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What are the prospects for this winter? Are we going to see another surge in respiratory bugs filling up the hospitals?
Yes, the warning signs are there already. Over 200 children were admitted to hospital with RSV (respiratory syncytial virus) the week before last - nearly all of them were small babies. Flu has yet to kick off but we know that Australia in its winter - often a predictor of what we can expect - endured a high number of cases, starting early.
Covid-19 - well, it hasn’t gone away. More than 200 hospital patients are currently testing positive for this virus, and 13 of these are in ICU. Most have other ailments but it’s fair to say that having Covid-19 isn’t helping their recovery.
So what’s going on here?
Winter always brings its challenges. The weather is often damp and we spend more time indoors; perfect conditions for spreading respiratory diseases. Flu has been around for centuries, RSV was first “discovered” in chimpanzees in the 1950s and Covid-19 is now firmly in the mix, though individually and as a population we enjoy more protection than when it was a novel virus back in 2020.
In terms of impact on the health service, a lot depends on timing. Last year was bad because flu and Covid-19 surged at the same time, after Christmas. RSV peaked just before the holiday season, so the children’s hospitals were jam-packed into the New Year. If each virus peaks separately (or, better still, doesn’t surge at all) the impact on the health service is reduced.
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What is the Health Service Executive doing to prepare for the winter?
The traditional HSE winter plan approach has been ditched in recognition of the fact that overcrowding is a year-round problem. Instead, the focus has been on hiring more staff (until the recruitment embargo was put in place), getting more efficient at moving patients in and out of hospital and encouraging people to avoid hospital (for example, by getting scans in the community or going to local injury units).
New rules have been introduced requiring older patients set for discharge to a nursing home to take the first option that comes up, rather than hang on in hospital in the hope of a preferred option. Every day, over 500 beds are occupied by so-called delayed transfers of care, about one-quarter of whom are destined for long-term care.
I’ve heard it all before. Bet you we end up with hundreds of patients on trolleys in the new year!
That could well happen, depending on virus trends. But it is the case that hospitals have more frontline staff than before to meet any surge that materialises. And before you go blaming the health service, you might want to ask yourself what you have done to minimise your chances of falling seriously ill this winter, thereby increasing the pressure on the health service.
One of the simplest ways to protect yourself is to get a vaccine against some of the most common respiratory bugs. Yet according to figures released by the HSE, very few of us are taking this basic step to protect our own health.
Uptake of the flu vaccine is a decent 59 per cent among those aged 70 and over, but falls to 18 per cent in 50-69 year-olds and 9.5 per cent in children aged two to 12. The vaccine is free for all these age groups.
Meanwhile, just 18 per cent of 50-69 year-olds, who are eligible for a free Covid-19 booster, have received it. Even among those aged 70 and over, uptake is 49 per cent.
Why is this the case?
Ask yourself! Vaccine fatigue seems to be widespread. Perhaps this is not surprising in the wake of the Covid-19 pandemic. Anti-vaccine propaganda is more prevalent than ever, and has contributed to hesitancy about vaccines.
Most of the population has received a Covid-19 vaccine, and therefore enjoys some protection against this virus. The booster currently available, therefore, will provide an incremental improvement in protection. For many people in eligible groups, the risk involved seems to be insufficient to convince them to get another shot.
It is remarkable, however, that just 10 per cent of immunocompromised patients have had a Covid-19 vaccine this winter. The HSE says about half of patients currently in ICU have not been boosted recently against Covid-19.
The apathy even extends to health staff, many of them frontline workers who will be treating patients with respiratory conditions. Just 11.5 per cent of health staff have availed of a Covid-19 booster, while 24.3 per cent have received the flu vaccine, according to the latest figures.
Ok, maybe I will go and get vaccinated - how do I go about it?
Your local pharmacy or GP should be able to help. The HSE website carries a list of pharmacies and doctors providing vaccines in your area (this is the link: Book online). You can also ring HSELive on 1800 700 700 for vaccine appointments.