Sick in number, time-consuming management of contact cases and the arrival of winter pathologies: the second wave of the Covid-19 epidemic is weighing heavily on the daily life of general practitioners who work in tense flow.

Already at the beginning of September, Michaël Rochoy, general practitioner in Outreau (Pas-de-Calais) recorded an increase in his activity of 30% compared to the previous year. And “for 2 weeks”, he has been facing “a marked acceleration in the number of positive cases and contact cases”.

“The figures which parade from day to day are essentially centered on hospital medicine, the point of the pyramid”, regrets Jean-Paul Ortiz, number one of the Confederation of French medical unions (CSMF). “But liberal doctors have seen tens and tens of thousands of suspected Covid patients in their offices,” he stressed on Tuesday during a press video conference, saying he was “worried about the turn of events”.

To the increasingly numerous Covid-19 patients is added the management of contact cases: “currently, this is what takes me the most time”, notes Michaël Rochoy. “I can have up to 5 to 10 calls from people asking me + I have been contacted, what should I do? +”.

Online sick leave issue, prescriptions, instructions … the acts follow one another. To which are added the special Covid medical databases to be completed, in particular for doctors who carry out antigenic tests. “It is an administrative time which is enormous. Honestly, it doubles the time of consultation”, judges Margot Bayart, general practitioner in a health center in the rural commune of Réalmont, in the Tarn.

However, this time, the wave of contaminations is added to winter pathologies, with their share of gastroenteritis and soon flu. Without forgetting the chronic patients. With an imperative: “do not miss pyelonephritis, urinary tract infections that go wrong, meningitis, suicide attempts …”, which would clog hospitals even more if they were not taken in time, explains Margot Bayart.

The impact of the drop in patient care during the first wave turned out to be significant, prompting health organizations to regularly remind people that the epidemic situation should not prevent people from getting treatment or going to see their doctor.

– “potentially all Covid” –

“The whole difficulty is to manage the potential Covid among these pathologies”, adds Margot Bayart, also vice-president of the union of general practitioners MG France. “We must share flows as much as possible”, while keeping in mind that the patients “are potentially all Covid”.

If the majority of them follow the recommendations and warn or tele-consult if they have symptoms, there are always asymptomatic and those who, during a routine consultation … indicate that they are coughing.

And doctors also find themselves again facing a catastrophic situation in some nursing homes where “things are blazing”, worries Jean-Paul Ortiz. “I have two nursing homes who are in major pain,” warns Margot Bayart. A finding shared by the regional health agency (ARS) of Occitanie for whom the situation in these establishments is “extremely critical”.

“We are even saying to ourselves that we are going to redo the night on-call duty”, notes Margot Bayart.

To manage all this, some doctors continue in the evening with meetings, exchange on the networks. The union of general practitioners MG France has denounced for several months the lack of strategy in the face of the Covid-19 epidemic and called for a framework and specific recommendations. This week, the High Authority of Health (HAS) published two articles for them, “the beginning of an answer” for MG France.

Without forgetting that the health crisis “is grafted on a shortage of doctors, a medical demography at half mast”, adds Michaël Rochoy.

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