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Journal LE MONDE Du Mercredi 29 Avril 2020 MERCREDI 29 AVRIL 2020 76E ANNÉE– NO 23422 2,80 € – FRANCE MÉTROPOLITAINE WWW.LEMONDE.FR – FONDATEUR : HUBERT BEUVE-MÉRY DIRECTEUR : JÉRÔME FENOGLIO SCIENCE & MÉDECINE SPÉCIAL 4 PAGES ESPOIRS DANS LA LUTTE CONTRE « LES TEMPÊTES IMMUNITAIRES » ; LE COVID­19, MALADIE MULTICIBLE EMPLOI : BRUTAL COUP D’ARRÊT EN FRANCE ▶ L’interruption de l’acti­ ▶ Selon le ministère du ▶ La fin des missions d’in­ ▶ Le gouvernement veut ▶ La construction, le vité économique provo­ travail, le nombre de de­ térim et le non­renouvel­ lancer une réflexion avec tourisme, le spectacle sont quée par l’épidémie mandeurs d’emploi sans lement de contrats courts les partenaires sociaux particulièrement touchés. de Covid­19 n’a pas tardé activité a bondi, en mars, ont nourri les entrées à pour adapter les règles Les intermittents réclament à se traduire dans les de 7,1 % sur l’ensemble du Pôle emploi. Les sorties d’indemnisation dans une « année blanche » statistiques du chômage territoire (hors Mayotte) par embauche se raréfient cette situation de crise PAGES 10 ET 30 Enquête ÉCOLES En Europe, les écoles rou­ L’OMS et la Chine, vrent en ordre dispersé. La reprise par étapes se les liaisons heurte à des réticences. En France, les directeurs dangereuses AVEC LES d’école sont perplexes L’Organisation mondiale PAGES 6-7 ET 14 de la santé sort très affaiblie de la crise STOPCOVID sanitaire, en raison En deux mois, l’idée d’une de sa forte proximité INVISIBLES DE LA application de traçage a avec le régime chinois. progressé de manière ful­ Premier volet de nos en­ gurante. Sur fond de con­ quêtes : « Covid­19, la dé­ troverse, la France étudie flagration géopolitique » désormais son déploie­ HORIZONS — PAGES 24-25 ment contre la pandémie PITIÉ­SALPÊTRIÈRE PAGES 12-13 Economie SOIGNANTS PAR SYLVAIN TESSON A l’hôpital Beaujon Les banques de Clichy, les équipes accusent le coup après centrales en un mois « dans le dur » ▶ ▶ Qui applaudit­on ? ▶ A la Pitié, chacun L’écrivain a aus­ PAGES 2-3 ultime rempart culté « les petites Le réanimateur, qui confirme que l’ingé­ mains » de l’hôpital ramène à la vie, ou niosité des person­ TERRITOIRES La Banque du Japon, ces rouages modes­ nels a vite permis de parisien, ces 10 000 Peu peuplés, isolés, la Banque centrale euro­ tes qui soutiennent remédier à l’impré­ péenne comme la Fed employés de l’AP­HP, le Cantal et la Lozère ont américaine multiplient aux métiers parfois la lourde machine paration politique su anticiper l’épidémie les programmes insoupçonnés hospitalière ? PAGES 22-23 de Covid­19. Et rêvent de soutien dans des de règles de sortie proportions gigantesques de crise « sur mesure » PAGES 16-17 PAGE 4 Chine Disparitions Social Hôpitaux Le très redouté Robert Herbin, HLM et bailleurs journal du le flamboyant privés face « Nous, les confinement entraîneur de aux loyers urgentistes, ne de Mme Fang Fang l’AS Saint­Etienne impayés subirons plus » PAGE 8 PAGE 21 PAGE 15 Philippe Juvin, chef des urgences de l’hôpital LE REGARD DE PLANTU Georges­Pompidou à Pa­ ris, et Mathias Wargon, chef de celles du centre hospitalier de Saint­ Denis, jugent que la crise « doit servir de socle pour refonder les hôpitaux ». Nous devons « inscrire dans la loi les moyens accordés aux urgences » IDÉES — PAGE 32 1 ÉDITORIAL GARE À UNE RELANCE ÉCONOMIQUE GRISE Enventechezvotremarchanddejournaux PAGE 35 Algérie 220 DA, Allemagne 3,70 €, Andorre 3,50 €, Autriche 3,80 €, Belgique 3,10 €, Cameroun 2 400 F CFA, Canada 5,70 $ Can, Chypre 3,20 €, Côte d'Ivoire 2 400 F CFA, Danemark 36 KRD, Espagne 3,50 €, Gabon 2 400 F CFA, Grande-Bretagne 3,10 £, Grèce 3,50 €, Guadeloupe-Martinique 3,20 €, Guyane 3,50 €, Hongrie 1 330 HUF, Irlande 3,50 €, Italie 3,50 €, Liban 6 500 LBP, Luxembourg 3,20 €, Malte 3,20 €, Maroc 22 DH, Pays-Bas 3,80 €, Portugal cont. 3,50 €, La Réunion 3,20 €, Sénégal 2 400 F CFA, Suisse 4,40 CHF, TOM Avion 500 XPF, Tunisie 4,10 DT, Afrique CFA autres 2 400 F CFA 0123 2 | CORONAVIRUS MERCREDI 29 AVRIL 2020 A l’hôpital Beaujon, « on est dans un cessez­ le­feu provisoire » Au sein de l’établissement de Clichy, dans les Hauts­de­Seine, les soignants accusent le coup après un mois « dans le dur ». Malgré la fatigue, ils se préparent à rester mobilisés sur la durée onze étages du bâtiment. Résultat : les REPORTAGE capacités de réanimation ont doublé, ans le couloir du service de passant de 30 à 62 lits au plus fort de la réanimation de l’hôpital crise, et permettant d’accueillir, depuis Beaujon, à Clichy (Hauts­de­ la mise en branle du dispositif, 110 pa­ Seine), la bâche de plastique tients atteints du Covid en « réa ». Près Dqui marquait l’entrée provisoire d’une de 400 l’ont été hors « réa ». des quatre unités pour patients Covid a Après un mois « dans le dur », les équi­ été déposée au sol. Dans les chambres, pes commencent à accuser le coup. « Les des techniciennes effectuent des prélè­ semaines sont lourdes, les collègues sont vements pour s’assurer que l’air n’est fatiguées et inquiètes », témoigne Céline pas contaminé. D’ici quelques heures, Bois, 44 ans, infirmière aux explorations cinq lits seront de nouveau disponibles cardiaques, venue en renfort dès le début pour des patients non atteints du Covid. de la crise. Plusieurs infirmières font état « On a fait tomber les bâches, mais ce n’est d’une fatigue physique liée notamment pas exclu qu’on soit amenés à les remettre au fait que la majorité de patients placés en place, prévient Catherine Paugam, la sous respirateur sont obèses. Avant que chef du service anesthésie­réanimation. des « brigades de retournement » ne On n’a pas prévu de se reprendre une soient créées, elles racontent avoir par­ énorme vague d’ici le 20 mai, mais au­ fois dû se mettre à cinq ou six pour pou­ delà, qui sait ? Si le scénario n’est pas le voir mettre ces patients sur le ventre. à poser des cathéters… Personne n’était nimation étaient toujours occupés, soit bon, on repartira », lance­t­elle. dans sa zone de confort. » « LES ÉQUIPES vingt de plus que la capacité normale En ce mercredi 22 avril, les admissions UNE « RÉVOLUTION INTERNE » Pour répondre à la crise, l’hôpital a mul­ SONT SOULAGÉES – un chiffre descendu à 46 lits au 27 avril. en réanimation sont en diminution ré­ Dans le bureau des cadres de santé, des tiplié les dispositifs innovants. Des « ges­ « Le reflux est temporaire, on est dans un gulière depuis une dizaine de jours dans cartons de masques sont empilés sur les tionnaires de lits » ont été mis en place QUE ÇA SOIT PASSÉ. cessez­le­feu provisoire, on va fonction­ toute l’Ile­de­France. A Beaujon, établis­ chaises. « Cela fait trente­cinq ans que je pour assurer le flux des malades. Des so­ ner en mode dégradé pendant plu­ sement de l’Assistance publique­Hôpi­ suis à l’hôpital, j’ai vécu le VIH, le H1N1, le lutions de téléconsultation ou de visites ELLES ONT TORT » sieurs semaines ou plusieurs mois », sou­ taux de Paris (AP­HP), la pression re­ SRAS, je n’ai jamais vécu ça. J’espère qu’on virtuelles à domicile ont été dévelop­ OLIVIER CORCO ligne Olivier Corcos. tombe un peu. L’heure est à la « décovidi­ ne le revivra pas, parce que c’était difficile, pées. Dès le début de la crise, « les barriè­ directeur médical de crise Au troisième étage, les 56 lits du service sation » d’une partie des lits, quitte à faire raconte une cadre du service. Il y a eu une res financières ont sauté. On nous a dit : d’orthopédie s’apprêtent eux aussi à être machine arrière si nécessaire. Il s’agit de journée avec sept entrants et sept sor­ “Ce sera oui à tout” », reconnaît le direc­ en partie « décovidisés » pour permettre mettre à profit l’accalmie pour renouer tants. Ça n’arrive jamais. Lors des trans­ teur médical de crise. teints du Covid des autres. Sur une porte, un redémarrage progressif de l’activité. avec les patients non atteints du Covid ferts vers la province, on avait à peine le Pour Sonja Curac, la chef du service des un panneau précise : « déchoc propre », « On a une fenêtre d’accalmie devant nous, qui ont déserté l’hôpital soit en raison temps de nettoyer la chambre que le urgences, c’est une « révolution interne » c’est­à­dire ne présentant pas de risque qui nous permet de réamorcer les circuits en des déprogrammations décidées un SAMU arrivait avec un nouveau patient. » qui a eu lieu, tant des synergies et des dé­ de contamination au coronavirus. Entre sommeil et de rassembler les équipes. On a mois plus tôt, soit par crainte d’être con­ « A aucun moment on ne s’est retrouvé cloisonnements auparavant inimagina­ vingt et trente personnes viennent se annulé 243 malades, si on peut en passer taminés en se déplaçant. Le hall d’entrée avec rien entre le précipice et nous, on a bles ont été possibles. « On n’a pratique­ faire tester chaque jour dans le centre de quelques­uns, ce sera déjà ça », estime de l’hôpital est désert. Sur les portes, des toujours eu en tête le coup d’après », as­ ment pas senti les journées avec beaucoup dépistage attenant. Marc­Antoine Rousseau, le chef du service. affichettes rappellent que les visites sont sure un responsable de la cellule de crise. de passages, parce que tout l’hôpital rou­ Les pathologies rencontrées habituelle­ Le chirurgien reconnaît toutefois que les suspendues jusqu’à nouvel ordre.
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