Patients have likely died as a result of ‘avoidable delays’ in Irish health system over recent weeks, IMO says

No plans to introduce mandated mask-wearing, Taoiseach says; Hospital overcrowding down on last week’s figures due to higher weekend discharges by staff

There are no plans to introduce mandated mask-wearing in public places, Taoiseach Leo Varadkar has said as hospital overcrowding increased on Tuesday.

There were 534 patients waiting for a bed on Tuesday morning, according to the Irish Nurses and Midwives Organisation’ (INMO) daily TrolleyWatch count. This is up slightly on 489 recorded the previous day but well down on the record figures set last Tuesday.

The improvement is partly the result of higher weekend discharges of patients due to more staff being in hospitals. There are also reports of lower attendances at emergency departments.

The separate HSE count was up 31 per cent on the same day last year.

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Earlier on Tuesday the INMO said stronger advice around mask mandates and hand hygiene is needed amid the surge in respiratory illnesses.

“We are once again calling on the chief medical officer to issue stronger public health advice in relation to mandated mask-wearing,” the union’s general secretary, Phil Ní Sheaghdha, said.

“It is our view that it is the responsible thing for policymakers and Government to do at this vital juncture when hospitals are not coping and people’s lives are at a higher risk.

“It is time for stronger advice on simple and inexpensive measures such as mask-wearing and handwashing. It shouldn’t be this difficult to issue strong advice in this regard when we are being warned about rising cases of flu, RSV and new Covid variants.”

However, Mr Varadkar said the Government is guided by the advice of chief medical officer Prof Breda Smyth, who he said “at least for now is not advocating that there should be a mask mandate”.

“But she is advocating that people who are in public transport or in healthcare settings and other crowded settings should consider wearing a mask.”

He said people who are experiencing respiratory symptoms should stay at home so as viruses are not spread.

Mr Varadkar added: “What is encouraging certainly when it comes to Covid and RSV - I think we are seeing the incidences peak.

“We are seeing the numbers in hospital with Covid falling which is a good sign but obviously we certainly haven’t seen flu numbers peak at this stage.”

Meanwhile the Irish Medical Organisation has said it is likely some patients have died as a result of “avoidable delays” in the health system over the last number of weeks.

“There is an even stronger likelihood that we will see further increased deaths and delayed diagnosis because some people who should present at our Emergency Departments in the coming weeks will not now do so because of fears of what they have recently seen,” Dr Matthew Sadlier of the IMO said in a statement on Tuesday.

“Years of underinvestment in both hospital and community healthcare infrastructure has left us a service which is dangerous for patients and for those who work within it,” Mr Sadlier added.

Opposition politicians responded to the latest INMO trolley numbers, with Labour TD Duncan Smith saying they are “still incredibly high” and Sinn Féin’s David Cullinane saying they are “unacceptable”.

Mr Smith said they show “the teeth of this trolley crisis continues to bite”, that the numbers are “nothing to celebrate and our health service workers are still absolutely pinned to their collars”.

He said: “I had one nurse on to me this morning, over 30 years’ experience in one of the main Dublin hospitals, who says it’s the first time she’s ever cried starting a shift and given the level of experience that they have and the level of workload that they have on the wards today.”

Mr Smith said that among the measures Labour wants to see from Government is “stronger public health advice” on mask-wearing and “back-to-basics hygiene”.

Asked if it mask wearing should be mandatory again in some places he replied: “Maybe on public transport and in congregated settings.

“I think that’s something we need to look at, at least for the month of January and February because the health service is in such a crisis.”

Mr Cullinane said the current crisis was “entirely predictable” and he argued Minister for Health Stephen Donnelly’s winter plan has “clearly failed”.

He said: “It’s now gotten to a point where it’s almost normal that a figure of 500 [people on trolleys] is almost a good news story because we almost hit 1,000.

“It is not. It is inhumane. It is unacceptable.”

He said healthcare resources must be maximised with staff redeployed to places that are under pressure.

University Hospital Cork has the highest number of patients waiting for a bed on Tuesday, at 56. University Hospital Limerick has the next highest at 44.

Recent evidence from the United States shows new Covid variants are leading to increased hospitalisations, Ms Ní Sheaghdha said. “We know that we will be seeing continued pressure on our acute hospital system until the end of February at the very least.”

“While we have seen decreases in those on trolleys in some of our larger hospitals, we are seeing high numbers of patients on trolleys in some of our smaller hospitals which is having a devastating impact. There must be no relaxation of the curtailment of non-elective care at this point.”

Mr Cullinane said the events of recent weeks should be a “watershed moment” that would lead to extra capacity being put in the system “once and for all”.

“We need more beds, we need more diagnostic capacity, and we need more doctors, nurses, consultants and healthcare professionals working in hospitals,” he said.

The HSE confirmed this week that more than 850 bed days have been lost in hospitals since the start of the year, the majority – 554 – due to the need for infection prevention and control.

On this Mr Cullinane said: “What hospitals have been saying to me for a long, long time, is that we don’t have sufficient numbers of single-isolation-room beds.

“I think [University Hospital] Waterford is a good example of where things can be done better,” he said.

Mr Cullinane said 150 isolation room beds were brought on stream there before the Covid-19 pandemic. “That means then that patients don’t get as sick and staff don’t get as sick. So obviously that’s one of the solutions,” he said.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times

Cormac McQuinn

Cormac McQuinn

Cormac McQuinn is a Political Correspondent at The Irish Times