFMTV.com. The latter believes that the gradual reduction of general practitioners and pediatricians in the city contributes to the congestion of emergencies.

“In recent years, we have seen a disappearance of pediatricians in town, but also general practitioners. In France, 6 million people do not have general practitioners. So these are people who as soon as it affects their child, go directly turn to the hospital,” he said.

According to Sylvie Hubinois, a liberal pediatrician in Saint-Germain-en-Laye, France has so far only trained 300 pediatricians each year. A number which has risen slightly, but which remains insufficient. “Paediatrics in France has always been weak, we have few pediatricians per capita compared to our European neighbors who also have a pediatrician system in town”, regrets the doctor.

“In town, we are overwhelmed, in addition to the usual consultations, pediatricians have to manage 10 to 15 emergencies a day!”, Continues Sylvie Hubinois.

A disruption caused by Covid-19?

Structural problems aside, the fact remains that the current bronchiolitis epidemic remains important from a health point of view. The specialists interviewed all underline the possible deregulating role played by the Covid-19 pandemic over the past two years, while recalling that these are only hypotheses.

During the winter of 2020, the epidemic had been contained due to confinements and barrier gestures, recalls Sylvie Hubinois, before it returned in the winter of 2021, due to the relaxation of epidemic braking measures.

For Véronique Hentgen, “on the vigor of this year, we only have hypotheses. All epidemics have been disorganized since Covid-19”. Proof of this is that this fall, many cases of bronchiolitis were reported very early, as early as October.

“We can ask ourselves the question of the ecosystem of epidemics, which all seem to have been impacted by Covid-19, which by its power has taken up a lot of space”, abounds Yvon Le Flohic.

Do not expose your children too much

In this unfavorable context, parents are urged to be cautious. Especially since the slowdown in the increase in cases could only be linked to school holidays, leading to a reduction in contact among children. “It can start again better after!”, warns Véronique Hentgen.

For pediatricians contacted by BFMTV.com, it is imperative that parents of young children, especially when they are under three months old, take precautions. Bronchiolitis is triggered mainly in toddlers, and is caused by a virus, RSV. Symptoms that should alarm are fever, difficulty breathing and eating.

“It is absolutely necessary to avoid overcrowded places, shopping centers for example. And during family meals, you must not pass the baby from arm to arm, even if it means appearing too cautious!”, insists Sylvie Hubinois.

Before remembering that bronchiolitis is in the vast majority of cases benign. “When the child is still eating properly, it is not necessary to go to the emergency room, but rather to his pediatrician or his general practitioner”.

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