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In the final 2 months before the event, Medscape Medical News's French edition spoke with the head of medical services at the Paris 2024 Olympics to get a gauge of the event's preparations. Pierre Mauger, an emergency physician by training, provided an overview of the Olympic polyclinic, which will be set up in Saint-Denis, France. He also discussed an appeal for volunteer health professionals as well as plans to handle unexpected events, such as an epidemic, heatwave, or terrorist attack.

How did you become head of medical services for the Olympics?

I am an emergency physician with 20 years of experience with Service d'Aide Médicale Urgente (SAMU: The umbrella organization that provides emergency medical services in France). I also have experience as a sports doctor, having worked for 10 years with two professional clubs: The Stade Français rugby team and the Paris 92 women's handball team. I have a strong interest in the medical organization of sporting events. I was in charge of the medical coordination for the UEFA European Football Championship in 2016 in France. When the games were awarded to Paris and the organizing committee was looking for a head of medical services, I applied and was selected.

You took up your position for the Olympics in November 2020. What have you done in these 3.5 years to prepare for the event?

There is a long strategic preparation process with several key points. One of the specifics of the Games is having a health center at the heart of the Olympic Village. This polyclinic in Saint-Denis will be open to all athletes and can accommodate 700 patients a day. It will include a pharmacy, an imaging department, two medical departments, and a physiotherapy service. Setting up this polyclinic took a long time. Tony Estanguet (the president of the Paris 2024 Olympic and Paralympic Games Organizing Committee) often says that the Olympics are "five world championships in one place." The first year of my term was almost entirely focused on the legal status of the polyclinic and finding the right support to set it up.

The past 2 years were dedicated to operational implementation, writing all the procedures, issuing calls for tenders for all the equipment, recruiting providers and volunteers, and then training them to be ready on time. We are now approaching the Olympics, and nearly 4 years have passed!

Was the polyclinic the most important part of the setup?

Yes, because it required the most time. The polyclinic necessitated a cooperation agreement with Greater Paris University Hospitals (AP-HP), Paris, France, and 18 months of work to achieve it because, officially, it is AP-HP that is opening an additional site with this polyclinic.

A legislative amendment and exemptions were needed to meet the International Olympic Committee's specifications. To open the polyclinic, we had to rely on a central hospital pharmacy, which a health center is not authorized to have. We obtained an existing six-story building that met the requirements to become a health center. This building is a training institute for physiotherapy, osteopathy, and podiatry and already has consultation rooms that will be available from June 1 after classes end. At that date, 3 weeks of work will begin. We will then move in.

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

Nearly 3000 volunteer health professionals will be deployed during the Olympics! About 8000 first-aiders will be mobilized for Paris 2024. Other first-aiders will be mobilized for fan zones organized by municipalities and for events organized by the State. Besides the polyclinic, there will be medical posts for spectators at the 39 competition sites. Each of these cities will offer care with an emergency physician, a physiotherapist, and an osteopath. On the sports site itself, there will be a sports doctor and an emergency physician. We recruited a local sports doctor in each city who already has a network of dentists, radiologists, laboratories, and MRI facilities. If athletes need simple care, they can go to this practitioner. If they need more acute care, they will be referred to the local hospital.

You posted on LinkedIn that you are still looking for volunteer doctors for the Olympics, especially emergency physicians. How many are still needed?

There are specialties where there is no shortage. We have just enough sports doctors but no surplus. We have enough nurses, just enough hospital pharmacists. We are lacking some radiographers, but we are mainly short of emergency physicians. We would need about 20 volunteer emergency physicians if each gave 10 days of their time. If they can only give 2 days, we would need about 100. We need approximately 200 days of emergency physicians. We are asking them to offer at least 3 days between July 24 and September 10. If doctors who know their summer on-call schedule can volunteer a few days to the medical service during the games and want to join the celebration, they should come forward. We have asked the State to help us communicate with establishments that have already established their on-call lists so they can inform their emergency physicians to volunteer by emailing us at medvolontaire@paris2024.org.

All health professionals during the Olympics will be volunteers. Do you not have a budget to pay professionals who might be missing?

We do not have a budget to plug the holes; it is clearly a risk. But the issue is not just a budgetary one; it's a general shortage. In France, emergency physicians are a critical resource, needed to keep hospitals and SAMU running and to manage the Olympics. The Games have committed not to pay emergency physicians to avoid them being more attractive than working in public hospitals and thus stripping them of their staff.

What will happen if you cannot recruit the necessary staff? Could you call on volunteer foreign doctors?

French law is not very favorable toward authorizing foreign doctors to practice here. Still, among the regulatory changes we made, we opened the polyclinic to foreign doctors. Some are coming, but this legislative change does not apply to competition sites. If a foreign practitioner wants to come to France, they would have to go through all the steps to validate their diploma, and we no longer have time for that. We fell behind on this program because we let hospitals set their on-call lists first to ensure they had enough staff for the summer before we started allocating volunteers.

Can students come to help?

Normally, we cannot call on them, but we are negotiating with the Ministry of Health to allow junior doctors and interns with replacement licenses to participate.

What are your expectations of the volume of medical activity that will be generated by the Olympics?

The Games will host 10,500 athletes, including 8000 in the Olympic Village in Saint-Denis. Accordingly, we can expect up to 700 patients per day.

Do you have a budget to finance medical services?

Yes, we have a budget of around €20 million, which encompasses the polyclinic and all medical sites of Paris 2024. 

The National Union of Medical Biologists has lamented the lack of epidemiological monitoring to assess the dengue epidemic's evolution. France's national COVID-19 screening platform, SI-DEP, no longer exists. How are you preparing to monitor a potential epidemic during the Games, and with whom?

We have many discussions with the Regional Health Agency of Ile-de-France and the Operational Center for the Reception and Regulation of Health and Social Emergencies on this subject. We will operate somewhat like an emergency department. At the polyclinic entrance, a triage doctor will welcome and direct athletes. If they are injured, they can be treated by specialized consultation services. If the athlete is ill, the polyclinic will admit them to a small unscheduled care service. Sick individuals who cough or have a fever can be isolated and will undergo polymerase chain reaction testing. We will do everything possible to avoid clusters in the Olympic Village. Regarding dengue, an audit on vector control will be conducted in early June to minimize larvae around the village.

Are you prepared to face extreme weather conditions?

We have a plan for extreme weather. We have a contingency plan for storms; Météo-France can warn us within an hour about the severity of an approaching storm. We fear storms because many structures are temporary, under tents. A storm can be more dangerous than a heatwave. We also have a specific action plan for a heatwave, which will be implemented in a progressive manner. This plan encompasses a range of measures, including public messages to encourage hydration, misting, and water distribution. It is statistically probable that we will face the combined challenges of storms and a heatwave. 

Is there a specific medical plan for the opening ceremony, which is planned to take place on the Seine?

Yes, of course. We have asked each delegation to provide an accreditation for a doctor to accompany them on their boat. We have a nautical plan with rescuers and some doctors. We will have one or two Paris fire brigade boats and possibly a boat equipped by a SAMU doctor. We will also have about a dozen rescue boats. On the lower docks, we will have our own systems in place, while the State will be responsible for managing the high quays. We will have a command center coordinating both systems.

What is planned in case of a terrorist attack?

We are responsible for medical care and will have State support. Terrorism is directly under the jurisdiction of the State. In such a case, the terrorist threat must be eliminated first before medical personnel intervene.

This story was translated from the  Medscape French edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.