As the daily figures point towards an imminent second wave of the virus in Ireland, concern is growing once again regarding the number of available ICU beds.
The number of patients being treated for Covid-19 in ICUs has been steadily increasing since the end of August.
On August 26th, only four people were being treated for the virus in ICUs, down from the 155-patient high recorded on April 10th and 11th.
According to the HSE’s National Adult Critical Care Report, published in September, 2019, Ireland had 255 adult critical care beds available.
However, the report also highlighted 19 ICU beds which were “non-operational” due to a “HSE employment pause”.
According to the HSE’s chief clinical officer Dr Colm Henry speaking this morning, there are currently 278 ICU beds in the Republic.
Tonight there are 90 people hospitalised,19 in ICU (23 & 8, 4 weeks ago).This is a very concerning trend.Please ignore noises that relay otherwise.We all have to protect our family, friends & health workers from being the next number. Please let's do it. We can #COVID19 @HSELive
— Paul Reid (@paulreiddublin) September 21, 2020
At the end of March as the pandemic began to take a hold in Ireland, ICU capacity was increased through a €100 million deal between the State and 20 private hospitals.
The three-month deal was made despite recommendations against it by the HSE, with the State later opting not to trigger a two-month extension period in May as the number of patients in ICUs decreased throughout the month.
Redeploying staff
In April, critical care specialists raised their concerns with the Government, saying the short-term solution of redeploying staff from other areas was not suitable in the long-term.
In a letter to then-Taoiseach Leo Varadkar, a group of critical care specialists urged the Government to rapidly increase ICU capacity as other urgent healthcare services would need to resume despite the pandemic.
“Our pre-pandemic intensive care unit occupancy of 88 per cent nationally and over 96 per cent in major units is well above the international recommended rate of 75 per cent.
“For too long the request of the critical care community for appropriate capacity has been deferred. serial reports over the past 15 years have consistently documented the inadequacy of critical care capacity in Ireland,” the letter stated.
[timgcap=Graph showing the number of patients being treated in ICU beds from March to September. Source: Covid-19 Data Hub]ICUhospitalbeds_AprilSept_CovidHub_large.JPG[/timgcap]
Although Dr Henry said the HSE are currently aiming to double ICU capacity, he warned that more intensive care beds were not the solution to the spread of Covid-19.
We can’t rely on intensive care beds as a line of defence
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“We can’t rely on intensive care beds as a line of defence,” Dr Henry told Newstalk Breakfast, adding that the only way to prevent spread of the virus was to limit contacts.
The president of the Intensive Care Society, Dr Colman O’Loughlin told RTÉ’s Today with Claire Byrne show that there was “a long way to go” in increasing intensive care bed capacity and that staffing remained an issue.
Dr O’Loughlin added that it takes a long time to “switch on a bed” as it requires at least six months training for a registered nurse to become an intensive care nurse.
He highlighted that Ireland operates a 1:1 nurse-to-patient ratio in ICUs, the international standard, which meant that an average of 5.6 nurses are required to operate one ICU bed.
Dr O’Loughlin also pointed out that the ability to take in overseas staff was no longer the same as before and reducing the number of people in need of critical care for Coivd-19 was the best way to help reduce the impact on the health service.
