Cyril Quemeneur1, Arthur James2, Elie Kantor3, Clément Monet4, Jean-Denis Moyer5. 1. Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France. Electronic address: cyril.quemeneur@aphp.fr. 2. Sorbonne University, GRC 29, AP-HP, DMU DREAM, Department of Anaesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France. 3. Department of Anaesthesiology and Critical Care, Bichat Hospital, Paris, France. 4. Départment Anesthésie et Réanimation B (DAR B), Saint-Eloi Hospital, CHU de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France. 5. Department of Anaesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP Nord, Paris, France.
In December 2019, the city of Wuhan in China experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). France was not spared and has faced three waves of COVID-19 [1]. This pandemic led to a massive increase in the need for acute care beds. It imposed a fast and thorough restructuration of the French healthcare system, which deployed 4,806 additional intensive care unit beds (+ 95% increase) [2]. This reorganisation required an intense activity for all clinicians. At the same time, the number of publications has increased constantly: more than 40.000 references for SARS-CoV-2 on PubMed and more than 10.000 references on the preprint server (8292 medRxiv, 2285 bioRxiv) by December 2020 [3]. A peak of almost 500 articles submitted in one week was noticed during the pandemic growth phase in April. It was therefore necessary to create a task force to select the most relevant articles and summarise them in order to make them accessible to the greatest number.
The rise of the bibliography Le Masque et la Plume
The multiplication of data on COVID-19 associated with the heterogeneity of standards of care and therapies tested worldwide required a daily literature review. Le Masque et la Plume (LMLP) was born. The primary purpose was to keep clinicians up-to-date and standardise care protocols. The online publication on the website of the French Society of Anaestheia and Intensive Care (SFAR) and the immediate cohesion of young anaesthesiologists all around France allowed to freely create a daily newsletter. The project aimed to summarise the abundant literature and keep the huge amount of information understandable and accessible while avoiding oversimplification. Thus, the main difficulty for the writing committee was to select the most relevant articles and to provide a synthesis without distorting the initial article.
LMLP: far from the galaxy of anaesthesiologist-intensivists?
The first issue was published on the 18th of March 2020 and was downloaded more than 4,100 times. Since this first number, 60 issues have appeared in 2020, initially on a daily format, and then on a weekly format during the second wave. The number of articles treated in 2020 amounts to 213 of which 27 are recommendations or experts’ advices, 129 are from peer-reviewed journals, 57 are non-peer non-experts (tutorial, epidemiology, summary shall). Finally, the total number of Le Masque et La Plume downloads was 170,430 at the end of 2020.Furthermore, to analyse the impact of our work on healthcare professionals in France during the pandemic, a link to an electronic questionnaire using a Google Form was integrated in the last two 2020 editions of LMLP. Out of 2183 downloads, 339 (16%) people responded to our survey. The mean age of respondents was 41 years (+/− 11.5). The mean number of issues read by the respondents was 30, i.e., 50% of the issues published at the time of the survey. Three hundred thirty-five (99%) readers worked in the healthcare sector with 276 (83%) of them being physicians, of which 150 (56%) were anaesthesiologist-intensivists, 25 (10%) emergency physicians, 25 (10%) general practitioners and 19 (7%) intensivists. The other professions were mainly represented by nurses (n = 36, 11%). Forty-three per cent of the respondents modified their prescriptions based on the data published in LMLP and 73% used it for training purposes. The quality of the content was estimated at 8.48 (1.05) on a scale of 0 to 10 according to the respondents. Those results do not represent all the readers of LMLP and should be interpreted cautiously. However, it confirms that the impact of LMLP reaches beyond the galaxy of anaesthesiologist-intensivists.
The end of the SARS-CoV-2 empire
The SARS-CoV-2 pandemic has clearly shaken our healthcare system; however, it has highlighted the strengths of our anaesthesiology and intensive care specialty: adaptability, versatility, cohesion and the ability to rely on younger generations from all over France. With LMLP, young anaesthesiologist-intensivists have confirmed their ability to face this crisis and emphasise the key role of their specialty in the management of this pandemic. It is time to explore new horizons and to open Le Masque et La Plume to non-COVID articles but always with the same purpose: making the knowledge accessible to all.
Conflicts of interest
The authors have no competing interest to declare.
Acknowledgments
The authors are indebted to all persons who are involved in Le Masque et La plume: Myléne Defaye, Fanny Bounes, Stéphanie Sigaut, Bénédicte Grigoresco, Emmanuel Weiss, Charles de Roquetaillade, Guillaume Savary, Emmanuel Pardo, Vincent Balech. We also thank Tobias Gauss for editing the manuscript.