PARIS – Dry-coughing as he pedals — a hack, hack, hack after-effect of his own personal battle with COVID-19 — the doctor cycles through the dark of pre-dawn Paris, speeding to a crisis meeting at his hospital where, way back in February, the disease carried away the first of what has now become more than a quarter-million dead in Europe.
In the nine months since then, critical care chief Philippe Montravers and the 150 doctors and nurses he leads at the towering Bichat Hospital in Paris have become experts about their enemy. That knowledge is proving invaluable against the second deadly surge of the virus that is again threatening to overwhelm European health systems.
Puffing and spluttering as he pedals, because his lungs are still congested, Montravers details the progress that he and his team have made in their care since they fought off the gruesome initial wave of cases last spring, therapeutic advances that are helping Bichat and other hospitals better resist the renewed tide of infections. Bichat in February was the first hospital outside Asia to record the death of a person infected with the virus: an 80-year-old tourist from China.
“In the first wave, people didn’t dare come to the hospital. They were scared, scared of being infected,” Montravers recalls. “When they arrived, they were on their last legs, exhausted, unable to move, and so — hop! — we intubated and ventilated them.”
Now, there are steroid treatments that weren't available to Bichat's doctors in the first surge. They have also learned not to put patients on ventilators if at all possible and to instead keep them awake and bathed in oxygen, dispensed through face masks instead of invasive tubes. The sick are also savvier, and are seeking help earlier for their symptoms, making them easier to treat.
Added together, these and other advances mean that patients more often are spending days instead of weeks in critical care and surviving in greater numbers.
“We’ve won about 15 days in caring for them and the mortality has dropped by nearly half,” Montravers says.
That picture is reflected nationwide, too. Although France now has more patients hospitalized with the virus than during the April peak of the initial wave, there are about 2,000 fewer in intensive care. The situation remains dire, with one death in four in France now linked to COVID-19 and the country again largely locked down. But hospitals appear to be holding, with capacity to survive the surge's high point projected to sweep across France in coming days.