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HSE CEO PAUL Reid yesterday warned the health service is now “under real threat” as we had towards Covid-19 hospitalisation rates last seen at the peak of the first wave.
There are 921 patients in hospital with Covid-19 today, with 75 people in intensive care. Hospital numbers peaked at 881 in mid-April last year.
Liam Woods, HSE national director of acute operations, told RTÉ’s Morning Ireland that he has never seen “a threat at this scale growing this quickly. And so that’s why we’re responding in the way we are”.
Despite plans announced in September last year to bring the number of critical care beds to 321, it has not increased significantly.
Last year, before the Covid-19 pandemic, there were 225 ICU beds in the public system. Temporary surge capacity in the earlier part of the pandemic brought this number to 354.
These were temporary beds, however, such as high dependency unit beds, preoperative and postoperative theatre beds which were brought back into service when non-Covid services resumed.
In September, when the HSE’s Winter Plan was unveiled, permanent capacity was at 280, with plans for an additional 17 ICU beds.
According to the HSE there are 287 fully-staffed public ICU beds. Yesterday 255 of the adult critical care beds were occupied – including 75 by Covid-19 patients – and 20 paediatric critical care beds were occupied.
The HSE said the number of available beds on a daily basis may differ subject to staffing and Covid-related absenteeism is a factor in this,
Yesterday Liam Woods said surge plans allow for this to grow to around 350 with a “reasonable standard of normal ICU care provision”.
After this point, he said hospitals would continue to care for patients but “the level of care is not the same”. He said significant training had taken place, but short-term training cannot replace permanent clinical staff running ICU capacity.
The HSE is also currently in talks with private hospitals, with an agreement expected that would provide for the use of around 25% of private ICU capacity.
The National Public Health Emergency Team (NPHET) has warned that unless people strictly follow public health advice, there could soon be up to 400 people in ICU beds.
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Absolute shambles, they had a year to work on increasing capacity significantly, they didn’t and now here we are back in lockdown again so as not to overwhelm the healthcare system.
@Mícheál Brennan: permanent capacity has been increased by 28%. That’s not bad, given the difficulties of training/hiring qualified staff to do an incredibly complex job in a pandemic.
It is not the case that ICU capacity is the reason we’re in lockdown. We’re in lockdown because significant numbers of people didn’t follow the guidance in December. Even if we’d doubled ICU capacity, that would be overwhelmed by a few more days of unrestricted social contract.
Suggesting that we increase ICU capacity as a response to people spreading COVID at parties is a bit like suggesting that we increase ICU capacity as a response to drink driving. The better solution is the one that keeps them out of hospital in the first place.
@Mícheál Brennan: setting up ICU beds is not like setting up a normal ward.
There wouldn’t be a need for extra beds if people were responsible.
@indh2004: there is a need for extra icu beds regardless. We had pre pandemic the lowest per capita in Europe and still do so blaming people for this is wrong. Of course behaviour contributes but the core issue is low capacity. Various reports have shown we need circa 500 icu beds in normal times to be on a par with other EU countries. This is the legacy of FF and FG and their 30 yrs in power and desire for a 2 tier health system. Systematic under funding and running down of the public system to drive people to private healthcare.
@Hundredth Idiot: We did this to ourselves and then some folks expect the government to sort out the mess by anticipating a peak level of infection 3 times the previous maximum, far enough ahead to implement and staff ?? Is this the basis of capacity planning in any service area? This should be a moment where we reflect on our collective, civic response to this pandemic instead we disregard covid and expect others to sort out out the consequences
@Shane Meegan: You are correct. While the people reflect on their actions, our HSE management team and politicians should also reflect on why our health system is so poorly managed.
Both sets of folk should be able to reflect in parallel, right?
@David Corrigan: The management of the HSE needs to be examined thoroughly.The nurses are managed by layers of managers,however patient care is compromised because of poor staffing levels and reliance on student nurses to work as care assistants,while on clinical placements.
@David Corrigan: agreed David. Covid should be the baseline for a serious discussion on what this country needs from its health system. The cost to lives and the economy deserve that at the very least
@Mícheál Brennan: did you not actually read the article?
Can’t argue with the great work by all helping people with COVID during a seriously bad time in the world, but I do have to ask about the heads of nphet and the HSE, if they are running from interview to interview and daily broadcast of figures etc, how are they actually doing work that can fix some of the issues hospitals are facing, surely it’s time they stayed in there offices and actually formulated plans
This is a shambles. The minister is stating that 135,000 people will be vaccinated by the end of February, like it is something he should be proud of. We are one of the slowest countries in Europe to roll it out. At that rate, we will be locked down until 2023. Seemingly, the EU under purchased the Vaccine and we are dependent on them for it, unlike the UK who ordered their own. Why can’t our pharmacies vaccinate like they are doing in the UK. A high up medic friend in the HSE told us he had two pages of questionnaires to fill out, including his mothers maiden name and date of birth, before he could receive the vaccine: crazy. What about PRSI number and ID. We are going nowhere at this rate. Disgraceful
@Carol Cunningham: You do realise that the UK are no longer part of the EU and may now do what they want, right? No EU country ordered the currently available vaccines themselves. They could not purchase vaccines from any of the 6 companies that the EU Commission were already in negotiations with.
@Carol Cunningham: Rubbish. For one you can’t compare us to the UK and secondly, we are rolling out vaccines at a rate per capita in line with all other EU countries. Its so easy to be negative…..
@Eoin McCarthy: Take a look at Denmark which operates under the same EU rules and is miles ahead of us. What’s the excuse for that?
@Dara Mac Fhionnain: That’s simply not true.
@michael: look it up. Them the facts
The health service has been under threat for many decades due to under funding and unfortunately this crisis has shown the cracks on how bad our services are funded. General care in hospitals, children services, mental health services.
It will continue on regardless of who is in government. Oh the promises!!
@RobbieL: The funding never was an issue. The problem is how the funds are managed by the HSE executive.
@David Corrigan: lots of brown envelopes and inside back patting going on its like the champagne fai. The defence forces the garda and the civil service and corporations. Big clubs for the in family’s. Lots off ff and fg friends in high places. Anyone who thinks the Delaney fiasco in the fai was only in one place it happened with the aib(dick spring)and banks. And all the other offices of government since the 1940s.
@David Corrigan: that is an issue but funding is also poor in many areas and wanton waste ala the children’s hospital and its 2bn cost is a huge factor. Imagine what an extra 1bn elsewhere could do
@Jess Delahunt: That is true Jess but it all boils down to poor management of funds within the HSE. Every year they go over budget but still nothing improves.
@David Corrigan: Yep, we have one of the highest per capita spends but this is not reflected in our health outcomes.
@RobbieL: under funding? Are you for real. You haven’t a clue.
In the year 2000, we had 23,000 hospital beds and 280 ICU beds. In 2020 we had 14,000 Hospital beds and 225 ICU beds. Only for the pandemic our ICU beds would still be that number. How much money has been spent by the HSE in last 20 years and we are worse off than we were in 2000. The last 12 months have been a culmination of repeated governments and the HSE mismanagement.
And in 2009, the HSE said we needed 579 ICU beds…
There would b no shortage of ICU beds if people cape to the rules they rush to draw down their PUP payments and dont follow the rules anybody found breaking the rules on Corona should be receive a heavy fine and their PUP payment should b stopped The rule brakers will b the first to complain if they cant get proper treatment the government are bringing in restrictions and nobody is inforcing them
@Tony Martin: Why fine the people who lost their jobs due to government restrictions. Standard fines yes but fining only people who have already been hurt financially is nonsense
@Sean Lucas: they wouldn’t be fined if the followed the rules, I.e. no house party’s
@Brian Carr: I mean why specifically people on PUP? Seems a bit unfair to assume they are the ones causing it.
In September – https://www.thejournal.ie/icu-bed-numbers-5217685-Sep2020/
“In 2009, the HSE said we needed 579 ICU beds. [...] We have about 280 at the moment. And that is down from the 354, we had in April,”
HALF the ICU beds defined as required a DECADE ago, way before the pandemic. So, keep blaming covid for the lack of proper investment on HSE…
Anyone else think they aren’t investing in making the health service more able to cope because when this is all over they will have extra doctors and nurses on the books they don’t want to have to keep paying?
Worth trying considering it’s been advised to be expeditiously implemented as a
priority element of standard care>
high dose, oral vitamin D supplementation to augment 25(OH)D >50 ng/ml helped to achieve SARS-CoV-2 RNA negativity in greater proportion of asymptomatic vitamin D-deficient individuals with SARS-CoV-2 infection along with a significant decrease in inflammatory marker. SARS-CoV-2 RNA negativity by cholecalciferol supplementation may help in reducing transmission rates of the highly contagious SARS-CoV-2 infection. A reassurance for public health workers regarding greater likelihood of SARS CoV-2 RNA negativity in individuals receiving therapeutic cholecalciferol supplementation will be encouraging.
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065
In the absence of a cure, or an effective safe vaccine for
SARS-CoV-2, it is timely to consider whether vitamin D de-
ficiency is an easily reversible host factor which increases the
risk of SARS-CoV-2 infection and worsens disease severity,
and by extension, whether optimisation of vitamin D status
through supplementation can ameliorate these risks.
In the context of the accumulating evidence outlined in this
position statement which strongly suggests a protective role
for vitamin D against SARS-CoV-2 infection and Covid-19
disease severity, this paper is a call to action for Health
Professionals and Policy Makers in Ireland to:
(i) Recognise the importance of enhanced vitamin D status
in skeletal and extra-skeletal health, and particularly in
the optimisation of immune response;
(ii) Identify more adults with vitamin D deficiency through
more widespread measurement of serum 25(OH)D;
(iii) Prescribe vitamin D at doses which achieve a restoration
of 25(OH)D levels to greater than 50 nmol/l, with a
confirmatory subsequent blood draw to ensure restora-
tion has been achieved;
(iv) Develop explicit population guidance and clinical pro-
tocols for vitamin D supplementation at these effective
doses, as part of a comprehensive policy response to
combat vitamin D deficiency and enhance the immune
function and overall health of the Irish population
This is especially important for older
adults resident in nursing homes or other long-term care set-
tings who are particularly vulnerable; here, sufficient vitamin
D supplementation to achieve a minimum serum 25(OH)D
level of 50 nmol/l should be expeditiously implemented as a
priority element of standard care.
Vitamin D and SARS-CoV-2 infection—evolution of evidence
supporting clinical practice and policy development
A position statement from the Covit-D Consortium
Daniel M. McCartney1 & Paula M. O’Shea2,3 & John L. Faul4 & Martin J. Healy5 & Greg Byrne1 & Tomás P. Griffin6,7 &
James Bernard Walsh8,9 & Declan G. Byrne9,10 & Rose Anne Kenny8,9
Received: 25 October 2020 /Accepted: 29 October 2020
https://link.springer.com/article/10.1007/s11845-020-02427-9
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