53

At the start of the COVID-19 pandemic, NephroCare operated 40 dialysis units in 7 regions across France, with a total of 2,740 patients on hemodialysis. The national COVID-19 crisis team acted early to implement the necessary measures to ensure the safety of dialysis patients and caregivers in the context of the pandemic. While most of these measures were conventional, some were specific to our organization. They were modified during the three successive waves of the pandemic. The first wave mainly impacted NephroCare Ile-de-France, which recorded an infection rate of 75%, with an impact on the dialysis parameters of non-COVID patients that was not observed during the second wave due to reduced strain (34% infection rate), and better management of COVID-positive patients. The effectiveness of the measures put in place is suggested by the absence of positive PCR tests in asymptomatic patients, and the complete match of anti-SARS-CoV-2 antibodies with COVID diagnosis in one severely impacted Ile-de-France unit, compared to the significant rates of positive PCR tests or serology in asymptomatic patients reported in the literature. The infection rate was also below the national rate reported by the French Biomedicine Agency. The third wave was characterized by the introduction of the SARS-CoV-2 vaccination, with a proportion of vaccinated patients comparable to that in the national data, and a decrease in COVID cases at the end of the third wave, while the national incidence remained stable over this period. In conclusion, this experience of a situation of unprecedented gravity demonstrated the responsiveness of the organization, major innovations, and the efficacy of the implemented measures.