People have been urged to consider alternatives before going to Emergency Departments (EDs) as hospitals come under increased pressure.
Attendances have been fuelled by a rapid increase in flu, Covid-19 and RSV cases, with 1,500 people currently in hospital with those illnesses.
The warning comes as figures from the Irish Nurses and Midwives Organisation (INMO) showed there were over 931 patients waiting on trolleys for a hospital bed on Tuesday morning, the highest number since the union's records began in 2006.
The HSE expects the rise to continue for “a number of weeks”, which will “seriously impact” hospitals.
In a statement on Tuesday, the HSE asked those who need medical care or assessment “to consider all options” before going to an ED during what “is going to be the busiest ever period experienced by the health service”.
It said: “While this surge of winter virus infections was predicted and planned for, the trends being seen are following the more pessimistic of predicted models and also appear to be increasing earlier than had been hoped.
“While some patients will regrettably experience long wait times in our emergency departments, urgent patients will always be prioritised for treatment and care.”
Damien McCallion, the HSE’s chief operations officer, said the “unprecedented combination” of very high levels of respiratory illnesses has led to stress on hospitals.
“Those who believe they may be seriously ill and require emergency care should of course come to hospital, but we would urge others to consider seeking support from pharmacists, GPs, GP out-of-hours services and minor injury units.
“These services have emergency responses in place for patients presenting with respiratory and other urgent health issues.”
Practicalities
However, emergency medicine consultant Dr Fergal Hickey has warned that people with respiratory conditions should not be advised to attend minor injury unity and will not be seen.
Speaking on RTÉ Radio’s Today show, Dr Hickey also pointed out that advising people to contact their GP was not practical as many did not have a GP or access to a GP.
He added the advice to speak to a pharmacist was also problematic as they can only provide over the counter medication.
Dr Hickey said the only people likely to heed the HSE's appeal to avoid attending EDs where possible would be older people who were the ones most in need of hospital treatment. These people could later present with strokes or heart attacks instead, he added.
Dr Hickey said he had contacted the HSE communications team to draw their attention to the issues surrounding their messaging.
He added the current problem predates the Covid pandemic and continued to centre around the shortage of acute beds. In Ireland, there are 2.8 acute beds per 1,000 people, while the OECD average was 4.3, he said.
“This will kill people. Why is this being allowed to happen? Why are old people allowed to die?”
EDs are “warehousing” patients and infection, he claimed, adding they are “a big petri dish” for respiratory conditions as there are not enough beds or isolation facilities.
He also warned this is going to be an issue in any further pandemics. – Additional reporting: Vivienne Clarke