Covid-19: Outbreaks in three hospitals severely curtail services

Large Covid-19 outbreaks in three hospitals have severely curtailed services, with one hospital, in Naas, halting all but critical care work, according to HSE officials.

In three hospitals this week – Naas, Letterkenny and Limerick – big outbreaks of the virus have impacted on staffing, with the knock-on effect of putting wards out of action and forcing a halt to elective care.

Currently, 161 staff in the University of Limerick Hospitals Group are off work due to being cases or contacts, most of them in University Hospital Limerick, officials said.

Another 77 staff at Naas General Hospital are out, along with 55 in Letterkenny General Hospital.

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Naas hospital finds itself in the same position as last April, with only critical care being provided, according to HSE chief executive Paul Reid.

This showed the need for the public to maintain their public health behaviours. “Many a game is lost in the second half, so we need the public to stick with us and see us through the duration of level 5 restrictions,” Mr Reid said.

Most of the staff absences were due to staff being contacts rather than cases but hospitals were being hit by a “double whammy” causing severe disruption of services, HSE chief operations officer Anne O’Connor pointed out.

Range of factors

Ms O’Connor said there were a range of factors behind hospital outbreaks, and in some locations capacity and older infrastructure may be contributory factors.

In a significant change in policy, hospitals are now required to test all inpatients before admission. Pre-admission testing had been advised for inpatients, but was not practised by all hospitals. However, the guidance was changed in the past two weeks, according to HSE chief clinical officer Dr Colm Henry.

Mr Reid told the weekly HSE briefing indicators such as case numbers, positivity and numbers of contacts were all positive, while hospital and ICU numbers were “stabilised and holding”.

“We haven’t seen the significant reduction we would liked to have seen” in hospital and intensive care numbers, he said. “As long as we have the virus and its presence, it puts our system at risk.”

While recognising the hope offered by the prospect of a vaccine, he urged the public not to get “distracted” when so many steps have to be gone through before one is approved.

There are currently 287 people with Covid-19 in hospital including 39 in ICU.

The average length of stay of virus patients in hospital is 17.7 days, and for those who require an intensive care stay, 34.7 days.

Over the last seven days, 78,245 tests have been processed, with an end-to-end turnaround time from referral to test result of 1.6 days where the test is negative, and 2.2 days when it is positive.

Overall positivity rates are 3.9 per cent, and 3 per cent for children. Among the latter, rates range from 5 per cent in childcare, 2 per cent in post-primary and 2.8 per cent in primary.

Outlining a picture of continuous improvement in trends, Dr Henry said cases were declining by up to 6 per cent, the 14-day incidence now stood at 145 cases per 100,000 people against a peak of 310, and cases among young people had fallen dramatically.

On track

“If the fall is sustained, we’re on track to reach 50-100 cases a day by the beginning of December, but that depends on everyone playing their part.”

Emergency department attendances and admissions rose last week, but are still up to 15 per cent lower than the same time last year.

More than 500,000 patients have been seen in virtual clinics set up during the pandemic, Ms O’Connor said. The did not attend rate, at 1 per cent, is much lower than with normal clinics.

She said there were currently 161 people in Citywest, including 68 people in self-isolation and 93 healthcare workers.

Asked whether people should be booking holidays to come home for Christmas, Mr Reid said it was “far too early” to call this either way.

“The next few weeks is our immediate lens, for people to hold their resilience. It is all very volatile. We would be reluctant to look beyond December 1st” when Level 5 measures are due to end.

Asked whether the HSE should order more flu vaccine to meet increased demand this winter, Mr Reid said this was not possible. This year’s order was 20 per cent higher than last year’s, he pointed out.