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A prominent GP has warned that Ireland will face a crisis in the provision of intensive care beds in the coming weeks if steps are not taken to urgently address the growing number of Covid 19 cases.
Dr Mary Favier, former president of the Irish College of General Practitioners and a member of the National Public Health Emergency Team, said the growing number of Covid 19 cases was particularly concerning.
Dr Favier said the fact that the number of Covid 19 cases was doubling every fortnight or more was a major concern given the ability to provide ICU beds for people in need of intensive treatment for the disease.
According to a 2019 HSE report, there were 255 intensive care beds in the system, but a daily HSE report on October 16 said that there were currently only 36 ICU beds available as the number of hospitalized with Covid 19 continues to rise. .
Dr Favier said there were a number of items to consider in relation to people with Covid 19 admitted to hospital, including a general rule of thumb that out of every 1,000 people who contract the disease, five will end up in the ICU.
“The other important thing to keep in mind is that the average ICU stay for most patients is two to three days, but the average stay for someone with Covid-19 is ten to 14 days, so which is much longer, ”he said.
“And that’s the average stay, but we’ve had cases of people with Covid-19 who spent four weeks or six weeks or even three months in the ICU, so they don’t have the same ICU bed rotation that they have. Covid “.
Dr. Favier said that although the number of Covid-19 patients in the ICU this weekend, 30 is roughly the same as last weekend, it is misleading to think that there has been no change as there is a lag of time with people who develop the disease.
“People in ICU today received Covid two weeks ago, but we know that the total number of people with the disease has doubled over the last fortnight, so at that rate, the number of people needing ICU in a fortnight it will probably double. “
Dr. Favier said the growing number of people requiring ICU due to Covid-19 will affect other people with serious conditions, such as those with lung or bowel cancer or heart conditions that require major surgery and ICU care.
“People facing major surgery for lung or bowel cancer or for a heart condition have to undergo a lot of preparation: blood tests, cardiac and anesthetic tests, a Covid test, so it takes several days,” He said.
“Normally, a consultant would be looking ahead a few days and see that there will be 15 ICU beds available, say four days in advance and most likely in the normal course most of them are still available.
“But now if you are a consultant and you only have three beds available due to Covid and there is a possibility that they will not be available in four days, you will not risk it and postpone the surgery, so there is this effect. effect.”
Dr. Favier said that this postponement of procedures, even though the patient may only require ICU care for 24 or 48 hours, is very stressful for patients with serious conditions and there is no guarantee that it will proceed even in the postponed date.
According to Dr. Favier, who lives in Cork, the problem is particularly acute in the city, as a consultant has to call other hospitals on the weekend to secure a bed for a patient, as all ICU beds in Cork they were busy.
Last week, the HSE said that Cork University Hospital had 20 ICU beds with the capacity to add 16 more ICU beds if needed, while Mercy University Hospital had six ICU beds with the capacity to add more. 12 beds.
However, Dr. Favier said the problem with using the augmentation capacity as proposed by the HSE in relation to CUH and MUH was that both additional places to place the beds and trained nurses are required for the staff of the new ICUs. temporary.
“You have to have a place to put the extra ICU beds and very often they end up in operating rooms where the hospital closes an operating room to accommodate the temporary ICU, so the procedures are canceled.
“It takes six ICU staff to tend to a bed, so you have to get them from somewhere else, such as coronary care or operating room nurses, as there is a limit to the number of people with the necessary skills, so that it is taking personnel from other areas.
“Besides there is some evidence from the UK, where they have done that to set up additional ICUs to deal with Covid, that survival rates are not as high when using staff from other areas compared to regular ICU staff.” .
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