Expert: Intensive care units lack resources to cope with coronavirus epidemic

Expert: Intensive care units lack resources to cope with coronavirus epidemic
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Intensive care units in public acute hospitals lack the resources to cope with a coronavirus epidemic, a medical expert has warned.

“You can cope with sporadic cases but if there is a large number we will struggle to cope and probably won't,” said Dr Rory Dwyer, clinical lead of the Irish National Intensive Care Unit Audit.

“But there is no doubt that if we had a major epidemic we'd lack the resources to cope with that.

The HSE has surge protocols and procedures in place but the system is already very stretched just with the existing workload.

Dr Dwyer was speaking before the launch of the ICU Audit Annual Report for 2018 from the National Office of Clinical Audit which found that a shortage of ICU beds is leading to delays in admissions of critically ill patients.

“I think we are all well aware that there are capacity issues in ICUs in Ireland. The number of beds we have per head of population is low by European standards. What the report shows is that it is leading to delayed admission to ICU because we are waiting for other patients to be discharged," he said.

Ireland has 5.2 ICU beds per 100,000 population, Britain has 7.2 and the European average is 11.5.

A capacity review by the Department of Health published in 2018 recommended an 80% increase in critical care beds – from 240 to 430, by 2031 but Dr Dwyer said the beds are needed now.

Those ICU beds would bring us up to 8.7 beds per 100,000 population, which would be a lot better than where we are now.

The report shows that bed occupancy is high, at about 88% overall and up to 96% in some units when 75% is the recommended level.

Once patients are admitted to ICU, survival rates in all units were within the expected range, indicating that the quality of care is good.

But the threshold for admission to ICU in Ireland is higher — a patient has to be sicker to be admitted because of a lack of capacity and that affects eventual survival.

“Our data shows that if you get to ICU the care is very good and equivalent to what you would get in the UK and against other health systems as well. The difficulty is getting in,” said Dr Dwyer.

Business group, Isme, says it is time for Irish employers to make plans for when cases of coronavirus are confirmed in Ireland.

“All businesses are now in a position to adopt basic levels of precaution ahead of coronavirus entering the Irish population,” the group said.

Consult with your staff, customers and suppliers. If you have Asian suppliers you need to talk to them immediately about their production and export plans.

Employers are also advised to maximise the use of remote and flexible working.

Meanwhile, recruitment platform, Indeed, expects all employees to be back in their offices today after fears of possible exposure to coronavirus were dispelled.

It emerged yesterday that family members of an employee based in Singapore who had visited a hospital caring for a coronavirus patient have all tested negative for coronavirus.

The company advised employees working in Singapore to work from home while the test results were awaited.

As an extra precaution, it deep-cleaned all three offices and also advised employees in Dublin and Sydney to work from home.

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