Hospital overcrowding: Flu kills 7 in just 14 days as A&Es struggle

Seven people have died of influenza, six in the space of a fortnight, at a time when emergency departments (EDs) are besieged by patients affected by the flu virus and the winter vomiting bug.

Up to December 18, one person had died. By January 1, the number had jumped 600% to seven, according to the Health Protection Surveillance Centre (HPSC).

The majority of hospitalisations are among the over-65s. The current flu vaccine is just 50%-60% effective in preventing hospitalisation among elderly people living in long-term care. However, it is 70%-80% effective in preventing death.

Experts at the HPSC have also analysed the norovirus (winter vomiting bug) and found that, in the five weeks to December 19, the number of cases rose from 29 to 97.

Writing in Epi-Insight, the HSE online bulletin, specialist in public health medicine Paul McKeown said the “heightened norovirus activity” was mirrored across Europe “providing additional confirmation that we are entering a period of generalised upsurge”.

“In the past, when upsurge periods such as these have commenced in the final weeks of the year, they are typically sustained for about 8-12 weeks,” said Dr McKeown. “In other words, we can expect this level of heightened norovirus activity to continue until at least the end of February.”

None of this is good news for Health Minister Simon Harris who is under increasing pressure to provide a more long-term solution to the perennial ED crisis.

Following a meeting of the ED task force yesterday morning, the minister said he was determined to break the “vicious cycle” of annual ED chaos.

Increasing bed capacity, addressing staff retention and an expanded role for GPs under a new GP contract were key to addressing the crisis he said. In the short-term, additional beds are being provided, including 63 in the acute hospitals. Mr Harris said the effects of this would be “immediate”, but Liam Doran, the general secretary of the Irish Nurses and Midwives Organisation (INMO), said there was an “element of recycling” in the figure of 63; that 55 had been promised last September and just 17 provided. He also said the effects would not be immediate, that it would be eight to 10 weeks in the case of some hospitals. While Mr Harris said Galway would provide 28 beds immediately, Mr Doran said the hospital had issued a circular cancelling all nursing leave in order to staff these beds.

The ability of private hospitals to play any significant role in resolving the ED crisis was also debatable. In Cork, where the Mater Private and the Bon Secours have been accepting patients redirected from the EDs at Mercy University Hospital (MUH) and Cork University Hospital (CUH) since the start of December, just 29 patients have been referred. A spokesperson for MUH said those transferred were low acuity patients with no discharge issues.

“More patients would have been transferred if the Mater Private were in position to accept higher acuity patients,” the spokesperson said.

A spokesperson for CUH said those transferred were medical and surgical patients who are due to be discharged in 2 or 3 days.

Mr Doran said resolving the ED crisis required “changing how hospitals work” so that senior clinical decision-makers — hospital consultants — were present at weekends.

He said consultants were the “pivotal grade” in a hospital, deciding who was admitted and who went home but that “no one wants to tread on their toes”. He said nurses intended to press ahead with industrial action next month unless their demands to invest in the health service are addressed.

“If it happens, it will be regrettable, but my members have had enough,” he said.

Talks are due to take place next week between the INMO, HSE and the Department of Health in an effort to avert a strike.

Yesterday, the number of patients on trolleys had reduced to 396, from a mid-week high of 612.