Hospital trolley numbers fall steeply amid Covid-19 preparations

A dramatic reduction in the number of patients on trolleys shows public hospitals are now refocusing on preparations for Covid-19, the Irish Nurses and Midwives Organisation (INMO) has said.

Its latest daily update on the number of people awaiting hospital beds put the number at 167 on Tuesday, a fall of two-thirds or 67 per cent since the same day last week.

The slump is believed to reflect the concerns of GPs and patients about attending hospital emergency departments and a possible move to begin freeing up bed capacity.

“We have long said that if hospitals can focus on essential services, the trolley figures will go down,” an INMO spokesman said.

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“That is being borne out, as hospitals are clearly refocusing on preparations for Covid-19, stopping some electives, and decanting patients.”

The decline in daily waiting numbers across the county has been precipitous – from 509 last Tuesday, to 394 on Thursday and 234 on Monday – although the INMO pointed out the numbers still remain too high and services too stretched.

“In the lead-up to a public health emergency, we should have free capacity in ICUs and emergency departments to take in patients. Instead we still see overflowing services, with patients on trolleys,” the spokesman said.

‘Paradoxical drop’

Dr Mark Murphy of the Irish College of General Practitioners (ICGP) said the unfolding situation would bring a “paradoxical drop” in the demand for general healthcare given concerns around attending services.

“I think the emergency departments are a bottleneck in the system that doesn’t have capacity and typically they [cater for] the sickest and most infirm patients, but there is always some wiggle room in attending. Sometimes you can delay it by a matter of days or weeks if possible,” he said.

For general practice in the community, however, he says the real concern among frontline staff is the supply of basic but essential materials, notably sterile equipment, gels and prophylactic kits. His staff are now on their last box of disposable facemasks, unable to replenish stocks.

In surgeries around the country, doctors are making their own small preparations – clearing away children’s toys, wiping down chairs and generally securing waiting rooms.

“In general practice, things are quite stressful. There has been good leadership from our unions and bodies... but we are on the frontline and we do feel we have limited supplies,” Dr Murphy said.

“In the next few weeks [we] will really need that equipment.”

He stressed the point that while there is an emerging reticence about hospital attendance, those who need medical attention should talk to their GPs about options and attend where necessary, but phone first.

Community-based testing

He said in the coming weeks there should be a move to consider alternative community-based testing for virus contamination to safeguard the medical integrity of clinics and hospitals.

“They are all things that are on the table,” he said.

The HSE said that "despite the challenges of a volatile market", Ireland has "adequate stock of critical supplies all across the country".

It said it had spent €27 million to date on a range of medical products, including lab, respiratory, ventilation and patient monitoring equipment.

“HSE has secured in excess of four million masks, both surgical and respiratory. In excess of €20 million has been invested in PPE (personal protection equipment),” it said.

“In excess of 3,500 PPE packs have been manufactured and distributed to GPs, public health departments and primary care centres. The HSE has also purchased 12 portable ventilators and 60 ICU ventilators.”