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covid fears Experts raised 'deep concerns' with Nphet over hospital capacity and exhausted staff ahead of lockdown

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Staff in hospitals have difficult months ahead

Staff in hospitals have difficult months ahead

Staff in hospitals have difficult months ahead

EXHAUSTED staff, a sharp increase in the number of hospital-acquired Covid-19 cases and “deep concerns” over capacity were just some of the fears raised by experts ahead of the last lockdown.

The issues about acute hospital preparedness ahead of the decision to lock the country down in October are revealed in an internal paper for the National Public Health Emergency Team (Nphet).

The joint Department of Health and HSE paper on Acute Hospitals Preparedness, presented to Nphet on October 15, warned that the situation in acute hospitals was “much more complicated” than during the first Covid-19 peak and that the sector was becoming increasingly challenged.

The paper, released under Freedom of Information legislation, was presented on the same day that chief medical officer Tony Holohan wrote to Health Minister Stephen Donnelly to recommend the country adopt Level 5 restrictions for six weeks.

Elective care had resumed in hospitals, noted the paper, creating significant backlogs in cases; staff who had previously been redeployed to assist with caring for patients with Covid-19 had returned to their posts.

Separately, the number of patients presenting to Emergency Departments (ED) and Injury Units had returned to pre-Covid levels, “presenting difficulties in terms of patient cohorting and physical distancing in EDs”.

“Hospital occupancy rates are back at pre-Covid levels and there is very little capacity in the hospital system to respond to an increase in presentations as a result of Covid-19,” states the paper.

Measures taken in hospitals during the first wave of the pandemic were highlighted, including reconfiguring the physical layout of most emergency departments to allow for the separation of patients into two streams: those more likely to have Covid-19 and those less likely.

To facilitate streaming of patients on arrival, many sites had to acquire extra space at the entrance to EDs. Some erected tents or portable

The report noted that “one of the major deficits identified early was the lack of isolation and negative pressure rooms in EDs (used to deliver aerosol generating procedures). Some EDs had these retrofitted as part of renovations commission”.

The paper detailed data on hospital-acquired Covid-19 infections, which showed that between June 21 and September 27 there had been a total of 53 cases.

“Of these, 50 cases were detected after 24th August, illustrating both the highly infectious nature of the virus and the urgent need to make every effort possible to protect healthcare workers and patients who are receiving care in our hospitals.

“There continues to be deep concern about the capacity of our hospital system to cope with a renewed surge in the number of Covid cases,” it added.

In terms of staffing levels, challenges with “absenteeism or the requirement to self-isolate impacting staffing availability alongside redeployment of staff to support Covid response measures” were highlighted.

The report said: “Although these challenges have eased substantially since the initial phase of the pandemic, particularly with acute staff returning from Covid redeployment, there is now the question of exhaustion among frontline staff as we face into the winter period.”

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