LAST UPDATE | 24 Mar 2022
THE PRESSURE ON Emergency Departments (EDs) is at its worst since the Covid-19 pandemic began, a senior emergency consultant has said.
It comes as senior politicians insisted there will not be a return to any restrictions, despite a spike in cases.
Covid-19 cases in hospital are up 29% in the last week. As of yesterday, there were 1,395 Covid-positive patients in hospital, with 55 in intensive care.
Latest figures from the Irish Nurses and Midwives Organisation (INMO) show that there were 546 admitted patients waiting for beds this morning. A total of 458 patients were waiting in EDs, while 88 were in wards elsewhere in the hospitals.
Speaking to The Journal, Irish Association for Emergency Medicine (IAEM) spokesperson and senior emergency consultant at Sligo Regional Hospital Dr Fergal Hickey said the pressure on EDs is “probably the worst we’ve seen during the whole Covid-19 pandemic”.
“It’s not that there are large numbers of patients in intensive care, there aren’t, although that number is on the way up, but the issue is twofold,” Dr Hickey said.
“One is that this is a more contagious variant of Omicron … but also there’s a lot of patients who are coming with other problems … and they are found to have Covid incidentally,” he said.
Dr Hickey said most patients in hospital with Covid-19 at the moment are “not particularly sick” but added that “you can’t put them with other patients who don’t have Covid”.
“It’s a real challenge, we cannot safely stream people in the way that we’d like to,” he said.
HSE chief operations officer Anne O’Connor said today that around half of those patients are in hospital because they had become sick after contracting the virus.
“In one way, that doesn’t really matter to us. If they are infectious with Covid, they need to be on a Covid ward, in isolation,” she said.
She named Sligo, Kerry and Limerick as places where staff are under particular pressure.
However, she added: “We are seeing huge pressures all around the country. This is not just unique to hospitals. It is across the board.”
O’Connor said some hospitals and services are being forced to cancel elective surgery, even if they are endeavouring to still provide urgent or critical care.
Staff shortages
More than 5,200 staff are currently absent due to Covid-19, she confirmed.
“If you go to Limerick yesterday, they had serious problems with some specialties, where they had a consultant and some of their team out with Covid,” O’Connor said.
“If they are gone, and their team is gone with Covid, we can’t provide that service.”
Dr Hickey told The Journal that at his Department in Sligo “there hasn’t been a day in the last two months that we’re not short of staff”.
“There isn’t a spare capacity in the system that we can transfer staff from elsewhere,” he said.
“All of this is happening at a time when we are seeing record numbers of patients coming to the Emergency Department.”
Dr Hickey added that staff morale is “the worst I’ve seen”.
“There’s a sense that the restrictions were lifted too dramatically,” he said.
Elective activity
The country’s most overcrowded hospital, University Hospital Limerick, last night announced a deferral of almost all elective activity as it attempted to manage “a sustained surge in emergency presentations and a significant increase in Covid-19 activity”.
A spokesman for UHL said the hospital had “moved to its highest level of escalation, meaning emergency and time-critical care for the sickest patients is being prioritised”.
Outpatient appointments, elective surgery and diagnostic investigations, have been “deferred until further notice”, and “affected patients will be contacted as soon as possible to reschedule their appointments and procedures,” he said.
A visiting ban remains in place at UHL which was treating 89 Covid positive patients, however, visits of one person per patient were being facilitated for parents visiting children, for people assisting confused patients and for people visiting on compassionate grounds such as for patients who are critically unwell or at end of life.
O’Connor said the health service has to get through the coming weeks and hope that case numbers and hospital figures start to drop.
“The only lever in a hospital, unfortunately, is to cancel planned work,” she said.
Tánaiste Leo Varadkar told a meeting of the Fine Gael parliamentary party last night that the chief medical officer does not see the need for further Covid restrictions.
He expressed his concern about rising numbers but stressed the Omicron variant of coronavirus is less severe, adding that the population is highly vaccinated and economic and social restrictions are not imposed for a bad flu season.
With reporting by David Raleigh and Press Association
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