The number of patients attending the emergency departments (EDs ) of local hospitals has dropped dramatically during the Covid-19 pandemic.
There were no patients waiting for beds at University Hospital Galway's ED on Monday or Tuesday of this week while only one patient was recorded as waiting on a trolley on each of these days at Portiuncula University Hospital in Ballinasloe. The emergency department at Mayo University Hospital in Castlebar was also empty on those days, according to the Irish Nurses and Midwives Organisation which records daily "Trolley Watch" numbers in the country's public hospitals.
There were a total of 22 patients waiting for beds on Monday and 37 on Tuesday in public hospitals throughout the country. Very low figures were also recorded for ED attendances in recent weeks.
This fall off in numbers has resulted in a major daily reduction in general hospital admissions which has prompted growing concern among health authorities that many people are missing out on vital treatment and care.
Despite strong assurances from hospitals that there were separate entrance and treatment pathways for coronavirus patients, fears about contracting this potentially fatal virus is stlll keeping sick patients away from EDs. These facilities were recording very high attendance rates prior to this global health emergency.
Tony Canavan, the chief executive of the Saolta University Health Care Group, which runs the seven public hospitals in Galway, Mayo, Roscommon, Sligo, and Donegal, renewed his appeal this week to people with health concerns to attend hospital. He said he was very concerned about this group's reluctance to access care and said the reduction in numbers was not due to people having "become healthier".
'While the coronavirus curve appears to have been flattened, many lives have been lost and the health of whole communities has been adversely affected by this insidious infection'
He reassured them that services were operating as normal and that every precaution was being taken to protect people's health and keep patients safe. He feared there were people with major health problems, such as heart attack or stroke symptoms, staying away from hospital during the current health crisis.
"The hospitals are so quiet, there has been a very significant drop in attendance at emergency departments which is of growing concern to us" he told this newspaper. A 50 per cent fall-off in numbers has been recorded on some days. "There is a reduction in the number of admissions to hospitals because of this." There are 200 vacant general hospital beds in Galway, Mayo, and Roscommon. Most are in Galway because it is the west's biggest hospital. A number of beds have been freed up at Merlin Park Hospital as some services have been transferred to the Bon Secours Hospital in Renmore for the duration of the pandemic.
He said that ED figures rose "very slightly" this week but the drop-off in the numbers of patients was still a major issue and was something which the hospital would address at the start of next month. People on hospital waiting lists would be high on his agenda.
Meanwhile managing the pandemic is still very much the top priority of the local hospitals. While the coronavirus curve appears to have been flattened and the number of patients in local intensive care units (ICUs ) are much lower than originally anticipated, many lives have been lost and the health of whole communities has been adversely affected by this insidious infection.
'If swift action, in terms of preparation, had not been take as early as it had been, the hospitals would have been "absolutely overrun"'
There were five patients with Covid-19 in the ICU department of UHG, one in Portiuncula University Hospital, and three in Mayo University Hospital this week. There are currently 21 vacant ICU beds in the three hospitals. A total of 294 confirmed cases of the virus were recorded in Galway, 332 in Mayo, and 91 in Roscommon as of April 18, the latest date for which figures were available, according to Mr Canavan.
"These [local ICU numbers] are lower than last week," he said. "A few things are helping us understand a little better what is happening. At national level, a peak in the number of deaths and cases [of the coronavirus] may have occurred earlier in April. The other thing they [the Department of Health] are saying is that the curve has been flattened. It looks like this is the case and our figures reflect it. There is absolutely no question that the decisions taken by the Government, the timing [of those decisions], and the [public] compliance with these measures has been responsible for this. In fairness, the reason we flattened the curve is because ordinary people were very, very compliant with the restrictions which were put in place."
A major health crisis was averted by communities working in partnership with the Government, he said, and added that a very grave situation could have been unfolding now in Ireland otherwise. If this country had experienced the same challenges as Italy did, our health service would not have been able to cope, he stated.
"In the middle of April we had 16 people in our ICUs in Galway and Mayo. In total, we have 30 ICU beds across the three hospitals [UHG, Portiuncula, and Mayo]. They were a little over half full then. When we were looking back a few weeks ago and planning and forecasting what would be required we believed there would have been a requirement for 100 beds - we were looking at the situation, for example, in Italy. But in reality we were only using 16."
'We all feel it would be good to get back some normality. However, the progress that has been made is quite delicate. It wouldn't take much to cause a further spread of the virus'
If swift action, in terms of preparation, had not been take as early as it had been, the hospitals would have been "absolutely overrun", he said. "There is no question about that. We went into this very, very nervous, even with all the preparation and work done. If we ended up in the same situation as Italy we wouldn't be able to cope. It's as black and white as that. The people who have survived Covid-19 in Ireland wouldn't have survived. The measures that were taken [here] were so important."
While significant progress has been made in stemming the coronavirus tide, Mr Canavan remained cautious about this highly infectious illness which has no respect for borders. He urged people not to become complacent and to continue abiding by the Government's personal safety regulations. "We all feel it would be good to get back some normality. However, the progress that has been made is quite delicate. It wouldn't take much to cause a further spread of the virus."
Major concerns over nursing homes
Among Mr Canavan's other concerns are helping nursing homes cope with the spread of Covid-19, ensuring residents remain safe, and looking after the well-being of healthcare staff who have become infected.
"To some extent, our focus is shifting to see how we can support people in nursing homes. There are 73 private nursing homes and 20 HSE facilities across the three counties of Galway, Mayo, and Roscommon. There are residents and staff in some of these homes testing positive for Covid-19. We know for sure more than half of the deaths from it throughout the country are in nursing homes or long term care facilities.
'Everybody is pulling together, the HSE, the hospital group, and communities. We are all trying to pull together to do our best'
"Within the HSE there have been structures put in place in both public and private long term care facilities. Our hospital group are contributing to this and are involved in a number of ways. The most important way is we are contributing staff, both medical and nursing staff are providing support as required. Our medical staff have been in these facilities for the last two weeks and our nursing staff are starting this week. They are available if and when required and will go into these individual homes. The reason we can do that is we still have empty beds on all sides [in hospitals] therefore there are some nursing staff we can release."
He acknowledged there were ongoing difficulties in relation to accessing personal protective equipment (PPE ) but stated the situation was much better now than a couple of weeks ago.
"We are trying to ensure that the nursing homes get the PPE that they require. They are getting some but they are saying they need more."
The Saolta chief executive said while a lot of work has been done in many areas there was still much to do. "We want to try and make sure that people in our long term care facilities are safe and are not afraid and that their families are not either. We are concerned about our staff, too. A number of healthcare staff tested positive for Covid-19. We are concerned about their wellbeing. We want to remain on top of the virus in the community, also. Everybody is pulling together, the HSE, the hospital group, and communities. We are all trying to pull together to do our best."