There have been 2,203 new confirmed Covid-19 cases in Mayo over the two-week period from Wednesday, December 30, to Tuesday, January 12, according to the latest information at the time of this newspaper going to print.
This week has seen another major spike in cases in the county with, from Monday to Wednesday evening, an additional 780 cases alone being reported in the county by the National Public Health Emergency team.
The HSE Community Health Care West team carried out 2,484 Covid-19 tests in Mayo during the seven day period from Monday, January 4, to Sunday, January 10.
The continuing increase in confirmed cases went hand-in-hand with an increase in the number of people hospitalised in Mayo University Hospital with the virus, with 82 confirmed cases and eight suspected cases requiring hospital treatment on Tuesday night in the hospital.
The hospital issued a statement on Tuesday to say that the facility was extremely busy due to Covid-19 and that there were very long waiting times for those admitted to the emergency department and there was limited bed capacity in the hospital.
As the country's acute hospital system comes under extreme pressure from rising Covid-19 numbers, the head of the local hospital group fears that the worst has yet to come.
Tony Canavan, the chief executive of the Saolta University Health Care Group, told the Advertiser Group this week that: "The situation will get worse before it gets better," adding "Do I think there will be more than 335 [Covid-19] patients in hospital beds [the current figure across the region]? I do. It will get worse over the coming days."
His comments come this week as the number of people with the virus in the region's hospitals (335 ) has almost quadrupled when compared with the previous pandemic peak of 94, which was recorded in mid-April last year.
This week local intensive care units report there are "very low" numbers of vacant beds available, at least 10 per cent of hospital staff in the Saolta group are on leave due to either contracting the coronavirus or being a close contact of a case, and the region's three main Covid-19 testing centres at Galway Airport, MacHale Park in Castlebar, and Castlerea Fire Station are "extremely busy" and are working at "full capacity", according to Mr Canavan.
He is very concerned at the way in which the Covid situation has disimproved. The number of patients hospitalised with the virus has more than doubled in a week.
"Last Tuesday there were 157 people with Covid-19 in hospitals across the whole group. This Tuesday that figure is three hundred and thirty five, that is a very significant increase," he said.
The Saolta chief identified two aspects of this situation which concern him greatly, stating: "335 beds is a huge number. At the height of the first wave on April 15 we had 94 Covid patients in hospital. That will give you a sense of the difference in scale."
The second worrying aspect he said is how rapidly the situation has changed. "Hospitals are divided into Covid and non-Covid streams to keep patients separate and to keep them safe. When numbers increase we have to adapt the physical infrastructure of the hospital. All of our hospitals are maintaining Covid and non-Covid pathways and dedicated Covid and non-Covid wards, the challenge this week is to adapt very quickly to the rising numbers."
There were 116 Covid positive patients hospitalised at UHG on Tuesday, 10 of whom were in ICU. There are 700 in-patients beds in this, the west's biggest hospital. There were 91, none of whom was in intensive care, in Mayo University Hospital. Mr Canavan said that was a "very, very high number" for Mayo because the 280-bed facility is a medium-sized hospital, while there were nine Covid patients at the 220-bed Portiuncula University Hospital in Ballinasloe.
Local acute hospitals are not just grappling with increasing Covid-positive patient numbers, they are also coping with significant staff shortfalls due to the virus. Some of these are very specialised personnel who are not easily replaced.
"Across the group, there are around 10 per cent of staff on Covid-related leave, 370 at UHG, over 100 at Mayo University Hospital, and over 60 at Portiuncula University Hospital. That is a very high rate all round. Both the numbers and the fact that some of these are specially trained staff is a major issue."
Mr Canavan continued, saying there are "very, very low numbers" of vacant ICU beds in the Saolta group's hospitals, particularly in UHG. ICUs are normally quite full in non-Covid times and very often work "at the margin", close to 100 per cent capacity, he said. The pandemic is putting a huge additional strain on an already busy department. However, there are arrangements in place to expand ICU capacity.
"We have been planning for that and hoping that it would never arise. In UHG, for example, we have the physical space in other locations in the hospital. We purchased additional equipment, such as ventilators, during the year [2020]. Last week we cancelled all elective surgery and the majority of out-patient appointments to free up staff, particularly theatre staff, to enable them to go to ICU."
Opening additional beds is entirely dependent on having the staff to manage these beds, of course. "We are under severe pressure but we are managing," said Mr Canavan. "We are, all the time, trying to recruit additional staff, particularly nursing staff, but it is not easy to do so these days because everybody is trying to recruit them."
There have been positive changes in the clinical management of Covid-19 since the virus first arrived here 10 months ago. There is more known about the condition and doctors manage it more efficiently now, he said. The average stay for Covid-19 patients [in general hospital beds] has reduced from in excess of two weeks in March/April to under a fortnight now. ICU stays are shorter too, being just over a week now, he noted.
