No capacity in main Dublin hospitals for extra patients needing intensive care

Ireland will struggle to deal with even a small number of severely ill patients should coronavirus cases occur here, a senior doctor has warned.

There is no capacity in the main Dublin hospitals to cater for extra patients requiring intensive care, according to Michael O’Dwyer, head of the department of anaesthesia and critical care at St Vincent’s University Hospital.

He says this is because repeated calls by doctors in recent years for extra ICU beds have been met by a “head-in-the-sand” response from the HSE.

With less than half the number of intensive care beds in place as are needed, the health service lacks the surge capacity required to cope with a rise in demand that could be caused by coronavirus cases here, he says.

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Dr O’Dwyer says the intensive care beds in St Vincent’s are running at “110 per cent capacity”, and there would be no space to accommodate an inflow of severely ill coronavirus patients.

“I haven’t had a bed free since Christmas, and on most days I’m running two over [capacity]. There is no way these beds would be free if the virus comes here.”

On Monday the Lancet published a study of critically ill coronavirus patients from Wuhan in China, where the present outbreak started. It says the death rate for these patients is "considerable", and the severity of pneumonia caused by the virus "poses great strain on critical-care resources in hospitals, especially if they are not adequately staffed or resourced".

More than 60 per cent of the patients in the study who were in intensive care ultimately died.

Surge capacity

Dr O’Dwyer says the study was carried out in a system with surge capacity, whereas the Irish system lacks one. While the pressure on intensive beds in St Vincent’s lifts somewhat in summer, this was unlikely to happen for some months.

Asked on Wednesday about ICU capacity, HSE national director Liam Woods acknowledged that if significant volumes of patients required care "there would be an impact in terms of our current ICU capacity".

“Our surge strategy, which we’re currently working on, is designed to precisely look at that issue.”

He said most patients requiring isolation would be accommodated in the 12-bed national isolation unit in the Mater hospital in Dublin.

Earlier this month an audit report found a shortage of ICU beds was leading to delays in the admission of patients and worse outcomes.

There were 255 ICU beds in the system last year, with 430 planned by 2031.