Covid-19: Health service needs to prepare for 'subsequent waves' of the virus

HSE CEO Paul Reid: 'Even with a vaccine, the reality is that we will be dealing with Covid-19 for a long time yet.'
Covid-19: Health service needs to prepare for 'subsequent waves' of the virus

HSE chief Paul Reid says behavioural, societal and healthcare changes will be needed to handle Covid-19. File Picture: Leon Farrell / Photocall Ireland

The health service needs to plan for "subsequent waves of Covid-19", the head of the HSE has warned.

Even with the development of a vaccine, societal changes will be needed, Paul Reid told the Oireachtas Covid Committee.

He added that a difficult winter and a resurgence of Covid-19 is "the worst possible scenario for our health services".

“While this is an eventuality that we hope to avoid, it is also a scenario for which we have been carefully planning,” Mr Reid said.

“Even with a vaccine, the reality is that we will be dealing with Covid-19 for a long time yet. We must all adapt our way of life through a combination of behavioural, societal, and healthcare delivery changes,” he added.

The meeting heard that 27 people had died from Covid-19 during the month of September and that 114 people remain in hospital with the virus, of which 17 are in intensive care.

The number of ICU beds has increased from a low base of 225 to 280 at present and will increase by a further 17 under the HSE’s €600m winter plan, but bed numbers remain significantly short of the 579 recommended in a capacity review.

“We monitor this quite closely and we are at 41 available today and it is always tight,” Mr Reid said.

“We have had a surge capacity before and we wouldn’t like to trigger it again but hospitals do have very clear procedures to increase surge capacity as required,” he added.

A rise in infections among healthcare workers was also of concern, he said. 

“We’re seeing an increasing trend of numbers of staff being absent due to Covid-related issues and that’s what we need to protect against.” 

Mr Reid was among a number of health officials to appear before the Oireachtas committee, where questions arose about testing capacity, turnaround times, and costs.

The HSE expects to spend €450m on Covid testing and tracing alone this year and costs are expected to run to €700m next year.

Around two-thirds of all tests come from the community and 90% are turned around in two days, but positive test results can take a day longer to communicate by phone. It is taking 3.5 days to process samples, issue results, and carry out contact tracing, the committee heard.

The current recruitment of 700 swabbers, 500 contact tracing staff and 158 public health staff will build capacity in the system, Mr Reid said.

“We’re modelling it out through winter. If we keep running the way this virus is running at the minute we will need more capacity in our labs and that’s something we’re continuously looking at and engaging on.” 

Director of the Health Protection Surveillance Centre, Dr John Cuddihy, confirmed a new questionnaire would be rolled out to ascertain people’s movements over a 14-day period as part of an enhanced retrospective contact tracing system to identify possible sources of infection and outbreaks.

On the issue of rapid tests, health officials said a range of alternatives were being examined to see what role they could play in testing and screening for Covid-19.

On serial testing, the meeting heard that 182,000 tests were carried out in nursing homes, 21,600 in food processing plants, and 3,214 in direct provisions centres, all of which yielded low rates of infection to date.

Asked whether further restrictions could be applied to smaller geographical areas rather than an entire county, Mr Reid said it would be a matter for the National Emergency Public Health Team (NPHET) but that it was his view that more localised restrictions could be problematic for people to adhere to.

Committee members expressed frustration that NPHET failed to appear before the committee in the past two weeks.

The hearing was among the last due before the Covid committee, which will conclude tomorrow after Health Minister Stephen Donnelly appears at the final meeting.

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