Public health officials are planning to “reboot” their messaging around Covid-19 protection in response to rapidly rising numbers of virus patients in hospital.
However, there are no plans to re-introduce a mask mandate in public areas, despite the number of hospitalised Covid-19 patients passing the 1,000 mark on Monday.
For the second week in a row last week, a record 28,000-plus patients attended hospital emergency departments. The demand, driven by increased attendance by older people, is adding to the strain on hospitals.
Hospital Report
Officials say they are concerned about the increase in hospital numbers, mainly due to its impact on the health service.
“Of course, we’re worried,” said HSE chief clinical officer Dr Colm Henry. “The concern is primarily about the impact on hospitals and in relation to unvaccinated people. We’re not so concerned about the impact on people who are vaccinated.”
“While it’s comforting to know ICU numbers have remained low and vaccines provide protection against serious illness, the rise in hospital numbers is very disruptive to hospital care.”
“When you have more than 75 patients with the virus in hospital such as Beaumont or Letterkenny, that puts several wards out of use, requires more infection control measures and results in more lost capacity.”
Chief medical officer Dr Tony Holohan and other senior public health officials meet regularly to review trends around Covid-19. Sources say there is “no appetite” for re-imposing measures and that officials favour “doubling up” on infection control measures in hospitals and the prevention of spread within the sector.
A reboot is also planned for public health messaging, including advice to stay at home if you have symptoms, to exercise the option of wearing a mask and for unboosted people to get the third dose of vaccine.
Over 30 per cent of Covid-19 cases currently in hospital are unvaccinated, though this group represents less than 5 per cent of the overall population.
The number of patients in hospital with Covid-19 has passed the 1,000 mark again, and may soon exceed last January’s peak.
There were 1,042 patients with the virus in hospital on Monday morning, up from 957 the previous day. There were 42 patients in ICU.
Meanwhile, the Health Protection Surveillance Centre (HPSC) has on Monday been notified of 2,100 PCR-confirmed cases of Covid-19.
On Sunday, March 13th, 7,271 people registered a positive antigen test through the HSE portal.
On Saturday March 12th, the HPSC was notified of 4,400 PCR-confirmed cases of Covid-19. A total of 6,853 people registered a positive antigen test through the HSE portal the previous day.
On Sunday, the HPSC was notified of 5,475 PCR-confirmed cases of Covid-19, and 5,791 people registered a positive antigen test through the HSE portal the previous day.
Hospitalisations in this wave of the pandemic peaked at 1,062 last January 11th, but have been rising again over the past fortnight following the lifting of all Covid-19 restrictions.
Latest data from the Health Surveillance Protection Centre (HSPC) shows there were almost 25,000 confirmed cases reported through the Computerised Infectious Disease Reporting system in the week ending February 26th, and almost 24,400 positive antigen tests.
Almost 300 new hospital cases were diagnosed over the weekend.
About half of all Covid-19 hospitalisations are incidental, ie, they involve patients admitted for another condition who tested positive for the virus while in hospital.
There are early signs the number of Covid-19 patients in intensive care may be edging up, after months of decline. There were 42 patients with the virus in intensive care, up one on Sunday and four on last Friday.
The rise in Covid-19 hospitalisations coincides with increased overcrowding in hospitals, with the Irish Nurses and Midwives Organisation (INMO) reporting 544 patients on trolleys on Monday morning.
The high number of Covid-19 patients and patients waiting for admission is having a “significantly negative effect” on the ability to provide timely and safe care, the union said.
INMO general secretary Phil Ní Sheaghdha described the combined pressures as “a recipe for disaster”.
“If our past experience of Covid and high numbers of patients on trolleys has taught us anything, we will be seeing the impacts of this on our health system for many weeks to come.”
Nurses have been “sounding the alarm” on the rise of trolley numbers since last summer, she said, and had also urged caution on the removal of mandatory mask-wearing in public spaces.
“The HSE and political system have a responsibility to the exhausted workforce to ensure their workplaces are safe. There must be no tolerance for hospital overcrowding while a highly transmissible airborne virus is making its way around our hospitals. Improvements to air quality in our hospitals must be a priority.
“If non-emergency services need to be curtailed in order to allow the HSE and hospital groups to get a handle on out-of-control trolley figures and Covid cases within the hospital system then that must be done.
“The HSE has a duty as an employer and as a service provider to take the necessary steps to scale up capacity. The current state of our health system is extremely concerning. It is now time for the Minister to attend the ED [emergency department] taskforce and to ask the HSE to put in place realistic short-term pressure-relieving measures,” she said.
Face coverings
Prof Sam McConkey, a consultant in infectious diseases, said while he supported the lifting of “draconian” public restrictions there was still a need for face coverings in public settings.
“I am sort of intrinsically a strong believer in civil liberties . . . [but] just because there is civil liberties doesn’t mean that you can’t wear a mask on public transport,” he said.
With cases rising, Prof McConkey said the shifting nature of required testing, PCR use and self-reported antigen results means current data on transmission is not reliable or comparable to previous data. He suggested a sub-set of steady, predictable indicators such as hospital testing would offer a safer snapshot of how the virus is spreading in society.
“The symptoms that we are seeing now in Ireland are not the same as they were two years ago and they aren’t as severe,” he said, pointing to fewer cases of extreme respiratory illness where people struggle to catch breath, and increasing levels of deteriorating mobility and delirium.
“My view is that Sars-CoV-2 is still a problem for people who are not vaccinated and it’s also a problem for people who don’t have a proper immune system.”
The latest HPSC data shows the highest incidence rates are in counties Donegal, Louth, Monaghan and Wicklow.
In the week to March 5th, 129 clusters had been reported – outbreaks of two or more people. The majority were in nursing homes, followed by acute hospitals. UCD virologist Dr Gerald Barry said while it was now a personal choice, mask wearing remained advisable and a practice he has maintained.
“It’s very hard to know what’s happening in the population as a whole,” he said of current data and people’s approach to testing and reporting, adding that rising numbers are of little surprise given the lifting of restrictions.
However, he also said hospital numbers could be misleading in that many people who test positive in those settings are in fact admitted for different reasons.
Although current infection rates pose more disruption to day-to-day life, higher rates of transmission will “add to the health burden of the country long term”.
Fine Gael Senator Jerry Buttimer has called for compulsory rules on transport and in shops and on Monday, infectious diseases expert Prof Jack Lambert told Newstalk Radio there should be a “clear message” from Government that people should “do the right thing” in terms of mask use.
