Saolta draws up ‘surge plan’ as ICU occupancy doubles

Bailey Allen Hall to become field hospital and Connacht Hotel to be 600-bed self-isolation unit

Front line support staff at University Hospital from left: Andrea Monaghan, Bidvestnoonan Contract Cleaning; Evelyn Fleming, Aramark Operations Manager; Sean Walsh, Porter; Michelle Greer, Aramark Catering Assistant; Pat Murphy, Laundry Department; Joe Lavelle, Bidvestnoonan Security; Annette McCabe, Services Department; and Angela Rowan, Switchboard.

Front line support staff at University Hospital from left: Andrea Monaghan, Bidvestnoonan Contract Cleaning; Evelyn Fleming, Aramark Operations Manager; Sean Walsh, Porter; Michelle Greer, Aramark Catering Assistant; Pat Murphy, Laundry Department; Joe Lavelle, Bidvestnoonan Security; Annette McCabe, Services Department; and Angela Rowan, Switchboard.

Saolta has drawn up a “surge plan” to meet the challenges expected to face the health service as the pandemic peaks - the HSE believes this will take place within the coming days and week. This will see a field hospital at the Bailey Allen Hall at NUI Galway and a self-isolation centre at the Connacht Hotel.

This involves expanding ICU capacity in local hospitals, purchasing additional ventilators, using Galway’s two private hospitals for vital cancer surgery and medical rehabilitation, and setting up a field hospital close to UHG. Provision for self-isolation, a centre for patients recovering from Covid-19, and expanded morgue facilities are also included in this plan to cope with the most severe outcome possible, should this arise. Patients requiring ICU facilities are being transferred to critical care units in other hospitals if their local units are full.

The number of Covid-19 patients occupying intensive care unit beds in the west’s three public hospitals has doubled within a week.

There were a total of 10 such patients at University Hospital Galway, Portiuncula University Hospital in Ballinasloe, and Mayo University Hospital on Tuesday of last week. However that figure had rocketed to 20 by this week. (There are about 140 patients nationally with the coronavirus in ICUs, according to the Minister for Health, Simon Harris.

LE William Butler Yeats

HSE Community Healthcare West, the National Ambulance Service and the Regional Emergency Management Office acknowledging the vast contribution of Captain Lieutenant Commander Martin Tarrant and crew of the L.E. William Butler Yeats for their assistance in establishing the COVID-19 Community Test Centre at Galway Port – ‘Fair winds and following seas’. Pictured at Galway Harbour on Wednesday were Breda Crehan-Roche, Chief Officer, Community Healthcare West, Gabriel Glynn, Ambulance Officer, National Ambulance Service; Staff from National Ambulance Service; Kay Kennington, Regional Chief Emergency Management Officer; Martin Tarrant, Captain Lieutenant Commander L.E. William Butler Yeats; Crew of L.E. William Butler Yeats. Photo: Mike Shaughnessy

If this rapid escalation in numbers continues in the west in the next week or weeks local ICUs would be full, according to Tony Canavan, the chief executive of the Saolta University Health Care Group which runs the local public hospitals.

However, the group, which provides acute and specialist hospital services in the west and north-west of the country, has reassured the public that it is expanding its services to cope with the expected rise in patient numbers. At the time of going to press on Wednesday evening there were 128 cases of Covid-19 in Galway.

Mr Canavan said while all Saolta’s local hospitals currently have vacant [general] beds and this is being maintained, the occupancy levels of its intensive care units is “changing quite a bit” due to the Covid-19 crisis.

“A week ago there would have been 10 people [with the virus] in the intensive care units in our hospitals in Galway and Mayo. That figure has doubled, there are now up to 20 between our three hospitals.”

Despite this rise in the number of patients, the hospitals are still working within their existing bed complements, he said. But if that rate of increase continues or escalates next week or over the next few weeks, the local hospitals will reach capacity.

He outlined that all Saolta hospitals have individual plans to expand their ICU capacity. “This is part of our ‘surge plan’, to increase ICU beds and ventilators on every site. We plan to double our ICU capacity across each of our hospitals in Mayo, Portiuncula, and UHG and this is also true for our whole hospital group. We hope it is enough but we don’t know if it is. We will do this first of all. We have 22 ICU beds in Galway and we hope to expand these to 40 and possibly more but our hope is that we never have to use them.

“In addition to that, we have also purchased some additional specialist equipment, including ventilators. We have 22 plus ventilators already and we have orders placed for more. We would be able to access about 40. I am confident they will be delivered on time, these are mainly units from abroad. Medtronic are also making their own ventilators and they would be a big supplier.” The Mervue based company is one of the world’s biggest ventilator manufacturers and is increasing its production from 400 weekly by the end of this month to 1,000 a week by June to help in the battle against the coronavirus.

Mr Canavan said Saolta has provided a “significant amount of training” to its existing hospital staff. “When required, they will move into the ICUs.” He pointed out that the hospitals were working closely together to provide the best patient services. This sometimes involved transferring patients to other hospitals when capacity issues occurred.

“Last week in Letterkenny [University Hospital] for example, its ICU reached capacity so the next person who required ICU care was transferred to Galway because it was quiet. We have taken patients from Letterkenny, Portiuncula, and Mayo University Hospitals in the last week. One of our strategies is we have our hospitals working together to provide the best service. We are not just managing individual sites, we are looking at the whole group. That co-operation gives us all confidence in the system.

“Pathways of care are in place in our hospitals for more than a week now and are working well. We are managing to keep a level of separation between Covid-positive and Covid-negative patients.”

Covid19 Gardaí Stop Motorists

So where do you think you're going now — Gardai enforcing the COVID-19 travel restrictions at a checkpoint at the Coolough Roundabout on Wednesday evening.

The news that the two private hospitals in Galway came under the HSE’s wing last week will help greatly in the fight against the virus, he outlined. These facilities will act as part of the public health system for the duration of the pandemic. The fact that they are Covid-free is a major bonus.

“We are absolutely delighted they have come on board, it was a really good decision at national level. We hope, for example, that a lot of work taking place in Unit 4 in Merlin Park Hospital, ie, medical rehabilitation for people who have had strokes and require physiotherapy or occupational therapy, will move over to the Bon Secours Hospital. We hope this will happen later this week or early next week. It is likely some orthopaedic work will move too and possibly other work as well.”

Urgent, time-sensitive surgical procedures will take place at the Galway Clinic, according to the chief executive. “If someone has cancer, for example, and requires surgery we hope to transfer that work to the Galway Clinic. That kind of work can’t stop, it must continue.”

The Unit 4 and Hospital Block (which mainly catered for orthopaedic patients ) buildings at Merlin Park Hospital will now be used as centres for recovering Covid-19 patients.

“These will be available to take patients when they finish in UHG. Those are people who would come in with Covid and recover but would not be ready to go home.”

The Bailey Allen conference and event centre at NUI Galway, which has theatre-style seating capacity for more than 1,000 people, will be used as a field hospital should the need arise during this public health crisis. It is understood it would provide 116 extra beds.

“We have put together a proposal for what is called a field hospital which will give us significant capacity,” Mr Canavan said. “It is really important that we get extra beds but we would have to staff these. We submitted our proposal on Friday last to the national HSE and are awaiting approval. We are planning for absolutely the worst but we hope it is not going to get to that point. We hope that it will just be on standby and that we never have to use it.”

The Connacht Hotel on the Dublin Road, one of the city’s longest established hotels and comprises rooms, suites, and apartments, will act as a self-isolation centre during the pandemic. It will cater for people living in the community who cannot self-isolate at home and may provide up to 600 beds.

“We have prepared a submission for the HSE on this, too. These may be people living in very vulnerable situations such as being homeless or in unsuitable accommodation such as group accommodation. The model it would be run on would be the same as that for the Citywest Hotel in Dublin.”

Sadly, as the death toll from Covid-19 continues to rise, local health and council authorities must also make provision for an anticipated increase in deaths.

“Already 175 people have died in Ireland from Covid-19 and we expect that figure to rise. Part of our planning has to be around how we are going to look after people when they pass away and do it respectfully. We have made provision for additional capacity in our morgues. We have put additional capacity onto one of our hospital sites - UHG. We are working with our four local authorities - Galway City and County Councils and Mayo and Roscommon Co Councils. We already have morgues in UHG, Portiuncula, and Mayo University Hospital - the Portiuncula and Mayo morgues can be extended further if its comes to it.”

Mr Canavan appealed to people to continue abiding by Government regulations in a bid to halt the spread of the coronavirus. He said staff morale was “very good” in the local hospitals and healthcare workers were doing everything they could to provide quality care and save people’s lives. However, it was important that the public did their best to protect their own health and, if at all possible, avoid getting infected by the virus. This would reduce the pressure on intensive care units and also on the medical teams who will have “really difficult decisions to make, for themselves and others, as regards access to critical care beds”.

 

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