Coronavirus: ‘We can save hundreds; the public can save thousands’

Medics have reacted with alarm at images of people gathering in packed Dublin pubs and flouting the Government’s “social distancing” guidelines introduced to prevent the spread of coronavirus.

One doctor pointed to the limits of the State’s health system to help people who will become critically ill, warning that the public would save many more lives than the country’s hospitals if it complied.

"We can save hundreds and we will save as many as we can, but public engagement will save thousands of lives," said Catherine Motherway, president of the Intensive Care Society and a consultant anaesthesiologist and intensive care physician at University Hospital Limerick.

Dr Motherway said she was upset at the images of people drinking in a packed Temple Bar pub, even though the Government said last week that indoor events of more than 100 people should be cancelled and people should try to distance themselves from others.

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Dr Motherway warned the country’s hospital system would not be able to cope if Ireland was as badly hit as Italy where there have been 1,800 deaths.

“We will be unable to cope with the surge of critically ill people coming into us if what happens in Italy happens here. The health service could well be overwhelmed,” she said.

‘Public buy-in’

The Limerick doctor said the hospitals were “at the back end of the problem” and the public at the “front end”. There had to be “significant public buy-in” to save lives by following the guidelines of maintaining social distancing, washing hands regularly and other simple measures.

“The public can save a lot more lives than the hospitals. If they slow it down, we will do our best to cope and the less of a surge we have, the better we will be able to cope,” she said.

“I don’t want to be deciding between patient A and patient B – that is not where I want to be. I want to be able to treat the patients as they come in.”

The Government’s strategy to cope with the outbreak of the Covid-19 infection is to push out and lower the peak of the infections in order to buy the health service time.

“We have been given time by Italy. We know what is coming. Italy didn’t know what was coming. They got hit really badly, very quickly, so we should learn from that,” said Dr Motherway.

ICU capacity

The health system has 255 intensive-care unit (ICU) beds and the HSE is ramping up capacity, but Dr Michael O’Dwyer, head of anaesthesia and critical care at St Vincent’s hospital in Dublin, said that even a properly resourced system of 400-500 beds could not cope in a worst-case Covid-19 surge.

“I don’t think there is a health system in the world to scale up to what is a worst-case scenario and provide the sort of ICU needed,” he said.

Dr Chris Luke, an emergency medicine specialist from Cork, said the scale of the coronavirus pandemic "hinges completely on population behaviour".

The video of the packed pub over the weekend was “an amazing demonstration of the exact opposite of what social distancing is” and that if two or three people were infected in that crowd, then the virus was “now spreading like wildfire”.

“It demonstrates exactly how you could best spread the disease through a mixture of fecklessness and recklessness driven by intoxication,” he said.