Europe reopens however virus sufferers nonetheless overwhelm ICU groups

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Europe reopens but virus patients still overwhelm ICU teams

Nurses Nadia Boudra (left) and Yvana Faro (right) care for a patient in an operating room now used for unconscious COVID-19 patients at the AP-HP Bichat Hospital in Paris on Thursday April 22, 2021. France had nearly 6,000 critically ill patients in intensive care units this week as the government embarked on the dangerous process of cautiously liberating the country from its recent lockdown, too early for those on the front lines of hospital pandemics. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than at any point since the catastrophic first wave of the pandemic another shift away from prioritizing hospitals in several European capitals. (AP Photo / Lewis Joly)

Dr. Alexy Tran Dinh rocked the deeply sedated COVID-19 patient's head like a precious jewel in his hands, guiding his intensive care carers through the delicate process of rolling the woman from her stomach onto her back and leading the team like a dance instructor.

They moved in unison and with the utmost care only according to Tran Dinh's count, as the unconscious patient could die in minutes if she accidentally ripped the air tube from her mouth.

"One, two and three – on the side," instructed the doctor.

His next order followed quickly: "On your back."

"Perfect," he concluded when the move was complete.

The series of coordinated movements that brought in three nurses and a burly male nurse from another part of the Paris hospital was just one of the thousands of medical interventions – large and small, human, mechanical, and pharmaceutical – that maintained the 64-year-old retired Waitress on the verge of life while struggling to heal her sick lungs.

And she was just one of nearly 6,000 critically ill patients remaining in French intensive care units this week as the country embarked on the dangerous process of cautiously easing its recent lockdown – too early for some hospital frontline workers.

French President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May – although the number of intensive care units has remained stubbornly higher since the disastrous initial surge in the pandemic – means a move away of the prioritization of hospitals is taking place in several European capitals.

Europe opens again, but virus patients are still overwhelming the intensive care teams
The nurse Nadia Boudra (left), the doctor Alexy Tran Dinh (center) and the nurse Yvana Faro (right) look after a patient in an operating room that was used on Thursday in the Bichat Hospital, AP-HP, in Paris as a room for unconscious COVID- 19 patients, April 22, 2021. France still had nearly 6,000 critically ill patients in intensive care units this week as the government embarked on the dangerous process of cautiously liberating the country from its recent lockdown, too early for those in Hospitals are in a pandemic. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than ever since the catastrophic first wave of the pandemic, marks one further shift away from prioritization of hospitals in several European capitals. In France, Greece, and elsewhere, the cursor moves back to other economic, social, and educational needs. (AP Photo / Lewis Joly)

In France, Greece, and elsewhere, the cursor moves in the direction of other economic, social, and educational needs. Governments are using increased vaccination to back up arguments to ease restrictions, even though only a quarter of adults in Europe have received a first dose.

With a record number of COVID-19 patients in intensive care medicine, Greece announced the reopening of its tourism industry from mid-May. The Spanish prime minister says the state of emergency, which allowed curfews and travel bans, will not be extended when it expires on May 9, in part because vaccinations allow restrictions to be safely de-escalated. This despite more than 2,200 critically ill COVID-19 patients who still occupy a fifth of Spanish intensive care beds.

Starting Monday, Italy's schools in low risk zones can reopen to full-time classes, and restaurants and bars have outdoor seating. The Netherlands is ending a night curfew and reopening outdoor bars and cafes terraces for the first time since mid-October, even as hospitals reduce non-urgent care to increase intensive care beds for COVID-19 patients.

Europe opens again, but virus patients are still overwhelming the intensive care teams
Student nurse Soraya Ngin Tun (left), Dr. Atanas Sabahov (center left), nurse Rim Omrani (center right) and student nurse Landry Nzoyem (right) are resting at Bichat Hospital, AP-HP, in Paris on Thursday, April 22, 2021. France still had nearly 6,000 critically ill patients in intensive care units this week as the government embarked on the dangerous process of cautiously liberating the country from its recent lockdown, too soon for those in hospitals on pandemic fronts. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than ever since the catastrophic first wave of the pandemic, marks one further shift away from prioritization of hospitals in several European capitals. (AP Photo / Lewis Joly)

In France, Prime Minister Jean Castex said the recent spurt of infections, which brought the death toll from COVID-19 to over 100,000, has begun a slow retreat that has allowed all schools to reopen and lift restrictions on day travel to end on May 3rd. Castex also indicated that outdoor shops and services in restaurants and cafes, which have been closed since October, could reopen in mid-May.

"The peak of the third wave seems to be behind us and the pressure of the epidemic is easing," Castex said on Thursday.

That's not how it feels to Nadia Boudra, a nurse at Bichat Hospital in Paris. Her 12-hour shift on Thursday began with the uncomfortable task of sealing the body of a 69-year-old man who died in a body bag overnight with COVID-19 just hours before his daughter flew in from Canada hoping to find him alive to see.

Europe opens again, but virus patients are still overwhelming the intensive care teams
Dr. Philippe Montravers rests on Thursday April 22, 2021 at the Bichat Hospital, AP-HP, in Paris. France still had nearly 6,000 critically ill patients in intensive care units this week as the government embarked on the dangerous process of cautiously liberating the country from its recent lockdown, too early for those on the front lines of pandemics in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than ever since the catastrophic first wave of the pandemic, marks one further shift away from prioritization of hospitals in several European capitals. (AP Photo / Lewis Joly)

"We have our noses in. We see what happens, we see people dying – a lot," she said. For them, reopening schools and possibly eating and drinking outdoors in May are "too early" – a misleading message that "things are getting better".

"Sure," she said, "that's not the case."

After Boudra sent the man's body to the hospital morgue, he took care of the critically ill retired waitress who was now housed alone in the makeshift intensive care unit for COVID-19 patients in an operating room. The tender care, expertise and technology used to keep this one woman alive provided a micro-level view of the significant national efforts – human, medical, financial – that France and other countries are still making in intensive care units since healthy people are now planning getaways and drinks with friends.

Europe opens again, but virus patients are still overwhelming the intensive care teams
Sister Guillaume Meuleman is seen through the window of an operating room at Bichat Hospital, AP-HP, in Paris on Thursday April 22, 2021. France had nearly 6,000 critically ill patients in intensive care units this week as the government embarked on the dangerous process of gently releasing the country from its recent lockdown, too soon for those on the front lines of pandemics in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than at any point since the catastrophic first wave of the pandemic another shift away from prioritizing hospitals in several European capitals. In France, Greece, and elsewhere, the cursor is moving back to other economic, social, and educational needs. (AP Photo / Lewis Joly)

When the woman was passed out, 5,980 other critically ill patients in other intensive care units across France were kept alive around the clock with human and mechanical devotion. Automated drops supplied sedatives, pain relievers, and medication to prevent deadly blood clots and leaks from the woman's veins. Enriched oxygen, which was first blown through water to warm and humidify it, was mechanically pumped into her lungs. The ICU team also took a call from the woman's daughter, who calls morning and evening for news. It was bad on Thursday morning: Tran Dinh told the daughter that her mother's breathing had worsened.

"If you took the machines away, she would die in a few minutes, maybe less," said the doctor. "There is no room for error."

But this patient wasn't even the most fragile. An artificial lung, a last resort for patients with lungs afflicted by the disease, kept a 53-year-old man alive. State-of-the-art treatment is costly and resource intensive and reserved for patients strong enough to have a chance of survival. About 50% are still dying, said Dr. Philippe Montravers, Head of the Surgical Intensive Care Unit in Bichat, managed by the Paris Hospital Authority AP-HP.

  • Europe opens again, but virus patients are still overwhelming the intensive care teams
    A worker passes in front of a collection of portraits of medical staff at Bichat Hospital, AP-HP, in Paris on Thursday, April 22, 2021. France had nearly 6,000 critically ill patients in intensive care units this week as the government began the dangerous process of cautiously liberating the country from its recent lockdown, too soon for those on the front lines of the pandemic in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than at any point since the catastrophic first wave of the pandemic another shift away from prioritizing hospitals in several European capitals. (AP Photo / Lewis Joly)
  • Europe opens again, but virus patients are still overwhelming the intensive care teams
    The medical staff, including Dr. Alexy Tran Dinh, attended an afternoon meeting at the Bichat Hospital, AP-HP, in Paris on Thursday April 22nd, 2021. France had nearly 6,000 critically ill patients in intensive care units this week when the government stepped in over the dangerous process of cautiously pulling the country out of its recent lockdown, too early for those on the front lines of the pandemic in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than ever since the catastrophic first wave of the pandemic, marks one further shift away from prioritization of hospitals in several European capitals. (AP Photo / Lewis Joly)
  • Europe opens again, but virus patients are still overwhelming the intensive care teams
    Sister Yvana Faro holds a patient's hand in an operating room now being used for unconscious COVID-19 patients at Bichat Hospital, AP-HP, in Paris, Thursday April 22, 2021. France had nearly 6,000 critically ill patients in intensive care units this week as the government began the dangerous process of gently lifting the country out of its recent lockdown, too soon for those on the front lines of pandemics in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than ever since the catastrophic first wave of the pandemic, marks one further shift away from prioritization of hospitals in several European capitals. (AP Photo / Lewis Joly)
  • Europe opens again, but virus patients are still overwhelming the intensive care teams
    A Covid-19 patient under ECMO (Extracorporeal Membrane Oxygenation) passed out on Thursday, April 22nd, 2021 in the Bichat Hospital, AP-HP, in Paris. France had nearly 6,000 critically ill patients in intensive care units this week as the government began the dangerous process of gently lifting the country out of its recent lockdown, too soon for those on the front lines of the pandemic in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than at any point since the catastrophic first wave of the pandemic another shift away from prioritizing hospitals in several European capitals. (AP Photo / Lewis Joly)
  • Europe opens again, but virus patients are still overwhelming the intensive care teams
    Center nurse Yevana Faro is attending to a patient in an operating room now used for unconscious COVID-19 patients at the AP-HP Bichat Hospital in Paris on Thursday April 22, 2021. France still had nearly 6,000 critically ill patients in intensive care units this week as the government embarked on the dangerous process of cautiously liberating the country from its recent lockdown, too soon for those on the front lines of pandemics in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than at any point since the catastrophic first wave of the pandemic another shift away from prioritizing hospitals in several European capitals. (AP Photo / Lewis Joly)
  • Europe opens again, but virus patients are still overwhelming the intensive care teams
    Sister Nadia Boudra attends to a patient in an operating room now being used for unconscious COVID-19 patients at Bichat Hospital, AP-HP, in Paris, Thursday April 22, 2021. France had nearly 6,000 critically ill patients in intensive care units this week as the government began the dangerous process of gently lifting the country out of its recent lockdown, too soon for those on the front lines of pandemics in hospitals. President Emmanuel Macron's decision to reopen elementary schools on Monday and allow people to move around more freely again in May, despite the fact that the number of intensive care units has remained stubbornly higher than at any point since the catastrophic first wave of the pandemic another shift away from prioritizing hospitals in several European capitals. (AP Photo / Lewis Joly)

His unit has four ECMO devices, all of which are used for COVID-19 patients. The man has been linked to his for over a month, "but is not improving at all," said Montravers.

"This machine only buys time," he said. "It's a lifebuoy, nothing more."

Sister Lea Jourdan said taking care of someone who is so fragile that they are physically and spiritually wearable.

"You have to take care of everything, all the tubes, and not tear anything out when you turn it over," she said. "It's hard to see the positives and tell yourself, 'He will survive.'"

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