Diabetes Doc Who Turned His Unit to COVID-19 Sees End in Sight

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APRIL 28, 2020 -- Endocrinology units turned entirely over to patients with COVID-19 when the pandemic struck the French capital could start returning to routine care soon, says one expert from the front line.

Jean-François Gautier, MD, PhD, is professor of medicine and head of diabetes and endocrinology at Lariboisière Hospital, in Paris, France.

Gautier transformed his unit into an inpatient unit dedicated to patients infected with the virus when it struck hard in Paris in March.

Medscape Medical News caught up with him to discover how he made the transformation, what impact this had on his staff and regular patients, and when he envisages going back to routine care.

Why did you transform your department?

The reasons are very simple. The first is that we decided to be involved, as diabetologists, in the care of patients with COVID-19. Everyone involved with my department agreed.

The second reason, which is the most important, is that we share our building with the intensive care unit, the infectious disease department, and internal medicine.

So, in 3 days, when the surge happened, we totally repurposed the department, switching from routine diabetes and other endocrinology patients to noncritical patients with COVID-19.

It was very, very rapid, and all our nurses and physicians had to be trained by the infectious disease and intensive care staff.

How did that affect the team?

It was very stressful for everybody even if we, in our department, are accustomed to taking care of very complex diabetes patients with a lot of comorbidities.

We are trained to take care of heart failure, kidney disease, and infectious disease in patients with diabetes, but it was totally different to monitor oxygen saturation and respiratory frequency, and it was difficult for us.

What did you do with your regular patients?

When the epidemic arrived in Paris, all specialties stopped routine care and they only took care of the emergencies related to their specialty.

We had to disseminate them to other units in other buildings of the hospital, most of them to rheumatology and also to neurology.

Continued

We were able to keep 60 beds for non-COVID-19 medical patients for all specialties — diabetes, rheumatology, neurology, etc — and we kept 60 beds for surgery.

The capacity of our hospital is 800 inpatient beds, and with our building totally dedicated to patients with COVID-19, we were able to take care of 125 noncritical patients.

In the intensive care unit, we increased the number of beds from 15 to 18, but of course it was not enough.

So we stopped all routine surgery and transformed the recovery rooms to intensive care units for patients with COVID-19, and the number of intensive care beds increased to 66.

Medscape Medical News
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