Why intensive care beds are at the center of Ireland’s latest Covid crisis

The recent surge in coronavirus cases in Ireland has strained many intensive care units, causing hospital beds in some locations to run out.

The chief executive of the University of Limerick Hospitals Group said on Friday that the intensive care unit in The hospital was fullThis creates additional pressure on the employees.

Colette Cowan said she believes that by next Wednesday all elective procedures will be paused as the hospital group prepares for an increase in the number of Covid patients.

How did the country find itself in this situation again? There are many factors that play a role in this, but the key is the country’s ability to treat patients in intensive care.

How many intensive care beds are there in Ireland?

The state has only about 300 ICU beds. That number could be increased to about 350 by reallocating staff and resources as needed, although that would mean cutting back on other scheduled care.

If more than 350 ICU beds are needed at any one time, the system risks becoming overwhelmed, according to a report in critical care capacity From December last year.

Ireland has historically lagged behind other developed countries in the area of ​​intensive care. The state had just over five households per 100,000 inhabitants in 2019. The UK had more than seven, France 16 and Germany 28. Only Sweden and New Zealand have fewer beds than Ireland.

There has been more investment in the hospital system since the outbreak of the pandemic. At the start of 2020, the state had a base capacity of just 204 ICU beds, but that had been increased to 280 by last November, and now stands at about 300.

Providing equipment was previously a major issue, but now the biggest limitation on ICU capacity is the provision of experienced staff, especially nurses.

Even before the emergence of the Covid virus, Ireland’s hospitals were close to capacity. The OECD’s «Health at a Glance» report showed that the state had the highest bed occupancy rate in Europe in 2019.

What happened during the last covid wave?

In the worst wave of infection last January, there were 330 patients in intensive care, of whom 221 had Covid.

A total of 2021 patients were hospitalized with Covid on January 18.

The ICU system neared peak capacity due to Covid, but it wasn’t overwhelmed by the end. The mass abolition of other services had to create additional capacity within the system.

What do experts expect could happen this time?

On Wednesday, Neft Hospital’s chief epidemiologist, Dr. Philip Nolan, shared several scenarios for how the situation in the country’s hospitals could develop this winter if no action is taken.

The «optimistic scenario» he outlined «sees about 1,000 in hospital and 200 in critical care» in December. The «pessimistic scenario» would see more than 2,000 people in hospital and at least 400 people needing critical care.

This translates to more than 2,000 people in hospital and at least 400 people requiring critical care — not all of these people can be cared for in the ICU, and many will receive advanced respiratory support in highly accredited wards and units. 18/20 pic.twitter.com/2oUKo0baSv

– Professor Philip Nolan (@PhilipNolan_MU) November 17, 2021

Even the most optimistic scenarios have alarmed those who run hospitals and work in intensive care units across the country.

Dr Coleman O’Loughlin, president of the Critical Care Society of Ireland, spoke to The Irish Times about his concerns this winter. “There are only 300 ICU beds in the country. So even if 500 ICU beds required, only 300 beds would get it, and it would be a mixture of Covid and non-Covid.

«There will be cardiac arrest, there will be bad pneumonia, there will be pancreatitis, and there will be Covid. We have nowhere to put these patients,» he said.

If the republic sees 200,000 cases in December, as public health officials have made clear, health care will «collapse», said Collette Cowan, who heads the University of Limerick Hospital Group.

«It will lead to the collapse of health services and I don’t mean to be blatant,» she told RTÉ on Friday.

«We can get to a certain level, but besides that we also have a lot of people coming to the emergency department for treatment for other diseases.»

Health officials warn of a Tough few weeks for the country, but said the situation could still change with «small changes» in behaviour.

«Anyone who will contract Covid-19 in December has not yet been infected,» said Chief Medical Officer Dr Tony Holohan. «Their injury is not inevitable and there is still time to prevent it through small changes in our behaviour.»