It may be autumn before we can safely meet again, warns Cork ICU expert 

It may be autumn before we can safely meet again, warns Cork ICU expert 

A CORK former president of the Intensive Care Society of Ireland has predicted that it may be late autumn before enough vaccinations are administered for people to safely meet again. Picture Denis Minihane.

A CORK former president of the Intensive Care Society of Ireland has predicted that it may be late autumn before enough vaccinations are administered for people to safely meet again.

It comes as concern mounts around the large numbers of people with Covid-19 requiring hospital care with 1,975 Covid-19 patients hospitalised nationally yesterday, of which 200 were in ICU.

On Sunday night, there were 213 people in Cork with Covid-19 receiving care at hospitals in the city.

Twenty-two people with Covid-19 were in critical care units across Cork University Hospital and the Mercy University Hospital.

Head of the ICU at the Mid Western University Regional hospital in Limerick, Dr Catherine Motherway, who hails from Ladysbridge in East Cork, said that two-thirds of ICU capacity is now made up of Covid-patients.

She said that having so many patients battling the same condition is highly unusual in an ICU setting.

"Intensive care units across Ireland are always busy," she said of the ICU where she is based. "We are used to that pressure but there is always worry around where we are going to get the next bed from. There are a lot of young people across the age spectrum with covid-19 who have experienced a severe shortage of breath and require high levels of oxygen and respiratory support."

Longer ICU stays being witnessed

Dr Motherway added that the average hospital stay of an ICU patient nationally has now increased significantly.

"There are around 300 people in intensive care and two-thirds of them have Covid. It's really unusual for so many patients to be dealing with the same disease. People who get sick with Covid stay a long time. They stay an average of two weeks. Normally, the majority of ICU patients are only admitted for five or six days but our critical care resources are now dedicated to this one disease."

Dr Catherine Motherway, former President of the Intensive Care Society of Ireland said it may be late autumn before people can safely meet again. Photograph: Leon Farrell / Photocall Ireland
Dr Catherine Motherway, former President of the Intensive Care Society of Ireland said it may be late autumn before people can safely meet again. Photograph: Leon Farrell / Photocall Ireland

The festive season had been an extremely difficult time for Dr Motherway and her colleagues.

"We were worried about Christmas because we knew that people would want to get together. We knew that generations would meet. With the best will in the world, there was always going to be intergenerational mixing. It was known that if young people got it they would transmit it, unknowingly and unwillingly. The numbers rocketed and now we are seeing resulting hospitalisations and unfortunately deaths."

She added that the number of lives saved will depend on the population's adherence to public health guidelines.

"I know it's boring at home. I know it's hard to look outside your window in the middle of winter and see that there is little to look forward to. Nonetheless, we need to control the rate of transmission in the community to treat everybody who contracts the disease. It's a big ask because as Irish people we love to sing. We love eating out and sports. At the moment all that has to be put on hold but it's for a very good reason."

Healthcare system needs support of public 

Dr Motherway emphasised that the healthcare system will be unable to contain the virus without the support of the Irish people.

"Very advanced healthcare systems including that of North Italy's were so overwhelmed when they had unmitigated viral transmission. We saw people across the entire spectrum requiring hospital care. The only thing we can do while we are waiting for a vaccination programme to roll out is bide our time. Life will return to near normal eventually but this is going to take a good few months. We need to limit our contacts down to whoever is necessary even though I understand this has been very difficult for us all. I imagine it will be late Autumn before there will be enough people vaccinated for us all to get back together again. It's going to be much slower this time around. We were so good in the first and second surge that this third surge was unexpected."

CMO voices capacity concerns 

Last night, Dr Tony Holohan, Chief Medical Officer at the Department of Health detailed how the third wave of the pandemic has seen higher levels of hospitalisations across all age groups.

Dr Tony Holohan, Chief Medical Officer, Department of Health. Picture Colin Keegan, Collins Dublin
Dr Tony Holohan, Chief Medical Officer, Department of Health. Picture Colin Keegan, Collins Dublin

“There are now more sick people in hospital than any time in the course of this pandemic.”

Dr Holohan expressed serious concerns about the surge in hospitalisations and the lack of critical care beds available.

Figures from Sunday showed there were just 22 critical care beds available nationally, with only one bed available in Cork.

“The current levels of infection we’ve had have essentially forced us into a situation where we now have to make those beds [critical care beds] available for Covid, which means they’re not available for all of the significant, potentially life threatening acute medical and surgical needs that either arise out of emergencies or as a result of the need to provide urgent care.

“We want those beds not to be given up to a preventable illness,” he said.

Second week of surge plans 

Dr Vida Hamilton, national clinical advisor and group lead of acute hospitals with the HSE said the HSE has now had to implement its national critical care surge plans for the first time since the pandemic.

“This is the second week that we’ve been in surge.

“Our critical care nurse escalation plan is in place at the moment.

“It starts out with a buddy system, where a non-critical care nurse works with a critical care nurse to care for a single patient and then as surge escalates we have the one critical care nurse supervising two then three non-critical care nurses.

“I have to thank very much our non-critical care staff, both nursing and medical, who are stepping up to take on these additional challenges working with very difficult patients in high tech environments that they’re unfamiliar with,” she said.

Meanwhile, Sinn Féin's Thomas Gould said more ICU beds are urgently needed.

“There needs to be a change of strategy. The government needs to decide that we have to have additional ICU beds,” he said.

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