Ambulances with patients were left waiting outside Letterkenny University Hospital last night as the facility was under increased pressure due to Covid-19.
The Irish Nurses and Midwives Organisation (INMO) has raised concerns about staffing levels at the hospital.
Neil Donohoe, the INMO's regional representative, said at one stage there were seven ambulances in the queue outside the hospital and there had been concern about delayed care which could have led to “disastrous outcomes".
Letterkenny hospital has been under pressure since before Christmas, he said, adding: “There has been no let up.”
While the vaccination programme provided “light at the end of the tunnel,” staff are “just burnt out,” he told RTÉ's Morning Ireland.
Mr Donohoe called on the HSE to invoke its major emergency plan as staffing levels are under pressure because some have the virus, others are close contacts and some staff have had to take leave because they have no childminding support.
When asked about the possibility of the HSE instructing nurses who were close contacts to return to work, Mr Donohoe said such a derogation policy is a risk and would be counter-productive.
The hospital has since apologised for the delays.
In a statement, LUH said: "It has been an extremely busy weekend at Letterkenny University Hospital. Throughout the weekend there has been a large number of patients presenting with suspect or confirmed Covid-19, many of whom required admission to the hospital.
"As a result of the sustained level of these presentations over the course of today, the hospital has had few beds available, which has resulted in delays in admission specifically for patients going to the dedicated Covid-19 zone. As part of the hospital’s response to this serious situation, clinical teams assessed patients who were delayed being admitted from the ambulance. This was to ensure that patients were treated in clinical priority."
The hospital confirmed it has secured additional staff, "which is enabling it to open a further 11 beds in order to respond to the demand.
"While there were ambulances delayed late this afternoon, over the course of the evening they have, and continue to be released.
"The hospital would like to apologise to patients for the distress that these delays cause and would like to acknowledge the huge effort of its staff."
Infectious diseases expert Professor Paddy Mallon says this situation could be repeated in other hospitals.
“What happened in Letterkenny is that they have a pathway for patients presenting with Covid and then they have a pathway for patients that present without Covid,” he explained adding that other hospitals have similar operations.
“If you have a big surge of people coming into hospital with either confirmed or suspected Covid, there’s only a limited capacity at the front of house to manage those patients safely.”
Prof Mallon has warned that all the indications are that “things will get worse before they get better” with Covid cases.
Figures in the North were expected to double in the coming weeks, he said, and the same thing could happen here, he told Newstalk Breakfast.
“I think things are going to get a lot worse before they get better. I would really appeal to everyone in the country to treat this with the seriousness it deserves because the worst is yet to come given the numbers we have at the moment.” The only solution was for everyone in the community to go back to behaving the way they did during the first wave last March, he said. It was no longer about stabilising numbers. The numbers had to be “crushed”.
The scenes outside Letterkenny Hospital on Sunday could happen in any other hospital around the country, including St Vincent’s hospital in Dublin where he works, he said.
Meanwhile, an intensive care consultant has moved to reassure nurses who have been redeployed to intensive care units that they will receive every support from ICU colleagues.
Dr Michael Power told Morning Ireland that 1,300 nurses had received intensive care training since last April and they were now being identified so they could be approached and redeployed.
The availability of staff was a key issue in the provision of intensive care beds, he explained.
Dr Power acknowledged there was concern at the steady daily increase in Covid patients in intensive care units. There had been 19 in the last 24 hours, he said, last week it was between 10 and 20 per day, but only four were discharged on Sunday.
There has been “a constant increase in presentations,’ he said.
When asked about the prospect of the “rationing” of critical care, Dr Power said that would not apply at the moment and that each patient was dealt with on a case by case basis in consultation with their family.
Dr Power said that at present there 292 ICU beds, up from 282 last week, and that there were 37 critical care beds available. Some hospitals had called the intensive care ambulance service to transport critically ill patients from one hospital to another to alleviate pressure.
The oxygen supply situation had improved since March and April, he said with a 50% increase in supply, however there were some “flow” problems internally with hospitals exercising “oxygen economy” which meant “enough but not too much.”
It comes as an alert was issued to staff at South West Acute Hospital in Enniskillen appealing for them to go directly to the hospital due to increasing pressures on the healthcare system regionally on Sunday night.
South West Acute Hospital said: “Attention all off-duty staff in the vicinity of SWAH. Due to increasing pressures this evening on the NI Healthcare System, we are appealing to you to contact or go directly to the hospital. Thank You.”
On Sunday, eight further deaths due to coronavirus have been reported in Ireland.
An additional 6,888 new cases of the virus were also confirmed by the Department of Health.
Of the new cases, 2,088 were in Dublin, 862 in Cork, 469 in Limerick, 405 in Wexford, 320 in Waterford and the remaining 2,744 cases are spread across all other counties.
The North saw a further 17 deaths due to Covid-19 and 1,112 additional positive cases.