Warning on future of emergency departments in wake of Covid-19

Without segregation ‘virus could spread like bush fire’, says emergency medicine group

Although emergency departments have been less busy since coronavirus emerged, admissions to hospital wards have remained more or less the same. File photograph: The Irish Times

Although emergency departments have been less busy since coronavirus emerged, admissions to hospital wards have remained more or less the same. File photograph: The Irish Times

 

Emergency departments (EDs) in hospitals cannot be allowed to become “reservoirs” for future outbreaks of Covid-19 due to a lack of investment in infrastructure, doctors have warned.

While EDs are segregated to create a separate pathway for suspected Covid-19 cases, the Irish Association for Emergency Medicine has warned that investment is required to enable sufficient levels of future physical distancing.

If that is not done, they have said, there is a real danger of crowded departments becoming a breeding ground for the virus.

“If it happens it would spread like a bush fire,” said a spokesman.

On Tuesday the association called for investment in EDs, a treatment area under less pressure since the outbreak but one they feel could come under particular threat in the future.

While they have said safeguards such as increased space and additional isolation capacity are required to reduce the risks posed by infectious diseases in general and particularly seasonal flu, Covid-19 is now the obvious focus of concern.

The body also said staffing “must be adequate to compensate for the extra time required in certain patient encounters in safely putting on and taking off personal protective equipment.”

Are people still tightly packed?

Although EDs have been less busy since the emergence of the coronavirus, the level of admissions to hospital wards has remained more or less the same, said the association.

For now the departments have effectively been cut in two to isolate suspected cases from other hospital patients. But the association says the virus will be here for some time and its services, much like transport, will have to adapt safely.

Until now, said the spokesman, the normal scene in a typical ED is people packed tightly in waiting areas and separated only by a curtain once assessed by medical staff.

In recent weeks the number of people waiting on trolleys in public hospitals has fallen dramatically. But the fear is that this number – a key indicator of stress on the system and physical presence in EDs – could begin to creep back up once relatively normal hospital activity resumes.

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