“We are looking for volunteer emergency doctors to help us during the Games”

Dr Pierre Mauger

Paris, France – Less than two months before the opening of the Olympic Games in the capital, we interviewed Paris 2024 Dr Pierre Mauger, head of medical services for the Paris 2024 Olympic Games, on the medical preparation for the event. This trained emergency doctor presents to us the polyclinic specially dedicated to the Olympic Games which will be installed in Saint-Denis, launches an appeal to recruit volunteer health professionals for the competition sites, and especially emergency doctors, and discusses the solutions envisaged to cope the unexpected (epidemic wave, heatwave, attacks).

Medscape France: How do you become responsible for the medical services of the Olympic Games?

Dr Pierre Mauger: I am an emergency doctor, with 20 years of Samu experience (in Yvelines, Eure and Seine-et-Marne). I also have the hat of a sports doctor, having worked for around ten years for two professional clubs (the rugby players of Stade Français and the handball players of Paris 92-Les Lionnes d’Issy). I have a great interest in the medical organization of sporting events. I was responsible for medical coordination for Euro 2016 in France. Quite naturally, when the games were awarded to Paris and the organizing committee was looking for a head of medical services, I applied and I was accepted.

The Olympic polyclinic, which will be installed in Saint-Denis, will be open to all athletes and will accommodate 700 patients per day.

You took office in November 2020. What did you do during these three and a half years to prepare for the event?

Dr. Mauger: There is a lot of strategic preparation work which is long with a few key points. One of the specificities of the Games is to have a health center in the very heart of the Olympic village. This Olympic polyclinic, which will be installed in Saint-Denis, will be open to all athletes and will accommodate 700 patients per day. There will be a pharmacy, an imaging department, two medical departments, and a physiotherapist service. This polyclinic took a very long time to set up. Tony Estanguet (president of the organizing committee for the Paris 2024 Olympic and Paralympic Games, Editor’s note) usually says that the Olympics are “five world championships in the same place”. The first year of my exercise was almost focused on the legal status of the polyclinic and who to support to carry it out.

The last two years have been devoted to the operational set-up, the writing of all procedures, calls for tenders on all equipment, the recruitment of service providers and volunteers, as well as their training, to be ready to deliver in time. We arrive at the Olympic Games and almost 4 years have passed!

Was this polyclinic the most important subject?

Dr. Mauger: Yes, because it was the one that took the most time. The polyclinic required the signing of a cooperation agreement with the AP-HP and 18 months of work to get there because officially, it is the AP-HP which is opening an additional site.

A legislative modification and exemptions were required to meet the specifications of the International Olympic Committee (IOC). To open this polyclinic, we had to be able to rely on a pharmacy for indoor use (PUI), that is to say a hospital pharmacy, which a health center is not authorized to have. We obtained the provision of an existing 6-storey building which met the prerogatives to become a health center. This is a training institute in physiotherapy, osteopathy and podiatry care which already has consultation boxes – which will be made available on 1^er June after the end of classes. On this date, three weeks of work will begin after a first phase of one month of work in the summer of 2023. We will then move in.

In addition to the polyclinic, there will be medical stations for spectators at the 39 competition venues.

How many healthcare professionals will participate in medical services during the Olympics?

Dr. Mauger: Nearly 3,000 health professionals, all volunteers, will be deployed during the Olympics! In terms of first aiders, around 8,000 first aiders will be mobilized for Paris 2024. Other first aiders will also be mobilized for fan zones organized by municipalities, and for all events organized by the State. In addition to the polyclinic, there will be medical stations for spectators at the 39 competition sites (in Paris, Lille for handball, Marseille for football or Châteauroux for sports shooting, etc.). Each of these cities will offer a range of care consisting of an emergency doctor, a physiotherapist and an osteopath. On the sports site itself, there will be a sports doctor and an emergency doctor. In each of these cities, we recruited a sports doctor based locally and who already has his network of dentists, radios, labs, MRIs, etc. If athletes need simple care, they can go through this practitioner. If they need more acute care, they will be referred to the area hospital.

We are especially short of emergency doctors. About 200 emergency doctor days would be needed.

You relayed a message on LinkedIn indicating that you were still looking for volunteer doctors during the Olympics, particularly emergency doctors. How many are needed to ensure the event?

Dr. Mauger: There are specialties where there is no tension. We have just the necessary number of sports doctors but we do not have enough margins. We have enough nurses, just enough hospital pharmacists. There is also a bit of a shortage of radio technicians, but we are especially short of emergency doctors. If the volunteer emergency doctors all give ten days, it would take around twenty. If they can only spare 2 days, it would take a hundred. Around 200 days of emergency doctors would be needed. We also ask that they be able to offer at least 3 days between July 24 and September 10. If doctors, who know their on-call list for the summer, can offer to participate in the medical service for a few days during the games and want to participate in the celebration, let them come forward. We asked the State to help us communicate with establishments that have already established their on-call lists so that they can tell their emergency doctors to volunteer by writing to us at [email protected].

The Olympics have undertaken not to pay emergency doctors so as not to be more attractive than public hospitals and to strip them of their clothes.

All healthcare professionals will volunteer during the Olympics. So you don’t have the budget to recruit professionals who might be lacking?

Dr. Mauger: We don’t have a budget at the moment to plug the holes, it’s clearly a risk. But the problem is not only a question of budget, it is a question of general shortage. In France, emergency doctors are a fairly critical resource and we must share it both to keep hospitals and Smur running but also to manage the Olympic Games. The Olympics have undertaken not to pay emergency doctors so as not to be more attractive than public hospitals and to strip them of their clothes. There are arrangements, organizations, pooling to be found.

Nearly 3,000 health professionals, all volunteers, will be deployed during the Olympics! And around 8,000 rescuers will be mobilized.

What will happen if you are unable to recruit the missing staff? Could you call on foreign volunteer doctors?

Dr. Mauger: French law is not very favorable to us in authorizing foreign doctors to practice in the territory. Among the regulatory changes, we opened the polyclinic to foreign doctors. Some are arriving but this legislative change does not apply to competition venues. If a foreign practitioner wanted to come to France, he would have to go through all the stages of validating his diploma at the Order level and we are no longer in time to do this. We fell behind on this program because we let the hospitals draw up their on-call list to be sure that they had their numbers for the summer and only then did we attack the distribution of volunteers.

Can students come as reinforcements?

Dr Pierre Mauger: Normally, we cannot call on them but we are currently negotiating with the Ministry of Health to ask that junior doctors and interns with replacement licenses can participate in the system.

Do you have any idea of ​​the medical activity generated by the Olympics?

Dr Pierre Mauger: The Olympics will welcome 10,500 athletes, including 8,000 in the Olympic village of Saint-Denis. This represents 700 patients per day.

Do you have a budget for financing medical services?

Dr Pierre Mauger: Yes, we have our own budget for the entire Paris 2024 healthcare offering (the polyclinic and all medical sites) of around twenty million euros.

The SNMB deplored the absence of epidemiological monitoring to assess the evolution of the dengue epidemic. There is no longer Sidep to monitor Covid. How are you preparing to follow a possible epidemic wave during the Games and with whom?

Dr. Mauger: We are having numerous discussions with the ARS of Ile-de-France and the Operational Center for Regulation and Response to Health and Social Emergencies (CORRUSS) on this subject. We will operate a bit like an emergency service. At the entrance to the polyclinic, a triage doctor will welcome and guide the athletes. If one of them is injured, they can be treated in specialized consultation services (in sports medicine, cardio, gynecology, psychology, etc.). If the athlete is sick, the polyclinic will welcome him in a small unscheduled care service. Patients who have a cough or fever can be isolated and carry out a PCR test. It is obvious that we will do everything to prevent there being clusters in the Olympic village. Concerning dengue fever, an audit in terms of vector control will be carried out at the beginning of June to try to have as few larvae as possible around the village.

Are you ready to face a climate catastrophe?

Dr Pierre Mauger: We have a plan for extreme weather. We of course have a storm contingency plan – Météofrance can warn us in a fairly short window (one hour) about the level of violence of the arriving storm. We are afraid of storms because many structures are ephemeral, under tents. A thunderstorm can be meaner than a heat wave. We also have a specific action plan to deal with an episode of high heat with a progressive plan (from messages to the public inviting them to hydrate to the implementation of misting and the distribution of water ). Statistically, we will have to face thunderstorms and a heat peak.

Is a specific medical device planned for the opening ceremony which should take place on the Seine?

Dr Pierre Mauger: Yes of course. We asked each delegation to give one of their accreditations to a doctor to accompany them on their boat. We have a nautical system with rescuers and a few doctors. We will have one or two boats from the BSPP (Paris fire brigade) and perhaps a boat equipped by a Samu doctor. We will also have a dozen rescue boats. On the lower platforms, we will also have our own devices; the State manages its systems on the high quays. And we will have a command center which will coordinate the two devices.

What is planned in the event of an attack?

Dr Pierre Mauger: We have the hand to manage care and can have the support of the State. Terrorism is directly within the jurisdiction of the State. In this case, the terrorist threat must first be eliminated before the intervention of caregivers.

Register for Medscape newsletters : select your choices