Hospitals have been put on war footing for the next two weeks amid fears the Covid-19 surge risks “unthinkable” intensive care decisions for the most seriously ill patients.
SE chief Paul Reid issued a call to arms yesterday in a letter to hospital managers – but it will mean the cancellation of hundreds of surgeries among waiting list patients.
It comes amid concerns that up to half of the people booked for Covid-19 booster shots are “no-shows” in some vaccination centres despite waning immunity and vulnerability to infection.
Mr Reid said struggling hospitals, particularly the largest, should prioritise Covid-19 care and urgent time-sensitive non-Covid patients.
They should also maximise all available capacity inside and outside hospital and report on the additional surge intensive care beds which can be created within the next seven to 10 days.
“This may necessitate curtailing all other activity to facilitate redeployment of staff to critical care areas.”
He said intensive care doctors told him they were already facing increasing difficulties in meeting the needs of patients who required specialist high-dependency care.
“The consequences of such an occurrence although unthinkable, are also well understood by each of you.”
It comes as another 4,650 new cases of the virus were reported yesterday. There were 643 Covid-19 patients in hospital, of whom 118 were in intensive care.
Chief medical officer Tony Holohan said that one in six people in Ireland experienced a cough, sore throat, high temperature or other flu-like symptoms last week.
Mr Reid said the booster appointment no-shows – which could be down to people feeling secure with their first course of vaccine – meant the drive to cut down on infected patients ending up in hospital was more difficult.
Donegal GP Dr Denis McCauley, of the Irish Medical Organisation (IMO), said he did not think it was due to apathy but the public needed to be reminded boosters were among a range of key measures to protect people at risk of infection and get the country out of the current crisis..
Mr Reid said unvaccinated patients were occupying around one in five intensive care beds.
The HSE plans to send more non-Covid public patients to private hospitals and increase the number of beds used per week from around 1,100 to nearly 3,000 as part of its safety net deal.
Anne O’Connor, HSE chief operations officer, said a typical larger hospital would have 100 planned inpatient and day case surgeries and procedures a day, including chemotherapy.
If all elective activity was cancelled, except for cancer and time-critical cases, there would be a 65pc cut in activity.
Other hidden difficulties include therapy services, including physiotherapy and occupational therapy provided in the community, which are suffering and are operating at around 53pc less than a year ago.
She said there were 1,721 surgeries cancelled from mid- September to the first week in November but that was an underestimate because it did not take account of hospitals deciding to reduce bookings in advance due to pressures.
Around 54pc of Covid-19 patients in intensive care are not vaccinated, 1pc are partly vaccinated and 45pc are fully vaccinated.
The HSE’s Covid-19 testing service is under record pressure and in the last seven days they tested around 200,000 lab samples.
It is now buying in some services from private testing companies based in airports and members of the army are also now involved in swabbing.
Damien McCallion, who oversees vaccination, said he expected the 161,000 over-80s to have had their booster shots this month.
The 336,000-strong cohort of people aged 70 to 79 will have received booster shots by the end of this month.
However, many of the 60-69 age group will still not be vaccinated at the end of December because of the delay in giving them a second dose of AstraZeneca vaccine and the need for at least a five- month gap before they get the booster.
He said the aim is to have the majority of this group either vaccinated or “given an appointment” by the end of December.
The HSE has lost a lot of staff due to Covid-19-related issues in recent weeks.
Mr Reid said the plan is to give healthcare workers a derogation from the new Government measures which requires fully vaccinated household contacts of a confirmed case with no symptoms to stay at home for five days and take antigen tests.
Evidence of the impact of booster shots so far is that cases in the over-85s accounted for just 0.4pc of cases of the virus in the last two weeks.
People aged 65 to 74 made up nearly one in five hospitalisations.
Cases of the virus in children aged under 18 years made up more than a quarter of infections in the last fortnight.
There are 336,000 people in their 70s and 130,500 of these have got a booster so far. Of 161,000 in their 80s, 132,200 have had booster shots.
Visit our Covid-19 vaccine dashboard for updates on the roll out of the vaccination program and the rate of Coronavirus cases Ireland