France turns high-speed trains into hospitals on wheels

The clinics on rails are moving patients from areas where hospitals are overwhelmed to areas with capacity to treat the sick

The high-speed train whooshing past historic First World War battle zones and through the chateau-speckled Loire Valley carried a delicate cargo: 20 critically ill Covid-19 patients and the machines helping keep them alive.

The TGV-turned-mobile-intensive-care-unit is only one piece of France's nationwide mobilisation of trains, helicopters, jets and even a warship to relieve congested hospitals and shuffle hundreds of patients and hundreds more medical personnel in and out of coronavirus hotspots.

“We are at war,” President Emmanuel Macron tells his compatriots, again and again, casting himself as a warrior and harnessing the might of the armed forces to fight this invisible foe.

But while the extraordinary mobilisation seems to be helping, critics charge the 42-year-old leader waited far too long to act in the first place. France, one of the world's wealthiest countries with one of the best healthcare systems, they say, should never have found itself so deep in crisis.

Medical staff take care of a patient infected with the coronavirus in a train at the Gare d'Austerlitz train station in Paris. Pool via AP, File

Medical staff transfer a patient infected with the coronavirus to a train at the Gare d'Austerlitz train station in Paris. Pool via AP

Medical staff carry a patient infected with the Covid-19 onboard a medicalized TGV high speed train at the railway station in Strasbourg. Pool via Reuters

Medical staff carry a patient infected with the Covid-19 onboard a medicalized TGV high speed train at the railway station in Strasbourg. Pool via Reuters

Medical staff carry a patient infected with the Covid-19 onboard a medicalized TGV high speed train at the railway station in Strasbourg. Pool via Reuters

Medical staff carry a patient infected with the Covid-19 onboard a medicalized TGV high speed train at the railway station in Strasbourg. Pool via Reuters

Medical staff carry a patient infected with the Covid-19 onboard a medicalized TGV high speed train at the railway station in Strasbourg. Pool via Reuters

Medical staff members gather before carrying patients infected with the novel coronavirus as they arrive at the Saint-Jean train station in Bordeaux, southwestern France. AFP

Medical staff members gather before carrying patients infected with the novel coronavirus as they arrive at the Saint-Jean train station in Bordeaux, southwestern France. AFP

Medical staff members gather before carrying patients infected with the novel coronavirus as they arrive at the Saint-Jean train station in Bordeaux, southwestern France. AFP

This aerial picture of the deserted Saint-Jean train station in Bordeaux, southwestern France. AFP

A French Police officer patrols inside an empty Gare de Lyon train station in Paris, France, 04 April 2020. EPA

Mr Macron had just emerged from weeks of damaging retirement strikes and a year of violent “yellow vest” protests over economic injustice when the pandemic hit. Now, he is struggling to keep the house running in one of the world’s hardest-hit countries.

The Rungis food market south of Paris, Europe’s biggest, is transforming into a morgue as France’s death count races past 8,000.

Nearly 7,000 patients are in intensive care, pushing French hospitals to their limit and beyond. Doctors are rationing painkillers and re-using masks.

France's centralised state and powerful presidency make it easier to co-ordinate the patient-moving efforts, which have crisscrossed the country and even extended to overseas territories. And nearly three weeks of confinement are starting to bear fruit: France reported its lowest number of deaths on Sunday in a week, and a slowing growth in infections.

But the pandemic has exposed weaknesses in the world-renowned state hospital system after decades of cost cuts. When the president visited a Paris hospital on the front lines of the virus battle, an angry neurologist challenged him to reinvest massively.

A nurse adjusts tiny face shield for a newborn baby to protect from new coronavirus at the newborn nursery of the hospital in Samutprakarn province, central Thailand. AP

Members of the medical staff hold palm tree branches at the emergency unit of the Molinette Hospital on Palm Sunday, during the coronavirus disease (COVID-19) outbreak, in Turin, Italy. REUTERS

A motorist rides through a disinfection tunnel during a government-imposed nationwide lockdown as a preventive measure against the COVID-19 coronavirus in Chennai. AFP

Employees of the Lantz funeral company, wearing face masks as protective measures, pull the coffin of a victim of the COVID-19 at an hospital in Mulhouse, eastern France. AFP

Christian devotees stand in circles marked on the ground to maintain social distancing as they hold palm branches to celebrate a Palm Sunday event at the Christian neighborhood during a government-imposed nationwide lockdown as a preventive measure against the COVID-19 coronavirus, in Islamabad. AFP

Afghan four-year old Ahmad Yosuf plays with a Spiderman toy in the yard of his house as kindergartens continue to be closed due to the fear of coronavirus outbreak in Kabul, Afghanistan. EPA

A woman wearing a protective mask holds a hydrangea at a greenhouse of the Saracino garden centre in Aprilia, Italy. EPA

A man walks his dog in front of the Eiffel Tower in Paris on the twentieth day of a lockdown in France aimed at curbing the spread of COVID-19. AFP

A man plays with a football on Eastgate Street in a near-deserted Chester city centre in north-West England as the warm weather tests the nationwide lockdown to combat the novel coronavirus pandemic. AFP

Municipal workers disinfect the streets of La Paz as a preventive measure to slow the spread of the novel coronavirus, COVID-19. AFP

Residents take part in a socializing hour in the courtyard of their apartment complex while keeping a social distance during the global outbreak of the coronavirus disease (COVID-19), in Pasadena, California, U.S. REUTERS

An aerial view shows less than usual passersby seen at a pedestrian crossing at Ginza shopping and amusement district after Tokyo Governor Yuriko Koike urged Tokyo residents to stay indoors in a bid to keep the coronavirus disease (COVID-19) from spreading, in Tokyo, Japan. REUTERS

The Ruby Princess, with only crew onboard, docks at Port Kembla, Wollongong, Australia. A criminal investigation will be launched into how cruise line operator Carnival Australia was allowed to disembark Ruby Princess passengers in Sydney, resulting in several deaths and COVID-19 outbreaks throughout the country. EPA

Employees of LG Twins broadcast their intra-team game played for fans at a empty Jamshil baseball stadium, as South Koreans take measures to protect themselves against the spread of coronavirus (COVID-19) in Seoul, South Korea. Getty Images

“When it was about saving Notre Dame, many were moved,” Dr Francois Salachas said, a reference to the Paris cathedral that was severely damaged by fire a year ago, prompting immediate, massive pledges of public and private funds for reconstruction. “This time it’s about saving public hospitals, which are going up in smoke at the same speed as Notre Dame almost did.”

Many think Mr Macron did not anticipate the severity with which the virus could hit and set a bad personal example. Similar criticisms have been levelled at other world leaders including the presidents of Mexico, Brazil and the United States.

In February, Mr Macron made a point of repeatedly kissing Italy’s premier on a visit to Naples to show there was nothing to fear. At the time, the virus was already spreading fast across France, but limited testing meant health authorities didn’t yet know.

In early March, he toured a retirement home even as he announced that families should no longer visit elderly relatives. That same day he went with his wife to a Paris theatre where the owner tweeted that the president wanted to show that “life goes on”. By then, the official virus infection numbers in France were doubling every two days.

In mid-March, as Covid-19 was ravaging neighbouring Italy, France went ahead with the first round of nationwide municipal elections. First lady Brigitte Macron strolled the banks of the Seine, crowded with Parisians enjoying a sunny day despite recommendations of social distancing.

Then, on March 16, Mr Macron abruptly changed his tune, declaring war on the virus and announcing nationwide confinement measures. A week later, he appeared wearing a face mask for the first time at a field hospital set up by troops outside Mulhouse, the eastern city that saw an eruption of cases stemming from a five-day evangelical gathering.

The armed forces took on a crucial role, as military and hospital authorities worked out the system to shuttle patients to less-strained hospitals and medics to virus zones in need.

The first "medicalised" TGV made its inaugural trip on March 26. Doctors in protective gear pushed gurneys along the nearly empty platform of the train station in the eastern city of Strasbourg as safety warnings echoed from loudspeakers. Inside the double-decker cars, patients and webs of tubes and wires were squeezed past luggage racks and rows of seats. Once they were secured, the train sped off towards less-affected hospitals in the west.

While the militarised mobilisations are popular, public debate has mushroomed over the relatively low numbers of people being tested for the virus in France and shortages of medical equipment. Mr Macron ordered all face masks requisitioned for medical personnel after it became evident France entered the crisis well short of the necessary supply.

"The question of masks is now the priority question for the French," said Jean-Daniel Levy of polling agency Harris Interactive. He said the public feels the government "didn't take enough responsibility" for masks at the outset.

France has had to send some patients for treatment to tiny neighbouring Luxembourg, as well as Switzerland and Germany, which has conducted massive nationwide testing and confirmed more cases than France while recording a death toll about one-fifth as high so far.

Mr Macron, a centrist, has taken fire from both ends of the political spectrum.

Far-right leader Marine Le Pen told France 2 television that “the government lied about the preparedness of the country”, while far-left leader Jean-Luc Melenchon said Mr Macron, a former investment banker, “used to think that the free market would meet the country’s needs, so his mental framework collapsed”.

Among the broader public, Mr Macron “is seen as relatively authoritarian”, Mr Levy said. That hurt him during the protest movements, but helps his popularity now because “we want to have a strong authority figure” to manage the crisis.

In the National Assembly, the lower house of parliament, a fact-finding mission is scrutinising the government's handling of the emergency.

Mr Macron said while visiting a mask manufacturing company that it’s not yet time to focus on what went wrong.

“When we’re fighting a battle, we must all be united to win it,” the president said. “And I think those who seek to send people to trial when we have not yet won the war are irresponsible.”