Up to half of all people booked for Covid-19 boosters in some vaccination centres are failing to turn up, according to HSE chief executive Paul Reid.
Although the booster campaign was progressing well, there is a high level of people not coming forward, Mr Reid said, with “no show” rates of 25-50 per cent in come centres.
This may be due to a “sense of security” given people are vaccinated, he speculated at a media briefing on Thursday.
Mr Reid warned of “significant” curtailment of services in some larger hospitals to allow priority to be given to coronavirus patients and non-coronavirus urgent care.
The HSE boss has written to all services outlining the actions being taken. Each of the model 4 hospitals will identify surge intensive care unit (ICU) beds, to be supported by the redeployment of staff from other activities they will have to curtail, he explained.
As a result, the level of physiotherapy, speech and language therapy and occupational therapy being provided next month may be 53 per cent less than in December 2020, the briefing heard.
Covid-enforced cancellations could also mean elective procedures cut by 65 per cent, according to HSE chief operations officer Anne O’Connor.
Mr Reid said health staff are under an “inconceivable level of strain” and “at their wits’ end” due to the current virus wave. “Any organisation that had to deal with one wave of Covid would be extremely challenged. To have to deal with four waves, plus a cyberattack . . . many organisations would not have survived.”
The level of risk and impact from the virus is higher now than at any other time in the pandemic, he said.
Outlining actions the HSE will take to deal with the current surge, Mr Reid said staff will be redeployed to assist frontline colleagues and this will lead to curtailment of elective care.
Planned use of private hospital capacity is being increased from 1,100 bed-days a week to 3,000 in the coming weeks. Testing capacity will be expanded to new centres with increased throughput and private operators will also carry out testing.
The vaccination programme will also be expanded so more boosters can be administered, he added.
‘Lost a lot of staff’
The HSE had had to wait "a number of weeks" while the National Immunisation Advisory Committee made recommendations on expanding the programme, during which it "lost a lot of staff".
Mr Reid said he would be very concerned if the new rule requiring close contacts to self-isolate for five days while taking antigen tests were applied to healthcare workers.
The HSE is working out the details of a derogation that would allow its staff continue to work under monitored conditions, he said.
On Thursday, there were 643 Covid-19 patients in hospital, up 20 per cent in a week and 40 per cent in the last fortnight. This includes 118 patients in ICU, up 34 per cent in the last week and 38 per cent in the last two weeks.
Since the end of June, 43 per cent of hospital patients with the virus were unvaccinated.
“The reality of it is patients from less than 10 per cent of the eligible population in terms of vaccination are taking up 43 per cent of the Covid beds, whilst patients from 90 per cent of the eligible population, ie: those who have been vaccinated, are taking up just 54 per cent,” Mr Reid said.
Last January, the more than 200 patients then in ICU represented about 10 per cent of total hospitalisations, he said.
At present about 19 per cent of total Covid-19 hospitalisations are patients in ICU.
While there is much discussion on antigen testing and the booster programme, these are not “magic wands” and will not solve the situation instantly.