Hospital operations postponed as more ‘plans blancs’ launch in France

The status allows establishments to divert resources to Covid patients and is likely ‘go national’ within days, says the health minister. Pharmacies can also now open on Sundays

The ‘plan blanc’ protocol in France enables hospitals to divert resources towards Covid patients, meaning non-urgent operations and procedures will be postponed or cancelled
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Six regions in France have enacted official ‘plan blanc’ status, which enables hospitals to reschedule operations and divert staff towards critical care services, as the fifth wave of Covid continues.

The regions are Île-de-France, Occitanie, Pays de la Loire, Corsica, Provence-Alpes-Côte-d’Azur and Bourgogne-Franche-Comté. The status was officially enacted yesterday (December 8) by their respective regional health agencies, les agences régionales de santé (ARS).

  • The ARS Ile-de-France said the move was necessary because “hospital tension has increased over the past few days”, with the region’s hospitals now caring for 2,608 Covid patients, of which 505 are in critical care.
  • In Pays de la Loire, the ARS has asked its public and private hospitals to postpone “20% of the medical and surgical activities, except urgent interventions”.
  • The ARS in Occitanie has requested that its hospitals “gradually reschedule lower priority operations” without stating a precise percentage. In the region, Covid patients are taking up a third of 560 available intensive care beds, with acute care units in some departments now full to 92% and even 100% all patients considered, the authority said.
  • In Bourgogne-Franche-Comté, “more than 600” people with Covid are currently in hospital, including 100 in intensive care, the ARS said, warning that some operations would be rescheduled.
  • In Hauts-de-France, the ARS has asked several areas to activate the plan blanc, and open “114 extra beds in critical care and 260 in normal wards” by mid-December, in “anticipation of saturation at the end of the year”.
  • In Provence-Alpes-Côte d’Azur, the ARS has “called all voluntary health professionals (students, retired people, independent doctors) in the region to come to the aid of hospital care teams”.

The CHU hospitals of Bordeaux, Lyon, Rennes and Strasbourg have already enacted the protocol without waiting for official ARS direction.

Plan blanc will likely go national

It comes as Health Minister Olivier Véran said that the ‘plan blanc’ will probably be enacted nationally in the coming days.

The minister told France 2: “All areas are absolutely affected. There is now someone [with Covid] entering intensive care every six minutes in our country. If you remember, last Thursday I was talking about one person every 10 minutes.”

He added that most people being admitted to intensive care were not vaccinated, and that those who had been vaccinated but were being admitted were mainly immunosuppressed or have chronic existing conditions.

Pharmacies to open on Sundays

As a result, Mr Véran has also said that pharmacies will be able to open on Sundays in December and January “without restrictions”, in order to continue administering Covid vaccinations and boosters.

He said: “To simplify and increase this booster campaign, I have signed a decree that will authorise and encourage pharmacists that want to, to now open without limits in December and January.

“Why? Because pharmacists are essential pillars in this booster campaign. They are close to the people, and there are 15,000 of them who have doses of mRNA vaccines, and we want to get this done quickly.”

A decree in the Journal Officiel has provided for extra compensation for pharmacists that offer vaccinations on Sundays.

Mr Véran added that “France is one of the countries that is administering the most daily booster jabs, with more than 650,000 people receiving a booster yesterday”.

He said that this pace must be maintained, and that “we must go faster, stronger. It’s urgent”.

Read more:Lateral flow tests France: Shortages at pharmacies as demand rises

“We are increasing the number of centres that can give vaccinations; independent GPs, pharmacists, doctors, physiotherapists, nurses, and midwives. This week we are receiving more than four million doses of mRNA vaccines,” he said.

Some pharmacies may add an extra fee of €5 per prescription on Sundays and bank holidays. It is not yet known whether this additional fee will also apply to Covid tests.

40 Omicron cases and fifth wave to hit peak ‘by end of the month’

Mr Véran said as of December 9, around 40 cases of the new Omicron variant have been detected in France. He said: “We are managing to slow the spread a lot more than our neighbours [neighbouring countries].”

Overall, however, confirmed numbers of cases of Covid (most likely the dominant Delta variant) are still on the rise.

The most recent figures (from December 8) show that there were 61,340 new cases in the past 24 hours, 129 more deaths, a positive test rate of 6.5%, and 476,701 people who had a third dose of vaccine within the past day.

Yet, the health minister said that he expects the fifth wave to peak by the end of the month if the public “strictly respects barrier methods” and limits gatherings.

He said: “We are seeing a slowdown in the epidemic growth. We were at a rise of 60% of cases in a week, then 40%. Now it’s at 25-30%.

“We don’t need to impose extra restrictions because people in France know how to stop the virus. It’s not having a drink with friends, even though it’s the festive end-of-year period. It’s not having drinks with colleagues.

“It’s in these moments that we can let your guard down [too much], when we might take our mask off too easily because we feel safe.”

Read more: Calendar: When do France's new Covid rules to fight fifth wave begin?

It comes as the government announced a range of new measures designed to curb the fifth wave, including mandatory masks in schools, calls for more home working, and the start of the vaccination campaign for vulnerable children from December 15.

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