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'Exhausted' healthcare workers worry about long winter as Covid-19 hospital numbers rise

Doctors treating patients with the disease have said the severity of the illness for those admitted to hospital has not changed.

In June RTÉ Investigates aired a two-part programme highlighting the work of staff at St James' Hospital and the severe impact of Covid-19 on the patients they were treating.
In June RTÉ Investigates aired a two-part programme highlighting the work of staff at St James' Hospital and the severe impact of Covid-19 on the patients they were treating.
Image: RTÉ

HEALTHCARE WORKERS WHO have been treating seriously ill Covid-19 patients throughout the pandemic are concerned they may have a long winter ahead of them with the number of patients in hospital with the disease increasing.

Yesterday there were 94 patients with Covid-19 in hospitals, an increase of four on the previous day, with 16 of these patients in intensive care. The majority of these Covid-positive patients are in hospitals in Dublin.

Speaking to TheJournal.ie Dr Paddy Mallon, consultant in infectious disease at St Vincent’s Hospital said healthcare staff are “exhausted” and concerned about the prospect of a stressful autumn and winter, trying to return to pre-Covid services while managing increasing numbers of patients with the disease. 

The health service has already shown signs of strain with the numbers of patients left on hospital trolleys creeping back up. Yesterday there were 203 admitted patients waiting for beds. 

“We have more or less been expecting an increase [in Covid hospitalisations] since the country started opening up again but we thought it would probably be a later stage in the winter,” Dr Mallon said.

“It’s obviously really disappointing, we didn’t think we’d be here yet and for many of us in hospitals we’re wondering is this going to be the start of a very long winter.

“Most of us had just managed to start getting back into our normal routines, clinics were opening back up and we were starting to catch up with waiting lists and missed surgeries. Now while we try to maintain all that we have this shadow in the background of Covid and an uncertainty about whether we’ll have to go back to curtailing services to manage an infection that is ultimately preventable.”

He said healthcare staff are not seeing any difference in terms of the severity of the illness among patients who are admitted with Covid-19.

“What’s particularly frustrating is we’re six months into this, we’ve been through a first wave of infection and seen so many people dying, we continue to see thousands dying on a daily basis around the world and there is still misinformation creeping into the conversation talking about this as if it’s a mild flu,” he said.

“For the people who are coming into hospital with severe Covid-19 infection, there is no similarity with flu, it’s a really very severe type of pneumonia.

It remains an incredibly difficult condition to treat. The reality is that someone with Covid-19 pneumonia is in a position where they are continually breathless, breathing probably 40 breaths per minute, doing that continuously for days and regardless of how much oxygen I give them, I can’t alleviate that and regardless of the medication I give them, I can’t alleviate it. It’s an incredibly stressful condition for someone to go through.

‘Suffering doesn’t have an age cap’

He said it is “irritating” to hear statistics about the majority of those who died with the disease either being elderly or having an underlying condition being used to dismiss the severity of Covid-19 and the value of the lives of those who have died.

“There is a person at the end of each those hospitalisation figures and they are suffering quite severely. Suffering doesn’t have an age cap, whether you’re over the age of 45 or 65 or 75 or 85, everyone suffers the same.

“We’ve seen it reported all the way through, whether it’s the government from a factual perspective or commentators in the mainstream media asking ‘well did these people not have serious underlying conditions?’ as if that makes it okay that someone might suffer horrendously from Covid-19 pneumonia.

What they go through, that is not a person dying of high blood pressure, that is not someone dying of diabetes or mild heart disease or another underlying condition, that is them dying of Covid-19 pneumonia. People who say these people would have died anyway display a complete ignorance of what medically is occurring.

Mallon said he believes “the vast majority of people who died from Covid-19 infection this year would probably still have been alive for Christmas”.

“I visited many nursing homes during the pandemic and there are lots of people living in nursing homes who are mentally very agile and physically very able and living fulfilling lives. To dismiss that and say just because they were in a nursing home they would have died this year anyway is morally wrong.”

Dr Mallon said he recognises that everyone around the country is tired of a process that seems perpetual, bombarded with news and figures about the disease and feeling the stress of the impact of the pandemic on their own lives.

However he said the situation can only now be improved by the kind of solidarity displayed by people across the country in the early days of the pandemic.

“When things are not working people will try to find something to blame – like kids out partying at the weekend – or try to wish it away, but you can’t with this away.

“We’re in a position where the only thing that’s going to help us improve the numbers and take the stress off the system and society in general and give people more piece of mind is a united community effort.”

‘Preparing for the worst’

Dr Eoghan de Barra, consultant in infectious diseases at Beaumont Hospital said doctors know a lot more about the virus than they did back in March.

“One thing we know now is that it takes time for sick people to present themselves. Most people happily won’t have a lot of symptoms but it’s pretty much a matter of time when numbers are increasing before we start seeing them in hospital.

“The numbers in hospital have doubled over the last week and the expectation is that’s going to continue to be the case unless we as a society do something. It will take about two weeks for any measures we take to make an impact so it’s likely the numbers in hospital will continue to increase until then.”

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He said health officials have learned from the experience of the last six months and know now what works to flatten the curve.

“We have the ability to switch it off, the problem is they’re not easy things to do.”

While the numbers may seem low compared to the country’s peak, Dr de Barra said it does not take much for the country’s health service to “really struggle”.

“We’re different to our EU partners, we don’t have the ITU [intensive treatment units] beds German has, for example, so we have to react more on public measures.”

He said people may have the perception that one or two admissions each day will not make a significant impact, but he pointed out that patients with Covid-19 who require hospitalisation often remain at the hospital for an extended period of time.

“One or two might be coming into the hospital but you’re not having the same number coming out each day,” he said.

Yesterday the HSE reported 11 admissions of patients with Covid-19 to hospital over a 24 hour period, with eight discharges over the same period.

He said the workforce is “tired” and has moved again now into a period of “fervent activity to prepare for the worst, while hoping for the best”.

Last night Acting Chief Medical Officer Dr Ronan Glynn spoke about the concerns of healthcare workers.

“We’ve a situation tonight where we’ve almost 100 people in hospital, 16 in critical care units. Our doctors and nurses around the country are very concerned about the potential impact this is going to have on the provision of non-Covid healthcare,” he said.

“The last thing we want to see is this impacting again on our cancer services and all the other services that need to go on on a daily basis.

“We have choices to make. In that context we have to protect our priorities and at the moment unfortunately certain elements of our social lives are less important than others and we have to be honest with people about that.”

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