Night falls differently during lockdown. There is a stillness. A silence that lies across Europe, extending both East of its borders and over the Atlantic, as a third of the global population is confined to their homes. The usual night-time haunts are empty, the hum of traffic, night shift workers and partygoers non-existent.

 

Yet, each night, the quiet is briefly no more. As people gather on their doorsteps and balconies, lean out of windows and stairwells, their cheers and applause echo across a nation and we are united in gratitude. We celebrate those who too often do not receive the praise they deserve, the people who are fighting on the frontlines of a different war, one which no one expected. Our healthcare workers.

The nightly applause for medical staff began in Italy, the country considered the epicentre of the European COVID–19 outbreak. Spain, France, and the UK followed suit. Such widespread gestures of thanks raise the question: how else are we supporting the life-saving efforts made by medical staff?

 

Supporting our health services

While governments grapple to source personal protective equipment (PPE), ventilators and, more simply, hospital beds, staff care networks are not currently a priority. Yet medical staff are not left without help – it is clear that current support overwhelmingly stems from the community. Individual action alongside help from businesses aims to alleviate the unavoidable pressure put on them during a health crisis.

In Monaco, there have been many proud displays of recognition. Every night at 7 pm citizens sing the national anthem to acknowledge the efforts of healthcare workers, as well as emphasise the much-needed unity the pandemic has borne. Supermarkets are dedicating the first opening hour each day to staff at the Princess Grace Hospital Centre, an action mirrored across many countries in lockdown. Along the coast, Nice is providing free taxi rides to all healthcare workers.

In addition, France’s main rail network SNCF announced that medical staff and personal carers would be able to travel for free. Some French regions, such as Grand Est, have also made local transport services free. Airbnb has made 20,000 rooms free for health workers to stay, amongst other groups vulnerable to the virus. This intends to reduce commuting hours and their chance of spreading the virus.

Gestures of gratitude from local and national businesses appear day by day in France but, perhaps most importantly, organisations are increasing their emphasis on psychological support. Much like in a physical war, doctors combatting the virus deal with an intensely high-pressure environment each day.

A helpline set up by Soins aux Professionals en Santé [Care for Healthcare Professionals] is now operational, providing a 24/7 service to those on the frontline; in its first days alone, approximately 200 medics would call each day. Issues such as shortage of masks, absence of testing and exhaustion linked to the pace of their work environment were most prevalent in their causes of stress. The most common testimony was personnel convinced that they were contaminated, but who had to continue to work.

The Fondation de France has raised money to set up psychological help units for health workers facing extreme working conditions due to the pandemic. No financial “thanks” has been implemented yet. The Director-General of Assistance Publique – Hôpitaux de Paris, a 44-strong hospital trust based in the capital, has called for a bonus for the “superhuman effort” made by medical staff.

In the UK, one of the countries most recently to go into lockdown, few measures have been implemented by government or by hospital trusts. A nurse based in a hospital in northern England revealed to Monaco Tribune that it was the sense of community that she found “heartwarming” and that the first nightly 8 pm applause moved her to tears.

“Psychological support seems to come from colleagues and our own teams,” she explained, after mentioning that hospitals have suspended car parking fees, made food in canteens free and that their chief executives were regularly giving thanks to workers.

 

Why psychological support is vital

A video released yesterday by the Princess Grace Hospital Centre in Monaco showed plenty of smiling medical staff asking citizens to “restez chez vous” (“stay home”). It provided welcome relief to anxieties caused by the predicted mass increase in cases, a well-documented problem against medical staff.

Many residents of Nice and the Riviera have signed up to join the Health Reserves. Extra staff would, in theory, be able to relieve pressures of this fast-paced environment and exhaustion caused by less-varied shift patterns. However, the majority in the Riviera region are still waiting to be deployed and some feel their skills are being wasted.

Christian Dusaintpère, an anaesthesiologist who retired just 2 and a half years ago, signed up last week to the reserves. When he was given information about his placement, he felt that Santé Publique had not taken advantage of his skillset.

“I was asked to provide phone consultations concerning general medical concerns. I won’t be able to do it from home because I have a bad Internet connection. I was offered to do it from a health centre in Vallauris. I accepted even though I think I would be more useful in my specialty. All this is on the condition that my former colleagues do not need me.”

#RestezChezVous ❤️

#RestezChezVous ❤️

Geplaatst door Centre Hospitalier Princesse Grace – CHPG op Donderdag 26 maart 2020

Every extra staff member is vital, no matter their posting. But, there is little doubt that help on the frontlines will provide crucial support to those already fighting COVID-19.

A study conducted by Chinese doctors showed that 70% of medical staff on the frontline in Hubei province suffered from extreme levels of stress. Amongst them, 50% suffered from depressive disorders, 44% had anxiety and 34% insomnia. Closer to home, two Italian nurses have committed suicide since the coronavirus outbreak forced the country into lockdown. Daniela Trezza, from the Lombardy region, was reported by colleagues to have suffered from acute stress due to the fear she infected many patients and staff after testing positive on March 10th.

Four doctors have tragically died in eastern France as a result of COVID-19, a figure which should act as a chilling reminder of the risk medical staff expose themselves to in order to care for those in need. Charles Guépratte, Director-General of the University Hospital Nice, puts it most simply. “We need to take care of our medical personnel, who are essential in this crisis.”

 

National Council fights for social plan

Last week Monaco’s Minister for Health and Social Affairs revealed that “several” cases of the novel coronavirus in the Principality are amongst medical staff. In a special government session, the National Council of Monaco and the Prince’s Government engaged in a heated debate over how to handle the health crisis. Stéphane Valeri, President of the Council, laid out a 30-point resolution plan containing key measures that they hope to implement.

It is telling of their current priorities that only two proposed points directly concern healthcare workers: to ensure they were provided with adequate PPE while treating patients and to have care given to their children. This is the base level of support required – it is hopeful to expect talk of bonuses and counselling just yet.

 

The fight continues

With the speed at which the virus spread through Europe and with the incoming wave of cases, quick response to patient welfare remains the priority. Yet, the current pace of governments’ implementation of support measures can be considered glacial. These grassroots displays of recognition must act as a sign of hope within the community during such uncertain times. In place of government-funded support, it is our responsibility to say it. Thank you. We support you.

 

If you are a medical professional in need of psychological support, these numbers below can provide support.

For workers at the AP-HP: 01 40 25 67 11  /  01 40 25 67 13  /  01 40 25 67 19

Soins aux Professionals en Santé: 0 805 23 23 36