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“We did not need to triage patients and select who accessed intensive care beds.” This was the official assessment of the Covid-19 first wave in France in June 2020. Is this certain?
Far from being an extraordinary feature of medicine in wealthy “Northern” countries like France or the UK, triage is an integral part of what means intervening and taking care of patients in many areas of medicine and public health.
What the trajectory of Covid-19 shows, with its highly visible controversies about shortages and health policies, is that clinical triage – the orientation/selection of patients – is rooted in more fundamental forms of systemic triage, operating on the basis of administrative, economical, and political criteria and tools. In the French context, neoliberal policies and the views of a technocracy uninterested in public health have shaped this systemic triage and deeply affected the trajectory of responses to the pandemic. What comparisons can be made with the UK?
What is decisive is therefore less to discuss whether triage happened or not than discussing and deciding upon the modalities and aims of triage in a collective and democratic way. Another triage is possible. Alternative experiences have existed and do exist. They provide for a renewed practise of social medicine mobilizing the creation of commons, community health and an emerging ecological triage. The Covid-19 pandemic thus opens a political window to rethink triage and our health policies and practices on a more social, democratic and ecological way.
The circulation of SARS-Cov2 is not simply a medical problem. It is also political, or better said, a mix, a critical event in what can be called pandemopolitics.