The ORSAN plan is placed above the white plans targeting hospitals. It is a system triggered by the government in the event of emergency situations in France. Like during the heatwave of June 2026.
The ORSAN plan is an emergency system triggered in France in very specific situations. For example, the government triggered it at its highest level (level 2) in June 2026 in the face of the extreme heatwave affecting France.
Definition: what is the ORSAN plan?
ORSAN means Ororganization of the Ranswer SANity but the full meaning is “Organization of the health system in exceptional health situations. It is a French crisis management system designed and coordinated by the Regional Health Agencies (ARS). Created in 2014, it aims to orchestrate the medical response during serious events, whether climatic, health or terrorist. When triggered, the ORSAN plan has two objectives:
- Optimize the care of patients directly affected by the event (victims of heat, an attack, patients affected by an epidemic, etc.).
- Guarantee continuity and quality of care for all other uninvolved patients, by best distributing medical resources.
What are the levels of the ORSAN plan?
To adapt to the severity and duration of a crisis, the ORSAN plan is structured around two progressive levels of mobilization.
Level 1: The Internal Mobilization Plan (PMI) / Vigilance: This first level is used to manage current and local hospital tensions (for example, a temporary saturation of emergencies or a slight shortage of staff). At this stage, the authorities inform, anticipate and put the health level on standby or moderate alert.
Level 2: The White Plan / Management of exceptional health situations (ESS): This is the higher level of crisis, triggered in the face of a large-scale event, a massive influx of victims or a crisis expected to last. It is this national level 2 which was activated in June 2026. Concretely, this level allows the authorities to take exceptional measures: strengthening of medical regulation (the capacities of SAMU centers are increased), mobilization and recall of staff to the hospital, deprogramming of operations or non-urgent consultations in order to free up beds. Finally, thePrivate clinics are used to relieve public hospitals.
On what dates was it activated?
Since its creation, it has been activated several times:
- 2014: Partial application during the Ebola alert.
- 2015: Full application during a particularly deadly seasonal flu epidemic.
- 2015 and 2016: Emergency activation following the attacks in Paris and Nice.
- 2020: National response to the Covid-19 pandemic.
- 2022: Activation to deal with an epidemic of historic bronchiolitis in infants.
- June 2026: Activation of the plan to respond to the heat wave and extreme heatwave.
Who triggers the ORSAN plan?
Triggering the ORSAN plan is the responsibility of the highest state authorities. It is generally activated by the Minister of Health or directly by the Prime Minister depending on the seriousness of the situation.
- In June 2026: It was Prime Minister Sébastien Lecornu who spoke to activate the climate component of the plan in the face of record temperatures.
- In November 2022: François Braun, then Minister of Health, activated it in the face of the bronchiolitis crisis.
- In February 2020: Olivier Véran, Minister of Health at the time, launched it at the dawn of the Covid-19 crisis.
- Between 2014 and 2016: The successive activations (Ebola, flu, attacks) were ordered by Marisol Touraine.
Principle: what does it consist of precisely?
Before the appearance of the ORSAN plan, the health response was essentially based on the “white plan”, an internal emergency system specific to each hospital and triggered by its director to restructure its services in the event of an influx of victims (recall of staff, deprogramming of non-urgent operations, opening of beds). The ORSAN plan is placed above the white plans. It serves as a regional and national umbrella to coordinate the three major health sectors together:
- The hospital sector (public and private).
- The outpatient sector (city medicine, general practitioners, SOS Médecins).
- The medical-social sector (notably EHPADs and reception centers).
To adapt to the nature of the crisis, the ORSAN plan is divided into 5 specific sections:
- ORSAN CLIM: Treatment of numerous patients following a climatic phenomenon (such as the heatwave of June 2026).
- ORSAN REB (formerly EPI-VAC / BIO): Management of epidemic and biological risks (Covid-19, bronchiolitis, flu).
- ORSAN AMAVI: Mass reception of non-contaminated victims (serious accidents, attacks).
- ORSAN NRC: Management of a nuclear, radiological or chemical risk.
Focus: The ORSAN REB component (Epidemic and Biological Risks)
Introduced just before the Covid-19 crisis, the ORSAN REB component is activated during major epidemics. Its operation adapts according to the severity and circulation of the virus:
Containment phase (start of epidemic): The objective is to stop the spread. Suspected or confirmed patients are immediately referred to “frontline” hospitals with high-security infectious disease wards and strict isolation rooms.
Active circulation phase (Stage 3 / Pandemic): When the virus circulates everywhere, individual logic fades in favor of collective management. The effort is then focused on three axes:
Protect fragile and immunocompromised people as a priority (particularly in nursing homes).
Take care of mild cases directly in community medicine (ambulatory) so as not to saturate emergencies.
Reserve hospital beds and intensive care exclusively for cases showing signs of seriousness.
