Covid-19: Hospitals move to crisis footing as cases surge

Extra ICU capacity to be identified as HSE warns of ‘unthinkable’ consequence of surge

Hospital managers have been told to immediately identify extra intensive care (ICU) capacity to deal with an expected surge in Covid-19-related admissions in the next two weeks.

Health Service Executive chief executive Paul Reid warned of the “unthinkable” consequences of hospital capacity becoming exhausted, with the numbers being treated for the disease having increased by 40 per cent in a fortnight.

Concern among Ministers and senior health officials about the ongoing surge in infections has grown and hospitals will now move to a crisis footing. This will see non-urgent care postponed and patients who can be discharged moved on to make space for the expected arrival of more people sick with the disease.

Private hospital capacity will also be used while non-Covid admissions will be avoided if possible to create extra capacity for pandemic-related admissions.

In a letter to hospital managers and the chief executives of the hospital groups, Mr Reid warned that “the entire health system, both hospitals and community healthcare, are now under very serious pressure”.

He said modelling from the National Public Health Emergency Team (Nphet) suggests the rise in cases “will not abate, at least in the short term”, meaning that “the pressure on our hospitals will continue to grow, and in turn the situation in ICU will continue to deteriorate”.

‘High-dependency care’

The Department of Health reported a further 4,650 cases on Thursday. The number of patients being treated in hospital was 643 (up nine on the previous day), with 118 in ICU (down one).

“If the disease continues to spread as it has in the past two weeks, we face the prospect of any remaining capacity being insufficient to meet anticipated demand,” Mr Reid wrote.

“Clinicians in ICU inform us that the system is already facing increasing difficulties in meeting the needs of patients who require specialist high-dependency care. The consequences of such an occurrence, although unthinkable, are also well-understood by each of you.”

Senior officials said the move to a crisis footing in hospitals was already under way, with many elective procedures being cancelled in recent days.

Speaking at a media briefing, Mr Reid warned of “significant” curtailment of services in some larger hospitals. Staff would be redeployed, he said, to assist frontline colleagues dealing with Covid cases.

Procedure cancellation

As a result, the level of physiotherapy, speech and language therapy, and occupational therapy provided next month is likely to be half of what it was last December. Elective procedures could be cut by as much as 65 per cent, according to HSE chief operations officer Anne O’Connor.

Meanwhile, Minister for Education Norma Foley has said antigen tests will be provided to primary school children where another child in their pod has tested positive for Covid-19.

Where two or more cases arise in a class within a seven-day period outside of the original pod, antigen testing will be offered to the full class. The tests will be made available from November 29th.

There was controversy on Thursday when the Oireachtas authorities said they would provide free antigen tests to people working in Leinster House. The Government parties immediately said that their TDs and Senators would pay for any tests.

When the matter was raised in the Dáil, Ceann Comhairle Seán O’Fearghaíl said it was not correct to say that a proposal had been made to offer Oireachtas members free tests, though this was the view of several TDs who earlier attended the Business Committee, where the plan was first raised.