Medic warns of Covid-19 'outbreak centres' at A&Es amid mounting congestion

Doctors  reporting a pattern in admissions to hospitals where people have come from holidays in non-green list countries and need to be isolated and swabbed for the virus
Medic warns of Covid-19 'outbreak centres' at A&Es amid mounting congestion

A leading consultant has warned hospital emergency departments (EDs) will turn into Covid-19 "outbreak centres" if mounting congestion in EDs is not addressed. Picture: Larry Cummins

A leading consultant has warned hospital emergency departments (EDs) will turn into Covid-19 "outbreak centres" if mounting congestion in EDs is not addressed.

Doctors are also reporting a pattern in admissions to hospitals where people have come from holidays in non-green list countries and need to be isolated and swabbed for the virus.

Dr Conor Deasy, a consultant in emergency medicine at Cork University Hospital, said there has been a surge in the number of patients attending his ED.

“We need to pay the same attention to containing this virus as we did back in March,” Dr Deasy said. 

“We need to protect emergency departments so that they can function effectively for those patients who have true emergencies. We also need to do our best to reduce congestion in emergency departments so they don’t become an outbreak centre for Covid-19."

He said health staff are doing everything according to the national guidelines.

"But if we’ve got people here that don’t need to be here, it creates congestion. We don’t have the same ability as restaurants have where you have to ring up in advance to say you're coming in.

“It’s an emergency department so it should be for emergencies. So, if you’re sick enough to be able to pre-book arguably you don’t necessarily need to be coming to an emergency department.” 

Dr Deasy said “an element of complacency” has drifted in with people coming to the ED and not realising that they needed to consider if it was the best place for them to receive treatment.

Doors have been put on cubicles to replace curtains in the ED but the basic infrastructure has not changed.

“Social distancing when you’ve got 242 patients as we did on Monday, is very challenging," he said. 

According to the TrolleyGAR compiled by the HSE’s Special Delivery Unit, CUH had 31 patients on trolleys in the emergency department and 12 had been waiting more than nine hours.

University Hospital Limerick had the second-highest number of patients waiting, with 17, and 11 were waiting over nine hours.

Prof Mary Higgins, an obstetrician and maternal-fetal medicine specialist based in the National Maternity Hospital, said the hospital has noticed that some patients have not isolated after returning from travelling to non-green list countries.

"This means that if they have Covid-19 they are putting other women and the staff who look after them at risk."

Dr Ray Walley, GP advisor to the HSE GP Expert Advisory Group on Covid-19, said they are hearing from GPs that some people displaying symptoms of Covid-19 are turning up at testing centres with the rest of their family in the car and with the vehicle packed with shopping bags.

“If you are being referred for a test and you’re driving yourself, that’s fine, but you don’t want to arrive with a group of people in your car if they’re well.," he said.

GPs are also hearing anecdotally that people have experienced symptoms of Covid-19 for seven or eight days before deciding to telephone their GP.

He said some people had become highly complacent in the last three weeks and the messaging will have to be changed to encourage people to become more pro-active.

“If your husband, wife or partner is doing the wrong thing you need to them up on that because the person who is closest to you is the one most likely to infect you.” 

Last night, the Health Protection Surveillance Centre (HPSC) announced a further 92 confirmed cases of Covid-19, bringing the total number of confirmed cases to 26,929. There were no new deaths.

The HPSC said 43 of the new cases are associated with outbreaks or close contacts of a confirmed case, with 12 cases identified as community transmission.

A breakdown of the figures shows that 24 cases are in Dublin, 24 in Kildare, 8 in Limerick, six in both Carlow and Kilkenny, five in both Meath and Clare, and remaining 14 cases are in Cork, Donegal, Kerry, Laois, Louth, Monaghan, Offaly, Waterford and Wicklow.

Meanwhile, in England, 292 people have tested positive for Covid-19 after an outbreak at a sandwich factory in Northampton, run by the Irish convenience food giant, Greencore.

A spokeswoman for Northamptonshire County Council said 79 people returned positive NHS tests and a further 213 tested positive through Greencore's private testing.

The company took the decision to proactively test workers as a result of a rise in cases in the town.

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