The level of Covid-19 infection in the community needs to be driven down much further than it is at currently and it is important people continue to abide by all the public health restrictions to achieve this, the chief executive of the Saolta University Health Care Group, which runs the local public hospitals in the west and north-west, stressed this week.
Tony Canavan said that while the number of cases in the community and in the hospitals is decreasing, his greatest fear is that the public will relax their behaviour too quickly and the level of infection will not be sufficiently suppressed. “I fear that people will breathe a huge sigh of relief but it’s way too early for this”.
He said he understood that people are tired, they have tolerated a lot, and the duration of the pandemic has been a long 12 months. However, it was essential that the significant improvements achieved recently in the reduction in the incidence of the disease, would not slow down or stop at a level of infection that was far too high.
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Speaking to this newspaper, the CEO said there has been “continued improvement” since last week in terms of the number of people being hospitalised and those requiring treatment in intensive care units.
He also said that the number of people hospitalised with Covid in the west has fallen by 126 since last week. Mr Canavan added that there are vaccination centres in every hospital and over the coming weeks the authorities will “be looking at moving them off the hospital [sites]”.
He said the reason for this is that many healthcare workers do not work in hospitals and “we do not want to be bringing them in there unless we have to”.
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The level of Covid-19 infection in the community needs to be driven down much further than it is at currently and it is important people continue to abide by all the public health restrictions to achieve this, the chief executive of the Saolta University Health Care Group, which runs the local public hospitals in the west and north-west, stressed this week.
Tony Canavan said that while the number of cases in the community and in the hospitals is decreasing, his greatest fear is that the public will relax their behaviour too quickly and the level of infection will not be sufficiently suppressed. “I fear that people will breathe a huge sigh of relief but it’s way too early for this”.
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He said he understood that people are tired, they have tolerated a lot, and the duration of the pandemic has been a long 12 months. However, it was essential that the significant improvements achieved recently in the reduction in the incidence of the disease, would not slow down or stop at a level of infection that was far too high.
Speaking to this newspaper, the CEO said there has been “continued improvement” since last week in terms of the number of people being hospitalised and those requiring treatment in intensive care units.
“This confirms we have reached the peak of the third wave [of the infection] and we are coming down the far side. Since Christmas, there has been unrelenting pressure [on the hospital system], it is relenting a little bit now. We are still at very high levels but it is an improvement on the way things were.”
Drop of 110 hospitalised
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There were 236 Covid-19 positive people on Tuesday in Saolta’s hospitals, a drop of 126 since the same day last week. That improvement has been evident on nearly all of the hospital group’s sites in Galway, Mayo, Roscommon, Sligo, and Donegal, he said.
The number of Covid-19 patients at UHG has almost halved in a week, from 98 last Tuesday to 51 this Tuesday. There are currently 62 such patients at Mayo University Hospital (MUH ) down from 93 last Tuesday. Portiuncula University Hospital (PUH ) has not reported an improvement but the numbers remain low, remaining at eight at the time of going to press, the same figure for Tuesday last.
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Patient numbers in local intensive care units continue to fall, also. These figures peaked on Wednesday last when there were 36 coronavirus patients in ICUs in the region. That number has been decreasing since then and now stands at 28. There are currently 13 Covid-19 patients in UHG’s 27-bed intensive care unit, a drop of four from the same day last week. There are three Covid-positive patients at MUH’s eight bed ICU, the same number as last week, and there are three people with Covid-19 at PUH’s seven bed ICU. Ten ICU beds are currently vacant in Galway and Mayo hospitals, (Roscommon hospital does not have an ICU ) - six in UHG, three at MUH, and one at PUH in Ballinasloe.
There are currently 198 staff on Covid-leave at UHG, a substantial drop on last week’s 342 figure
In addition to providing ICU facilities for critically ill Covid-19 patients, (as well as patients with many other conditions ) all the Saolta hospitals, except Roscommon University Hospital, also provide non-invasive ventilation (oxygen therapy ) in ward settings. A total of 28 patients were receiving this treatment at UHG on Monday. Mr Canavan said the hospital has capacity, in terms of equipment, to do more of this.
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Patients continue to be transferred from one hospital to another within the Saolta group if their local intensive care units become overstretched. Four acutely ill Covid-19 patients were transported by the specialised national ambulance service in the past week. A reduction in patient numbers was recorded here too but Mr Canavan said this figure could easily rise again.
Transferring patients
“Transferring patients is very important for us. It means that no hospital has to work in isolation, they are all co-operating. Generally, if we do a transfer, it is from a lower complexity hospital, such as Letterkenny or Mayo, to a high complexity hospital, like UHG.”
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One of the biggest sources of pressure on the seven Saolta hospitals, in Galway (UHG, Merlin Park University Hospital, and Portiuncula University Hospital ), Mayo, Roscommon, Sligo, and Donegal, is the high number of healthcare employees on sick leave due to contracting Covid-19 or being a close contact of a case. Saolta employs 10,000 staff across its five sites and almost 1,000 of them (990 ) were absent on Covid-related leave on January 14. This was the highest ever peak, according to Mr Canavan. The numbers have since began to fall with almost 800 absent across the group on Tuesday last, and 593 on the same day this week, a significant improvement, according to the hospital chief.
There are currently 198 staff on Covid-leave at UHG, a substantial drop on last week’s 342 figure. Mayo University Hospital is without 133 employees, down from 143 last week, and Portiuncula University Hospital has 18 staff on leave compared with 23 last Tuesday. The majority of the absent staff are nurses, and to a smaller degree, healthcare assistants, and porters. Most Covid-19 related absences are for 14 days, however, some employees are allowed to return within 10 days in line with the new National Public Health Emergency Team (NPHET ) recommendations.
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The Saolta chief executive said reports indicate that more than 60 per cent of Covid-19 cases in the region are probably attributable to the UK variant of the disease, which experts say is more transmissable than other strains of the virus. This would explain why Covid-19 numbers rose so rapidly in January and put local hospital under severe pressure.
Mr Canavan said while there was a mixed age group, ranging from people in their 30s to older people, being hospitalised with Covid-19, it was older people who were worst affected. “One thing we are absolutely sure about, after January, is the virus has the worst impact on older people. People aged 70 to 85 and 85 years plus, they are at greater risk of a fatal outcome from Covid-19. Eighty per cent of deaths are in over 85s but that group only account for four per cent of cases. We will see a significant number of deaths in all settings, nursing homes and hospitals. People will be surprised by the number of deaths in the third wave.”
Psychosocial cost
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He outlined that the “broader HSE family” is examining the psychosocial impact of Covid-19. This is part of the health authority’s long term response to the pandemic, looking at ways of helping people manage their mental health during this challenging time. He said healthcare staff, whom he described as “absolutely phenomenal”, are particularly affected.
'We have been told the availability of the vaccine is going to improve, starting from this week'
One third of nursing homes, in the public and private sector - there are 83 in Galway, Mayo, and Roscommon - are currently dealing with Covid-19 outbreaks. Mr Canavan receives reports daily, sometimes twice daily, from Saolta geriatricians on how these facilities are coping. He stated it was important to look outside the walls of the hospitals and try to help other facilities cope. A great sense of co-operation exists between the HSE’s community services, the private nursing homes, and the local hospitals, a relationship that has particularly developed over the last 11 months. He is very aware of the pressures on nursing home staff as they try to control the virus spread or keep it from their doors.
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“This has been a particularly difficult time for nursing home staff. They are living on the edge and are frightened but they are doing brilliant work. Hospital staff are working in a bigger environment and there may be more support available for them.”
'We expect there will be a number of large vaccination centres around the country and there will be smaller vaccination centres around these'
The rollout of the Covid-19 vaccine, which represents an important sense of hope in the battle against the coronavirus, continues. The staff and residents of nursing homes, as well as hospital staff, all of whom received the first dose of the vaccine, will receive their second jab this week. The focus last week was on vaccinating people aged over 65 who are living in mental health and disability residential care facilities.
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“We have been told the availability of the vaccine is going to improve, starting from this week,” said the Saolta CEO. “This will increase weekly until the end of the month, which is very positive. We have been recruiting vaccinators and people to work in our vaccination centres.”
These vaccinators comprise retired nursing and allied health professionals, such as physiotherapists, occupational therapists, and speech and language therapists. These would be recently retired, have maintained their professional registration, and would be interested in returning to the health service on a full or part-time basis, he said. The HSE also wants to recruit additional clerical staff and has run a local campaign to this effect this week in Galway, Mayo, and Roscommon.
Mr Canavan said there are vaccination centres in every hospital and over the coming weeks the authorities will “be looking at moving them off the hospital [sites]”. He said the reason for this is that many healthcare workers do not work in hospitals and “we do not want to be bringing them in there unless we have to”.
“We will be moving towards vaccinating everybody in the population and we expect there will be a number of large vaccination centres around the country and there will be smaller vaccination centres around these.”
