Covid-19: Staff levels in 'freefall' across health service

CUH set to trigger emergency 'tiered escalation plan' as appointments across adult hospitals suspended due to deepening coronavirus crisis
Covid-19: Staff levels in 'freefall' across health service

At Cork University Hospital, 180 of 1,400 nurses were unavailable for work this week because they had the virus, or were close contacts of a confirmed case, or self-isolating. Picture: Dan Linehan

Cork University Hospital (CUH) is poised to trigger an emergency “tiered escalation plan” to manage an unfolding Covid-19 crisis that has left staffing levels in “freefall” across the health service. 

The HSE confirmed yesterday that inpatient, daycase, and outpatient appointments at all adult hospitals were being suspended in light of the deepening Covid-19 crisis. 

The move to suspend non-urgent services comes as a further 10 deaths and 6,521 infections were confirmed and as the number of patients in hospital with Covid-19 exceeded 1,000 yesterday.

The suspension of non-urgent activity, the HSE said, would be reviewed on a weekly basis and urgent and emergency care would continue to operate.

“The coming weeks will see an ongoing and significant increased demand for hospital bed capacity related to Covid-19 based upon the data now available. This decision to curtail services is to ensure hospitals are as prepared as possible to manage the projected increased demand for hospital care in the coming weeks,” a HSE spokesperson said.

The escalating crisis has also forced Children’s Health Ireland (CHI) to curtail services to emergency, urgent, and time-sensitive procedures and care.

The National Public Health Emergency Team (Nphet) has expressed concern over the role of the new Covid-19 variant in accelerating the spread of the disease.

Professor Philip Nolan, chairman of the Nphet Epidemiological Modelling Group, said modelling showed a possibility of between 1,500 and 2,500 people in hospital by mid-January depending on how the current restrictions impact on transmission.

“We are clearly reporting exceptionally high levels of disease and the fastest rate of growth, we have a considerable way to go to suppress the virus,” Prof Nolan said.

The Irish Nurses and Midwives Organisation also warned that staffing levels were in “freefall” as staff rosters were “decimated” by Covid absences, surging patient numbers, and a lack of childcare for frontline staff.

INMO president and nurse Karen McGowan said the union’s executive council will hold an emergency meeting today to discuss the unfolding crisis.

“The staffing situation has reached dire levels in many hospitals. I am getting constant reports from colleagues across the country, speaking of wards closing, rosters unfilled, and services under pressure and unmanageable workloads,” Ms McGowan said.

“The Government do not seem to understand the severe staffing pressures happening at the moment,” she said.

At CUH, some 180 of 1,400 nurses were unavailable for work this week because they had the virus, were close contacts of a confirmed case, or were self-isolating.

Of its 130 critical care nurses, 30 were unavailable for work for the same reasons.

One ward at CUH has already been closed because of the staffing shortage.

Medical staff at CUH were told that hospital management is likely to move away from the regular team-based or speciality-based approach to a ward-based approach.

A source said this meant that staff levels look set to reach such a critical level, that the focus will be on just keeping wards open and beds staffed.

Internal CUH staff correspondence, seen by the Irish Examiner, shows just how concerned managers are about the evolving situation.

Medics have been told that given the large number of Covid-19 cases in the community, the widespread rate of community transmission, more hospitalisations can be expected, and that the situation will likely escalate significantly over the coming days and weeks.

Meanwhile, opposition politicians were informed that ICU levels could reach a peak of 400 while surge capacity currently stands at 350.

Separately HSE chief Paul Reid said "good progress" had been made in talks with private hospitals to provide extra capacity during the crisis and he urged them to "put on the green jersey at a time of national need".

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