Hospital ICUs activate ‘surge plans’ for Covid wave

Tallaght director calls for ‘one big last push’ from the public to protect hospitals

The number of coronavirus patients in intensive care units has more than doubled to 76 in just one week. Photograph: Alan Betson

The number of coronavirus patients in intensive care units has more than doubled to 76 in just one week. Photograph: Alan Betson

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Intensive care units are ramping up preparations to be ready for a further increase in the number of critically ill patients with coronavirus in the pandemic’s third wave, doctors have said.

The number of coronavirus patients in intensive care units has more than doubled to 76 in just one week as Covid-19 infections reach record levels not seen during the nine-month pandemic. There were a further nine patients admitted to hospital ICUs across the country in a 24-hour period.

“Everybody is tired and pressured,” said Prof Paul Ridgway, perioperative director and consultant surgeon at Tallaght University Hospital.

The hospital had been “significantly pressured” earlier than other large hospitals and described the current wave as “an extension of a second wave” rather than a third wave.

The south Dublin hospital has cancelled all but the most pressing elective and emergency surgeries to free up ICU space and staff to handle an increase in Covid-19 cases on top of non-coronavirus critical care, making this wave of the pandemic more complicated than the first in the spring.

Infections

“This time around we are dealing with normal loads of Covid-negative patients and then on top of that with the Covid situation. It has been sort of heaped on top of what is a normal load of non-Covid patients,” said Prof Ridgway.

He called for “one big last push” from the public to adhere to Level 5 restrictions to prevent further infections spreading in the community through social contacts.

“We need one last push. We have a vaccine. There is light at the end of the tunnel but this will not be won in the hospitals or indeed in the intensive care units,” he said.

“This will be won in society and how people behave over the next six weeks.”

HSE chief executive Paul Reid said on Tuesday that the health service was “under real threat now” and heading for “the peak of hospitalisations” seen in the first wave of the pandemic.

At the worst point of the first wave, in mid-April, there were 881 people with Covid-19 hospitalised and 155 patients with Covid-19 in ICUs.

Tallaght University Hospital is using its ICU unit as a specialised Covid ICU area and treating other ICU patients in the hospital’s recovery theatre and a post-operative care unit.

Care needs

“We had to take the decision yesterday to further limit our elective capability in order to provide staff and space to deal with our critical care needs,” said Prof Ridgway.

Dr Michael Power, critical care consultant at Beaumont Hospital in Dublin, said preparations were being taken right across hospitals “to be ready for the predicted very high ICU figures”.

“Many hospitals across Ireland have already now activated surge ICU capacity plans and have set up additional ICU beds and even additional ICUs,” he said.

“Thankfully, there are many nurses across Ireland’s hospitals with ICU training. Hospitals are redeploying these trained ICU nurses now from existing services to the ICUs to work in teams alongside permanent ICU nurses to meet the patients’ needs.”

Dr Power said hospitals were “working flat out” to provide ventilators and other required medical devices and to maintain adequate oxygen supplies to meet the needs of patients.

ICU admissions were running at about half of the capacity they were at during the first wave in March and April, he said.

Frontline staff were “wary that Covid may strike colleagues” and diminish hospital workforces at this time and were taking every precaution with personal protective equipment, he said.

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