Trainee doctors cover ICU shifts as Covid-crisis worsens

Cork University Hospital. Picture: Dan Linehan

Trainee doctors have been asked to cover intensive care nursing shifts as hospitals brace for a surge in Covid-19 cases.

With hundreds of frontline medical staff unavailable for work because of the virus, HSE chief executive Paul Reid warned yesterday that the number of people in hospital with Covid-19 is likely to be “double” last year's peak of 881 within days.

The number of Covid-19 patients in hospital has more than quadrupled in the last two weeks, but Mr Reid said the system still has ICU beds capacity.

However, there is a significant reduction in the number of qualified staff required to staff the beds, either because they have Covid-19 or are deemed to be close contacts of a confirmed case.

Cork University Hospital was caring for 126 Covid-19 patients at the weekend — around 20% of all of its inpatients.

However, at least 30 of its 130 intensive care nursing staff are not available for work because of the virus.

Medical staff were told there is a “severe and abrupt shortage” of ICU nurses for that night's shift in its Covid-19 ICU.

Management appealed for at least two trainee doctors to step forward to cover the shifts to help ICU nurses care for a ventilated patient.

UL Hospitals Group chief executive Colette Cowan. Picture: Liam Burke/Press 22

UL Hospitals Group chief executive Colette Cowan said 427 staff were unavailable for work across Limerick, Clare, and Tipperary due to the virus — up from 140 in just four days.

University Hospital Limerick was caring for 109 confirmed cases on Saturday.

In an email to politicians on Friday, Ms Cowan said the total number of Covid-19 patients within the group as of last Wednesday “exceeds the maximum experienced during the peak of the first wave” and that “in recent days we have been admitting about 10 new Covid patients per day”.

“Our staff retrained and redeployed to support this critical care surge capacity during the first wave and are ready to do so again when required, if demand exceeds current capacity,” she said.

She said attendances at UHL's emergency department ranged between 138 and 205 patients per day last week, but she warned, “the incidence of Covid-19 in the community means that we are facing significant challenges in discharging patients to long-term care facilities and stepping patients down for rehabilitation”.

However, she said UHL has opened a 60-bed block and this “additional single-room capacity is having a very real immediate impact in allowing us to isolate and treat Covid-19 patients” with “two of the three wards currently designated Covid-19 wards”.

Ms Cowan also noted “some hope for the region with the delivery to UL Hospitals Group of more than 1,500 Pfizer/BioNTech vaccines this week”, with 650 staff in total vaccinated up to last Tuesday, with plans to vaccinate some 1,500 staff within days.

She said: “While there is a renewed sense of hope, it is vital that we do not become complacent during this dangerous new phase of the pandemic”.

Limerick Fine Gael councillor Daniel Butler said he was concerned that Limerick and other parts will exceed their ICU bed capacity within days.

“The scale of transmission at the moment is hugely significant, and we’ve seen, day by day, increases in admittance to ICU and into the hospital system,” he said. "I’d be very worried about ICU bed capacity.

“My gut tells me that we might exceed bed capacity next week — that would be my real concern. The figures are only going in one way at the moment, and I think we could be looking at dipping into surgical capacity that the HSE has secured.”

According to the INMO’s latest trolley watch figures, 178 admitted patients are waiting for beds this morning in Irish hospitals.

168 patients are waiting in the emergency department, while 10 are in wards elsewhere in the hospital.

Two Munster hospitals are among the worst hit in the INMO figures.

University Hospital Limerick has 38 patients waiting for beds, while Cork University Hospital has 37.

The Mercy Hospital in Cork is joint third on the INMO with Letterkenny University Hospital both with 13 patients waiting on trolleys.