Coronavirus: Warning of ‘apocalyptic’ surge in non Covid-19 waiting lists

HSE to play catch-up and treat thousands of patients with other conditions

HSE chief executive Paul Reid said occupancy levels in hospitals would have to be limited to 80 per cent – instead of the normal level of over 95 per cent – to allow for safe levels of operation. Photograph: Leon Farrell/Photocall Ireland/PA Wire

HSE chief executive Paul Reid said occupancy levels in hospitals would have to be limited to 80 per cent – instead of the normal level of over 95 per cent – to allow for safe levels of operation. Photograph: Leon Farrell/Photocall Ireland/PA Wire

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Plans are being drawn up to treat thousands of patients not infected by Covid-19 as the health service attempts to play catch-up after two months in which normal services were shut down.

The move comes as one senior doctor warned of an “apocalyptic” surge in hospital waiting lists over the coming months as the profession struggles to perform operations while keeping patients apart to stem the spread of coronavirus.

The number of procedures that can safely be carried out daily is likely to halve as strict social distancing and other infection control measures are implemented, said Dr Gabrielle Colleran, vice-president of the Irish Hospital Consultants Association.

Patients requiring treatment for urgent conditions such as cardiac problems and cancer will be prioritised under the new approach, officials indicated on Sunday.

Health Service Executive (HSE) chief executive Paul Reid committed to publishing the plan but did not say when it would be completed.

Mr Reid said occupancy levels in hospitals would have to be limited to 80 per cent – instead of the normal level of over 95 per cent – to allow for safe levels of operation.

Much of the treatment for non Covid-19 patients will be delivered in private hospitals, which are currently working at just one-third capacity.

Second wave

However, Mr Reid said spare capacity would have to be maintained in the system in case of a second wave of the virus later this year.

“If there is any concern about a second surge there will be a step-back on the easing of restrictions,” HSE integrated care lead Dr Siobhán Ní Bhriain said.

All routine elective procedures were halted at the beginning of April to free up space and medical staff for a feared spike in Covid-19 patients.

Under the Government’s road map to reopening the country, elective procedures can resume in “phase one”, which starts on May 18th.

The number of patients in Ireland waiting to be seen by a specialist – already the highest in Europe – will “only be growing and growing” until there is a vaccine developed, Dr Colleran told The Irish Times.

She said there will be a “huge impact” from cancelled appointments, procedures and operations as well as new measures being implemented to control any outbreaks of Covid-19 clusters in hospitals as they open up again to routine care.

“I don’t like to be dramatic or cause fear in patients, but this is going to be apocalyptic,” she said.

Dr Colleran added she was “massively worried” about a rise in morbidity and mortality for people with conditions unrelated to Covid-19 – including cancer, stroke and heart disease – because of delays in seeing patients.

‘Post-match analysis’

“In two or three years’ time when we are doing our post-match analysis of how well we did handling this, we have to look at all the deaths.

“It’s not just how many people died from Covid, if our outcomes from stroke, or cancer, or heart disease go through the floor and we have way more deaths because people aren’t coming to hospital, because they are scared, or their surgery was delayed, that is all part of the impact.”

Many Irish hospitals are unsuited to the new social distancing rules required to allow services to resume.

Both patients and staff will require repeated testing for Covid-19, and infection control requirements are likely to require a move to virtual clinics and electronic charts.

In addition, throughput in operating theatres and other clinical settings will fall because staff will have to don and doff protective clothing regularly.

A further 19 people diagnosed with Covid-19 have died, the National Public Health Emergency Team disclosed on Sunday.

There have now been a total of 1,303 deaths associated with the disease in Ireland, it said in its latest update on Sunday.

Another 330 new confirmed cases were also reported. This brings the total number of cases to 21,506.

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