Patient numbers in the intensive care units of the west's public hospitals are being monitored 24 hours a day to ensure these critical care facilities will be able to cope with increasing admissions during the fourth wave of Covid-19.
Tony Canavan, the CEO of the Saolta Hospital Group which runs the seven public hospitals in the west and north-west, says while it is not known to what extent this wave will translate into hospital admissions and if it will peak in autumn, he is concerned about the effect it will have on the region's ICUs.
Hospitalisation rates rising
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Hospitalisation rates are rising and Saolta management is monitoring the situation "extremely carefully", he says. Hospitals, such as University Hospital Galway, with previously low numbers of Covid-19 patients are reporting increases in cases. The figures for the city hospital rose from three a few weeks ago to 20 on Monday. There were 13 Covid patients in UHG on Tuesday, five of whom were in the intensive care unit. Portiuncula Hospital in Ballinasloe had four Covid-19 patients on Tuesday, none of whom required ICU care.
There are 57 Covid positive patients in Saolta's hospitals in Galway, Mayo, Roscommon, Sligo, and Donegal, up from 15 in mid-July. The Saolta boss says the numbers have started to climb in the last two weeks. Some of these people are vaccinated and range in age from 20 to 80 years.
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"We know that of the 57 cases [hospitalised] across the group, some are fully vaccinated, some are partially, and some are not vaccinated. We have patients in hospital with Covid-19 who are sick because of it but are vaccinated."
While the number of patients hospitalised in the west and north-west's public hospitals in January because of the coronavirus was almost seven times higher than current figures (394 then, 57 now ), Mr Canavan is concerned for a number of reasons. The Delta variant is "extremely transmissable", the number of hospitalisations are growing, and we are "not at the top of the wave yet", he says.
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Vaccine programme
"It is absolutely clear that the vaccine programme is having an impact on the number of patients that end up in hospital. Because this is a novel virus we don't know everything about it and also it is a new vaccine and we don't know everything about it. The only thing we can do to deal with the uncertainty is to keep rolling out the vaccine, and for people in the community to take up the offer of the vaccine and do the things we know make a difference, such as hand hygiene, social distancing, wearing a face mask and avoiding circumstances where good practice is difficult.
"What we do know is, as society and the economy opened up the number of Covid-19 cases increased and when the schools up open the number of cases will further increase. We expect if there is an increase in the number of cases this will lead to an increase in [patient] numbers in hospitals. We hope that this will be less than the third wave."
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The Saolta chief, who took over as head of the hospital group in September 2019 and presides over an annual budget of almost one billion euro, says things are being managed well from a Covid-19 perspective in each hospital. His greatest concern is the ability of ICUs to cope with increasing patient numbers during the fourth wave.
"This is what worries me most. We hope they will be fine but it is an issue we are watching extremely carefully. The ICUs are being clinically monitored 24 hours a day. We are keeping a close eye on the numbers going up and down because the people who are sickest will be treated there. It is a limited resource, there are only a limited number of beds and staff. We need staff to run ICUs and our ability to increase beds is limited by the number of staff available." There are 14 ICU beds in Galway, between UHG and Portiuncula University Hospital.
Expanding the ICU in Galway?
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Plans to provide additional ICU care, if required, were "refreshed" on each hospital site two weeks ago, according to Mr Canavan. These included transferring patients from ICUs in smaller hospitals to UHG, expanding its intensive care unit to other locations in the hospital, and providing additional non-invasive ventilation (oxygen therapy ) in ward settings there. However, he stresses these plans depend on the availability of specialist staff.
"For the past two weeks we are watching what is happening in ICUs across the region and where appropriate, taking patients to Galway from the Letterkenny and Mayo hospitals. [Three patients were transferred from each facility to UHG recently]. This is to provide the best clinical care for patients and it also eases the pressure on Mayo and Letterkenny and allows them to see the next Covid-19 patients. There is also the prospect of expanding the ICU in Galway to other locations in the hospital, such as the theatre recovery area. We can also provide additional oxygen therapy in wards."
