A National Healthcare Response to Intensive Care Bed Requirements during the COVID-19 Outbreak in France.

Abstract Background Whereas 5,415 Intensive Care Unit (ICU) beds were initially available, 7,148 COVID-19 patients were hospitalised in the ICU at the peak of the outbreak. The present study reports how the French Health Care system created temporary ICU beds to avoid being overwhelmed. Methods All French ICUs were contacted for answering a questionnaire focusing on the available beds and health care providers before and during the outbreak. Results From 336 institutions with ICUs before the outbreak, 315 (94%) participated, covering 5,054/5,531 (91%) ICU beds. During the outbreak, 4,806 new ICU beds (+95% increase) were created from Acute Care Unit (ACU, 2,283), Post Anaesthetic Care Unit and Operating Theatre (PACU & OT, 1,522), other units (374) or real build-up of new ICU beds (627), respectively. At the peak of the outbreak, 9,860, 1,982 and 3,089 ICU, ACU and PACU beds were made available. Before the outbreak, 3,548 physicians (2,224 critical care anaesthesiologists, 898 intensivists and 275 from other specialties, 151 paediatrics), 1,785 residents, 11,023 nurses and 6,763 nursing auxiliaries worked in established ICUs. During the outbreak, 2,524 physicians, 715 residents, 7,722 nurses and 3,043 nursing auxiliaries supplemented the usual staff in all ICUs. A total number of 3,212 new ventilators were added to the 5,997 initially available in ICU. Conclusion During the COVID-19 outbreak, the French Health Care system created 4,806 ICU beds (+ 95% increase from baseline), essentially by transforming beds from ACUs and PACUs. Collaboration between intensivists, critical care anaesthesiologists, emergency physicians as well as the mobilisation of nursing staff were primordial in this context.