The head of the Saolta University Health Care Group, which runs Mayo University Hospital and a number of public hospitals in the west/northwest, has appealed to the public to continue to limit social contacts and abide by the Level 5 restrictions in order to protect people at greatest risk of contracting Covid-19.
Tony Canavan said those most vulnerable and likely to die are older people and we must do everything we can to protect this group, which has been disproportionately affected by the pandemic.
He said, while people of all ages are being hospitalised, unfortunately older people have "poorer outcomes". This was evident in January when a high number of deaths were recorded in this group. People aged 70 to 85 and upwards are at greater risk of fatal outcomes, 80 per cent of deaths are in over 85s but they only account for four per cent of cases.
"When we look back over January, Covid-19 really had a devastating effect on older people," he said. "People will be shocked by the number of deaths in the third wave."
While Covid-19 case numbers generally are going down, they need to reduce much further to save lives and relieve the "considerable pressure" on the acute hospitals, he stated.
The most marked improvement, in terms of a decrease in case numbers, occurred a fortnight ago and while progress is continuing, it is at a much slower pace now which is concerning, the group boss of seven public hospitals in the west and north-west, said.
"The situation is definitely improving and that is very, very welcome. However, the rate of improvement has slowed down and our fear is that it would settle at a high level."
Local hospitals remain under pressure but they are coping, he said. "The pressure has considerably eased relative to where it was." There are currently 188 Covid-19 positive patients hospitalised across the group in Galway, Mayo, Roscommon, Sligo, and Donegal (exactly double the number of the peak recorded in the first wave ) compared to 236 last week. On a group hospital basis, the greatest pressure, in this the seventh week of the Level 5 lockdown, is on Mayo University Hospital, which has the greatest proportion of hospitalisation numbers.
There were 34 Covid-positive patients in Covid wards at UHG on Tuesday, down from 51 last week and 98 the week before. There are eight patients with the virus in its 27-bed intensive care unit, a reduction of five on last week's number. Mr Canavan describes these figures as "a very steady downward trend".
A total of six Covid-19 patients are in Portiuncula University Hospital (PUH ) in Ballinasloe, down from eight last week. There are "very low numbers" in its ICU. Mayo University Hospital (MUH ) which is classed as a medium sized hospital, has 58 Covid-positive patients, a small reduction on last Tuesday's figure of 62. "That is a concern, not all of our hospitals are improving at the same rate," says Mr Canavan, who took over as head of the Saolta group, which employs 10,000 people and has an annual budget of almost one billion euro, in September 2019.
Despite the reduction in Covid-19 hospitalisation numbers, ICUs remain busy. There was one bed vacant at UHG, two in Portiuncula, and three at MUH on Tuesday. Patients continue to be transferred to hospital ICUs with greater capacity when necessary. Two patients in total were moved to UHG from Letterkenny and Mayo hospitals in the last week. Some 38 patients are receiving non-invasive ventilation (oxygen therapy ) outside ICUs in ward settings, at UHG currently. The figures for Portiuncula and MUH are 18 and 24 respectively.
Four wards at UHG are currently affected by Covid-19 outbreaks. An outbreak cannot be considered closed until 28 days from the last case being diagnosed. While Covid-related staff absences continue, these numbers are falling, but not as dramatically or rapidly as the CEO would like to see. UHG is without 165 staff now, down 22 from last week. These comprise 102 nurses, 34 health care assistants and porters, four doctors, 13 allied health professionals, such as physiotherapists, and the remainder are administration staff.
There are 13 staff on Covid-19 related leave at Portiuncula Hospital, down from 18 last week. Five are nurses, the remainder are health care assistants, porters, doctors, and clerical workers.
The health service is preparing for the rollout of the Covid-19 vaccine to the wider population. Mr Canavan said a radio campaign targeting the over 70s, the first group to be vaccinated, will begin shortly, to inform them they will be contacted by their GPs. The oldest people over 70 will be vaccinated first and he is confident this process will start by the end of February.
The Galway Racecourse is the likely venue for the mass vaccination programme but this could change, according to the CEO. Receiving a letter on Friday outlining the quantity of the vaccine being allocated to the west was a "big, big moment", he said.
"This was the first time since the vaccine came into the country that I got formal notification of how many vaccines we would have on a week by week basis. This was really important as it will allow us to plan."
Some 2,400 Covid-19 vaccine doses were received this week to provide the first jab to healthcare workers in the west and north-west who had not been previously inoculated.
"So far, we have three streams, the first and most important, is the priority group laid out by the Government - nursing home residents and staff. The first dose was given to all of these by January 24. We are now doing the second dose for those people and will be doing a 'mop up' exercise, vaccinating people who could not have received it previously because they had symptoms or were off sick, from next week.
"Our second stream is healthcare workers, we've done very well here as we were limited by the availability of the vaccine. There are about 17,000 of them in Galway, Mayo, Roscommon, Sligo, Donegal, and Leitrim. We have also started a second dose for a good proportion of them.
"Our third stream is the general public and we have been preparing to identify five locations in the region and to kit those out. Even though we don't have the vaccines yet, we want to have the system, infrastructure, and the people ready to go."
The hospital chief is conscious of how the vaccine situation can change. "We have to remind ourselves that things can change rapidly [in terms of vaccine availability]. Situations are not always in our control and we can whinge and moan or adapt. There is no point in wasting energy on what has not worked out. We must take difficulties as they arise, come up with solutions, and keep moving forward. I take my lesson from the hospital staff who are so flexible and have adapted so well [to the demands of the pandemic]. The job for me is to get as many people vaccinated as quickly as possible. Every person that receives a vaccine will improve things for you and me."
