LAST UPDATE | 23 Dec 2022

THE TAOISEACH HAS called on the HSE to deploy all available resources to deal with the hospital surge as Covid-19 and flu puts pressure on stretched facilities. 

Leo Varadkar told reporters today that there may be a need to use private hospitals to take the strain of an increasing crisis in admissions. 

The Fine Gael leader said that the it is envisaged that the stresses are expected to be much more intense in January, February and March.

Varadkar said that an ageing population and three viruses, Covid-19, flu, RSV were factors causing the problems at present. 

He sought to reassure the public that the State has prepared for this and will be able to increase capacity. 

“It is the case that government has prepared for this. It’s not a surprise. We have almost 1000 more hospital beds that we had two years ago. That’s the equivalent of three new hospitals.

“We’ve had 1000s of more staff, never had more nurses or doctors or midwives working in the health service and the biggest budgets for health ever.

“No matter how well you prepare, we’re still going to be under a lot of pressure as indeed will be the case across Europe and across the northern hemisphere this winter,” he said. 

Varadkar said he will meet senior HSE managers this afternoon and will ask them to make unprecedented resources available. 

“We’re going to do everything we can, certainly my message to the HSE senior leadership team is that I want them to deploy all the resources available immediately to us over the winter period to minimise the suffering and inconvenience that patients are going to face and to make sure that the staff in our health service, who are often pretty burned out at the moment, particularly having suffered the pandemic and that they feel supported to and that’s going to be the message as it started,” he added. 

The Taoiseach said that there is no proposal as yet to reintroduce mandatory mask wearing but he said the State was “encouraging” people to use face coverings particularly in public transport settings. 

He also asked people with “respiratory symptoms” to stay at home and not pass it on to children or vulnerable elderly people. 

Varadkar also said that they were: “really encouraging people who haven’t taken the vaccine, yes, whether it’s a new vaccine or Covid vaccine to do so. They do work.

“They can prevent you getting sick, when they don’t prevent you getting sick they certainly prevent you needing to be hospitalised or needing an ICU bed that might be used for somebody else. So that’d be very strong messages that we would be putting forward in the next couple of weeks,” he added. 

Antibiotic shortages 

The Irish Pharmacy Union (IPU) is calling for the government to introduce a serious shortages protocol to allow pharmacists to dispense alternative medicines, as they face ongoing supply issues with key antibiotics. 

Dublin based pharmacist and IPU Vice President Ann-Marie Horan said that the situation is set to become more difficult over the Christmas period when most GPs will close for a few days. 

“We are limited in how many boxes of amoxicillin we are allowed to order, and then as soon as they come in they are going over the counter to patients.

“When we run out of key anti-biotics – and pharmacies are experiencing this on a daily basis – we have to call up the prescriber and ask them to prescribe the alternative, which can be really time-consuming for us, and in the case of out-of-hours practices or doctors on hospital wards, they can be difficult to reach. 

“There is an urgency to this because people should not be waiting a week to start antibiotics,” she said. 

In the UK an emergency protocol has been brought in to allow pharmacists to prescribe alterative medicines themselves, Horan says that this is what is needed here. 

“We have rising levels of flu and covid-19, and people end up with secondary infections that require antibiotics. More people are also experiencing conjunctivitis as a symptom and there is a shortage of over the counter eye-drops too, so people are visiting ten pharmacies to try and find them. 

“Conjunctivitis may not be extremely dangerous but it is highly uncomfortable and it means children have to be kept home. The eyedrops which have to be prescribed by a GP are actually available, but we can’t dispense them over the counter, which, again, they can in the UK,” Horan explained. 

She said that there are obvious steps that the government could take to resolve some of the short term antibiotic supply issues, but that since the IPU called for a protocol to be introduced, they have not seen the government engage with the idea. 

More than expected

Earlier the HSE said they’re seeing more people currently in hospital with Covid-19 than had been expected in even it’s most “pessimistic projections,” it said as the Irish Nurses and Midwives Organisation’ general secretary claimed that hospital staff were being abandoned.

A government spokesperson has told The Journal that top officials are “monitoring the situation closely and receiving daily updates from the HSE and Department of Health,” a day after a National Crisis Management Team (NCMT) was established by the HSE.

The Taoiseach is meeting the acting CEO of the HSE Stephen Mulvany, along with Health Minister Stephen Donnelly this afternoon for a broad discussion on health topics, including winter pressures on the health service.

In a statement yesterday, the HSE warned that winter respiratory viruses would put the healthcare system under more pressure ”than has ever been seen,” something that INMO head Phil Ni Sheaghdha says could have been avoided.

Earlier today the INMO announced that 360 patients, including 19 children, are currently without a bed in Irish hospitals.

Speaking on Morning Ireland, Ni Sheaghdha said:

“Since mid July hospitals have been overcrowded to a level that we have been saying they are now have themselves reservoirs for cross infection. That didn’t happen yesterday when the crisis management team was set up, that’s been in place since July.”

“We have poor ventilation in our hospitals, we have situations where people who are undiagnosed with infectious diseases are on trolleys within reaching distance of the person on the next trolley. 

“The absolute pressure that’s now on nurses, doctors and others in the frontline, who are trying to do their best trying to cope. They are now becoming distraught. They’re extremely angry. They feel that they have been abandoned to a situation that was avoidable if planning had been put in place at the right time,” she said.

The HSE has stated its concerned that over 900 patients may be in hospital with flu in the first week of January, with that number likely continuing to rise further into January.

There are currently around 656 people in hospital with Covid-19, 26 of whom are in ICU and a further 600 hospitalised with other respiratory conditions.

When asked if hospitals should restrict visitors, Ni Sheaghdha said that that was their own decision to make however many cases were being spread from inside hospitals rather than being brought in by visitors.

“There must be an absolute focus between now and the end of February on delivering safe care. It is not sufficient to constantly come out publicly and say this is going to get worse and the HSE are going to have difficulty coping not good enough,” Ní Sheaghdha added.

Also speaking on the show, Dr Brian Kent of St James Hospital Dublin, warned that the peak in respiratory viruses including Covid-19 and the flu has come much earlier than usual.

“We’re seeing those viruses at a much earlier stage of the season than we normally would. So we often see it in the new year period and the early, early part of of the year when we have the most admissions with these with these injections,” Kent explained.

“Whereas now we’re seeing a very, very significant burden of illness at Christmas.”

“A lot of people coming in are coming in for other reasons and ended up having Covid identified almost by chance, or have symptoms caused by Covid. So we’re kind of getting a triple whammy of respiratory viruses. At the moment, our flu rates particularly have have really skyrocketed in the last in the last two or three weeks.”

“We’ve been seeing a reasonable amount of a virus that we always think of as a pediatric virus that can call RSV, which causes can cause quite nasty freezing illnesses. And again, we’re seeing a fair bit of that in in people who have who have asthma and COPD and underlying chronic lung conditions.”

Kent added that a major consequence of the current crisis is that hospitals will find it “much more challenging” to provide chemotherapy and surgeries in the coming months. 

Sinn Féin’s health spokesperson, David Cullinane, has slammed the government for the current overcrowding and said the situation has become an emergency.

“Emergency department dysfunction such as this is a symptom of everything going wrong at the same time in a health service which does not have enough capacity,” Cullinane said.

“After nearly 2½ years in the job, the Minister for Health has yet to produce a multi-annual plan for the health service.” 

“This is now an emergency and must be treated as such. All options must be on the table including utilising private health care capacity. We must mobilise all available resources to take pressure off our hospitals, our front line health care workers and to provide better care to patients.

“This emergency was entirely predictable. A shortage of capacity in our hospitals, insufficient GP capacity and particularly out of hours services and a lack of care options in the home and community are all factors driving patients to EDs,” he stated.

With reporting from Niall O’Connor.