HSE cannot be ‘certain’ of avoiding return to record hospital overcrowding

The Health Service Executive (HSE) has said it cannot be “certain” hospitals have seen the last of record levels of patients waiting on trolleys in emergency departments during the current wave of winter respiratory viruses.

Stephen Mulvany, HSE chief executive, said current pressures in emergency departments were at about half the highest levels last week.

The HSE said its internal count of patients on trolleys hit a high of 772 on January 3rd, but was down to 352 on Thursday.

“In our worst modelling that number could have gone over 800 in fact closer to 1,000,” Mr Mulvany said.

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Figures from the Irish Nurses and Midwives Organisation (INMO) also hit a record high of 931 on January 3rd. The nurses’ union said it recorded 497 patients waiting in emergency departments or wards to be admitted to beds on Thursday.

Mr Mulvany said the health service could not be “absolutely certain” that it could avoid a return to record levels of patients waiting on trolleys. “We can’t be sure, but everything we’re doing is to prevent that,” he said.

The HSE chief executive said the high numbers of patients waiting on trolleys was “impossible” to stand over.

Total admissions into hospitals were running 10 per cent higher than the HSE’s previous “most pessimistic model” heading into the winter surge, he said.

Two of the last three weeks saw record levels of attendance and admissions of patients over 75 years of age, he said.

The health service was prepared to continue to deal with “high levels of flu and other viruses” into February and possibly March, he said.

Emergency measures to bring more staff into hospitals on weekends and extend General Practice opening hours were having a “significant” impact in easing overcrowding in emergency departments, he said.

Damien McCallion, HSE chief operations officer, said the numbers waiting on trolleys in recent days were down from “some of those unfortunate peaks” seen at the start of last week.

The “emergency response” of having more senior healthcare staff and consultants working in hospitals over weekends had proved “invaluable” in tackling the ongoing pressures, he said.

“Clearly we know it’s not sustainable to work people Saturday and Sundays when they’ve worked during the week,” he added.

There were currently 622 people in hospital with Covid-19, 693 patients with the flu and 111 with respiratory syncytial virus (RSV).

Dr Colm Henry, HSE chief clinical officer, said cases of Covid-19 and RSV were beginning to level off, but it would be around a week before the HSE could be sure cases of flu had hit their peak.

“It is too early to say whether it has peaked or not, perhaps the rate of growth is beginning to abate a bit but we need another week [to see],” he said.

However, the second half of the flu season would continue to put pressure on hospitals as cases fell off, he said.

“This flu season could go on right through January, if not February as it begins to tail out,” he said.

The number of outbreaks of Covid-19 in nursing homes and hospitals were “going in the right direction”, he said.

The Omicron subvariant XBB. 1.5, dubbed Kraken by some scientists, appeared to be “much more transmissible” than previous iterations of the virus, Dr Henry said.

“It certainly appears to have a growth advantage over previous variants ... It may have – based on some early analysis – some characteristics that make it immune to antibodies, either from natural infection or vaccination,” he said.

Dr Henry added there was no indication the subvariant was “as severe” as previous variants that caused a higher rate of hospitalisation.