Worst-case winter could see 17,000 hospitalised for Covid and 4,350 for flu, according to HSE projections

Up to 17,000 patients could be hospitalised with Covid-19 and 4,350 with flu in the coming months, according to projections in the newly published HSE winter plan.

Should waves of both viruses occur, about 700 patients could require ICU admission for Covid-19 and 225 for flu, the plan states.

Even a low flu season could result in about 2,900 hospitalisations, including 150 ICU admissions, according to the projections drawn up by the Health Protection Surveillance Centre.

HSE chief clinical officer Dr Colm Henry pointed out that these were worse-case scenarios and said the outlook for this winter was uncertain. “There’s been a lot of talk about twindemics; while this is possible, it’s far from certain that will happen,” he told a media briefing on Tuesday.

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In Australia’s most recent winter, he pointed out, an early spike of flu cases was not followed by huge pressure on the health system. “Likewise we have not yet encountered a new variant of concern which has caused a level of disruption and illness that previous variants caused.”

He urged people to “play their part” by “embracing” the vaccine programme in time for winter.

Funding of €169 million has been assigned to the winter plan, which envisages the recruitment of 608 additional posts. Previous winter plans have failed to reach targets for recruiting staff.

A separate plan has been drawn up by the Department of Health for the possibility of a new Covid-19 variant of concern. The plan, which envisages the reintroduction of pandemic measures if an emergency occurs, was presented to Cabinet on Tuesday.

Minister for Health Stephen Donnelly told Cabinet colleagues of provisions for the rapid deployment of a nationwide testing and tracing operation, as well as a new mass vaccination programme, which would extend to all age groups if it was deemed necessary.

He said there are no plans in place at present to introduce compulsory mask-wearing. However, the plan does provide for masks to be introduced in certain locations and situations.

Mr Donnelly told reporters that the plan was being presented at a time there had been a significant increase in hospital admissions of those diagnosed with Covid.

The numbers of those in hospital with Covid have been steadily rising in the past week, up from just over 400 people on the Tuesday of last week to 474 people on Tuesday.

The number of flu cases this winter has already started to rise, and 17 people were hospitalised last week. Interim HPSC director Dr Greg Martin told the HSE briefing this could be due to increased surveillance and people being more concerned over their health as well as an actual rise in cases.

RSV (respiratory syncytial virus) cases are also rising, with 171 cases last week and 75 hospitalisations. Cases are tracking the pattern of last winter, when they peaked early.

Dr Martin said this could be a good thing, as it would make it less likely that flu, Covid-19 and RSV waves peaked at the same time. He said there was no reason not to expect this winter to be a typical one for flu, though it may arrive early.

More than 284,000 people availed of the free flu vaccine in the first week it was available, according to Eileen Whelan, HSE lead for testing and vaccination. The flu vaccine is available free to over-65s, healthcare workers and vulnerable groups.

Last week, the first week adapted vaccines were made available, 78,600 people were administered a Covid-19 booster.

Ms Whelan said that while Covid-19 testing capacity was being maintained at current levels, from next week National Ambulance Service staff would play a greater supplementary role in testing centres.

Only 4,000 people a week are getting PCR tests because only a small number of categories require testing, she said, but the system can cater for up to 20,000 tests, and can be scaled up further to 45,000 if required.

Dr Henry said there are no plans to redeploy frontline health staff who are not vaccinated away from patient contact, but if outbreaks occurred and it was felt that patients were at risk, “it’s something we would have to consider”.

Additional hospital and community beds will be provided along with increased staffing. It is also planned to extend the opening hours of some local injury units over the winter, in order to take pressure off hospital EDs.

More supports in the community will be provided as part of a plan to provide alternative patient pathways and reduce the number of presentations and admissions to hospital.

If Covid-19 cases surge, additional emergency measures will be put in place.