Cases of Covid and flu set to surge after Christmas, says HSE

Senior HSE figures have said hospitals will be on a state of high alert in the weeks immediately after Christmas in anticipation of a surge in the number of people attending Emergency Departments with Covid-19 and flu as a result of the increased socialising associated with the holiday period.

Cases and hospitalisations of both conditions have been rising in recent weeks and the expectation is that flu cases will peak in the first few weeks of the new year, contributing to an increase in pressure on the entire hospital system, they say.

The most recent figures for incidences of flu indicate that from a relatively low base the number of people over 65 hospitalised had almost trebled week on week while the corresponding figure among five to 14-year-olds had gone up by a third.

The latter figure, it was suggested, is of concern because while the vaccination rate for the former cohort is 72.7 per cent, it is just 10.9 per cent for those aged between two and 17.

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The number of people in hospital with Covid-19 on Wednesday, meanwhile, was 464 compared with 351 just five days earlier. The number of outbreaks in nursing home settings was up by 24 per cent although the number of cases involved is said to have been low.

Nine people were recorded as having died with Covid between December 4th and 10th.

Rates of infection were comparatively higher in the southeast with more than 50 cases per 100,000 people recorded in counties Waterford, Wexford, Carlow, Kilkenny and Kildare, more than twice the rate in Monaghan and Roscommon during the same period.

The number of RSV cases recorded actually dropped slightly but concerns remain that the Christmas and new year period will prompt significant increases in cases of all three viruses early in the new year.

At a media briefing on Thursday afternoon, the organisation’s senior figures said predicting the precise scale of the surge is more complicated due to the mix of competing viruses but urged people to use the remaining “window of opportunity” to get initial vaccinations or booster shots and observe the routine health and hygiene measures promoted through the pandemic to help keep numbers down.

“It’s an unusual winter because of the presence of Covid and other pathogens so we have to hope for the best but prepare for the worst through vaccination, vaccination, vaccination but also the sort of health measures that we have all become very used to,” said Dr Eamonn O’Moore, Director of national Health Protection.

“What we can say with certainty ... is that we will expect to see a sharp rise in the number of influenza cases over the coming weeks. Normally an influenza season lasts nine to 13 weeks and we will probably see the peak of that in early to mid-January, depending on a number of factors, not the least of which will be the degree of social mixing but also vaccination coverage and so on.”

Eileen Whelan, National Lead for Test and Trace, said that arrangements for the provision of vaccines to healthcare workers had been changed so as to help them obtain vaccines or boosters and she urged them to avail of them.

HSE Chief Operations Officer Damien McCallion, said that detailed guidance had been provided to hospitals in order to avoid a repeat of last January’s widespread cancellation of elective procedures. The intention, though, has been to not schedule so many in the first place.

“In terms of the outpatients side of thing, we try to minimise the impact of that in terms of demand,” said Mr McCallion. “Generally we try to keep that going as best we can through those tricky periods. We protect the cancer and other urgent care [and] we try to minimise scheduling some of that work needlessly in those critical weeks so that we don’t give patients the expectation of an appointment and then have to cancel.”

Commenting on the fact that the number of instances of people waiting on trolleys for more than 24 hours was up by almost a quarter on 2019, Interim Chief Executive Stephen Mulvany said an increase in the number of ED attendances and a disproportionate increase among those aged over 75, more of whom had to be admitted, had been among the factors that had increased pressure on hospitals.

He acknowledged, however, that while some hospitals had done well there were 14 “whose performance is poor”.

“This unfortunately points to evidence of variable levels of leadership impact, variable levels of management process effectiveness and variable levels of the quality clinical pathways and collaboration,” he said.

He said the provision of more beds, staff and support provided for under the terms of the HSE’s winter plan would help to address the issue.