For several weeks, France has been experiencing a severe influenza epidemic. But as the peak approaches, expected at the beginning of January, emergency services are facing a massive influx of patients. And run out of steam. In this tense context, it becomes essential to know when the hospital is essential… and when it is not. Dr Gérald Kierzek, emergency doctor, sorts out the situations.
All of France is seeing red this week
The flu epidemic continues to progress throughout France. According to the latest Public Health France bulletin published on December 31, all metropolitan regions are now in the epidemic phase, with the exception of Reunion, where activity has returned to its usual level. The dynamic is particularly marked in hospitals, where the intensity is described as “high”, all ages combined, but especially among children under 15 and people over 65.
Saturated emergencies, a system under tension
In the week of December 24 to 31 alone, more than 18,500 visits to the emergency room were recorded for flu-like illnesses, representing more than 5% of all consultations. Nearly 3,600 patients were subsequently hospitalized. A pressure which is explained in particular by the majority circulation of type A viruses, with a predominance of the subtype A (H3N2), known to be more aggressive in the elderly. This continued progression of the epidemic is resulting in extreme tension in hospital services, already weakened by end-of-year holidays and recruitment difficulties. Queues are getting longer and pick-up times are stretching out.
Faced with this situation, Dr Gérald Kierzek calls for collective responsibility.
“In times of hospitals under pressure linked to an intense epidemic, it is crucial to reserve emergencies for serious cases to avoid saturation”, he recalls. “Not all flus require hospital treatment.”
In community medicine, the intensity is slightly less, even if consultations remain numerous, particularly among those over 65, a population particularly exposed to complications.
When should you go to the emergency room immediately?
Therefore, certain symptoms should alert you without delay. Dr. Gérald Kierzek insists on the need not to wait when signs of seriousness appear, which may reflect a severe complication such as pneumonia or cardiorespiratory decompensation.
You must call 15 or go to the emergency room in the event of:
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Persistent or worsening breathing difficulties;
- Shortness of breath at rest or chest tightness;
- Confusion, disorientation or disturbances of consciousness;
- Inability to stay awake;
- Convulsions or stiff neck;
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Fever above 40°C poorly tolerated;
- Sudden worsening of general condition after 72 hours of progression.
“These signals should never be trivialized. They can be life-threatening,” underlines the emergency doctor.
Some people need to consult earlier, sometimes at the first symptoms, even in the absence of immediate signs of seriousness. The elderly, young children, pregnant women or patients with chronic illnesses or those who are immunocompromised are at increased risk of severe forms.
“In these profiles, the flu can quickly progress to hospitalization or admission to intensive care. Early antiviral treatment can limit complications,” explains Dr. Gérald Kierzek.
When emergencies are not necessary
Conversely, a classic flu in a healthy person generally does not warrant a trip to the emergency room. Fever, body aches, intense fatigue and dry cough are common, and certainly unpleasant, symptoms. But most often benign when they do not evolve unfavorably.
“In these cases, rest, hydration and paracetamol are sufficient. A GP, a teleconsultation or the advice of a pharmacist are appropriate responses”, calls back the doctor.
Avoiding emergencies for non-serious forms makes it possible to preserve the treatment capacities of hospitals and guarantee a rapid response to the most severely affected patients.