A coup de bamboo for a health system already on the brink of collapse? The ax falls tomorrow. From Wednesday, no caregiver, staff employed by a hospital, clinic, nursing home, will be able to come to work without providing proof that they have received at least one dose of an anti-Covid-19 vaccine. Concretely, he will see his contract and his remuneration suspended (but cannot be dismissed). Except for caregivers infected for less than three months or who have a medical contraindication.
An obligation to vaccinate which risks tense up even more caregivers already mistreated by months of fighting against the coronavirus. For weeks, health establishments and nursing homes have been organizing themselves to prevent this deadline from rhyme with contract suspensions, and therefore difficulties in providing care.
High numbers of vaccinated
If some take the floor or beat the pavement to express their opposition, their frustration, their decision to quit their job in order to avoid the vaccination box, in reality, the directors of hospitals and nursing homes do not fear a hemorrhage. According to Public Health France, on September 7, 83.9% of health professionals were fully vaccinated in nursing homes or USLDs, 84.1% of nursing staff employed in health establishments, and 91.1% of liberal professionals. According to Martin Hirsch, director of Assistance Publique-Hôpitaux de Paris (AP-HP), interviewed on France Info Monday morning, more than 95% of the staff of the 39 hospitals in the Paris region have already been vaccinated.
In Marseille, yet known for its low vaccination coverage, the time is not for generalized panic either. “Between 87 and 90% of the personnel are vaccinated, assures us Pierre Pinzelli, general secretary of the Public Assistance – Hospitals of Marseille (AP-HM). And this number keeps increasing. He regrets that some focus on the few nursing staff who oppose vaccination head-on. “We are not talking about the vast majority who had been vaccinated before the obligation and who continued. “
Additional meetings on the 13th and 14th
Nevertheless, the AP-HM has anticipated to prevent the 15th in the morning, it becoming impossible to manage the schedules. She offered to those who wish it individual interviews, interviews with a virologist, face-to-face meetings or web conferences to better explain that vaccination protects the caregiver, his entourage, his patients. And that the hospital is obliged to verify that all its employees have complied with the law, under penalty of fines. It is indeed up to the employer to provide proof that his employees are vaccinated. And it will then be up to the Regional Health Agency to organize checks. “I wrote to 2,700 staff for whom we had no precise information on their vaccination, to avoid ending up with contract suspensions”, continues Pierre Pinzelli.
In addition, the AP-HM offers all its staff to be vaccinated without an appointment. “We reinforced the vaccination lines with additional capacities and extended schedules on September 13 and 14, because some told us that they would do it as late as possible,” continues Pierre Pinzelli. No one will be able to say that he was not vaccinated because he could not! “
“Even if there are few suspensions, it will always be too much”
But there are still questions. “Even if there are few suspensions, it will always be too much,” he admits. We have identified around ten hospital services (out of 240) for which we are working specifically to ensure continued care. “In particular by hiring reinforcements or by reorganizing the services to ensure the operations planned or in emergency … Even if it means offering fewer consultations. “It’s lace and it changes constantly, blows Pierre Pinzelli. And things will continue to move after the 15th. ”Because any caregiver who is finally vaccinated will be able to return to his post.
The other risk is that some caregivers, having anticipated the vaccination obligation, have requested availability or resigned. Martin Hirsch acknowledged on France Info that “a few people, caregivers and non-carers, have presented their resignation to me”. And that this return to school is already marked by a lack of nurses. As for the AP-HM, “there is no significant movement of departures, we are on the usual averages, reassures Pierre Pinzelli. On the other hand, for sick leaves, we are on a high rate, but this has been the case since the start of the epidemic. “
More concerns on the side of nursing homes
If on the side of hospitals, the risks therefore seem rather controlled, concern points to the side of dependence. A sector where the understaffing is chronic is known… “There will remain perhaps 5 to 10% of unvaccinated, among which nurses and nursing assistants, whom we have difficulty in recruiting, regrets Pascal Champvert, president of the Association of Directors at the service of the Elderly (AD-PA). And in addition, nurses are mobilized in vaccination centers because the remuneration is better. “
For him, there is no doubt that some establishments will have a hard time even with only one or two employees less. “The state must tell us what it plans for these establishments.”
“There are disparities, some establishments reach 100% of vaccinated while others peak at 80%, confirms Florence Arnaiz-Maumé, general delegate of the National Union of Establishments & Private Residences and Home Help Services for the Elderly ( Synerpa). There will be HR tensions in certain places ”. The Union also fears a rebound in sick leaves. “The increase in sick leaves, we can see it on the ground,” she continues. Some caregivers invoke the vaccine directly. But sick leave of convenience remains extremely rare! “
For her, the difficulties should remain limited … At least in metropolitan France. “When we are at 2% of staff missing, it’s boring, but not until reviewing the rule [de l’obligation vaccinale]. On the other hand, we are considering asking for an exemption for Martinique and Guadeloupe. We are below 50%. There, the quality of service can be called into question. Olivier Véran had also, at the end of August, granted flexibility for overseas caregivers, ensuring that the vaccination obligation would take effect when the health situation improved in these territories. But that it would be maintained.