Hospital overcrowding to get worse amid ‘perfect storm’ of flu, RSV and Covid

Overcrowding in hospitals is likely to worsen as flu levels increase further, Minister for Health Stephen Donnelly has warned.

Speaking after a record of 931 patients on trolleys was set on Tuesday, Mr Donnelly said this was the result of a “perfect storm” of flu, respiratory syncytial virus (RSV) and Covid-19 waves.

The Government’s focus is on making sure that “all measures that can be taken are taken”, the Minister said. This includes the use of all available private bed capacity and diagnostics, increased homes supports and assistance for GPs.

Public hospitals will be able to access up to 360 beds in the private sector, twice the previously agreed amount, in a further measure aimed at reducing pressure on the health sector.

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Mr Donnelly is to brief the Cabinet on Wednesday on the measures being taken to alleviate the overcrowding crisis, and will meet senior HSE management again on Friday.

“We’re very keen to see senior decision-makers on-site, particularly when patients need them, late at night or at the weekend,” he told reporters at Beaumont Hospital in Dublin after a visit to its emergency department (ED). He toured the ED at St Vincent’s hospital earlier in the day and also met HSE officials.

Defending his preparations for the expected winter pressures on the health service, he said the Government has committed an “unprecedented” level of investment in health since the Covid-19 pandemic, including almost 1,000 additional hospital beds.

However, he said the health service has been hit by a “very severe” wave of flu, a “big wave” of RSV and renewed Covid cases.

“So we have this perfect storm of RSV, flu and Covid, obviously, as well as all of the normal pressures that really has absorbed the significant additional capacity that has been put into the system.”

Other countries in Europe are experiencing similar waves of respiratory viruses, he pointed out. “In spite of unprecedented additional public capacity being put in, and we will continue to add to that, this perfect storm of Covid, RSV and the flu has unfortunately put pressure on us here in Ireland, in the UK and in other countries as well.”

Mr Donnelly advised people to wear masks on public transport and in crowded indoor settings, but said he did not anticipate any change to existing advice from the chief medical officer on a mask mandate, which has been sought by the Irish Nurses and Midwives Organisation (INMO).

Mr Donnelly said the HSE had advised him that the flu wave is likely to get worse and to put more pressure on the system. “They don’t believe the flu wave has peaked.”

The 931 patients waiting for admission on Tuesday was well above the previous record of 760 patients on trolleys set in December and in January 2021. The most overcrowded hospital was University Hospital Limerick (UHL), with 97 patients waiting.

The INMO called on the Government to reintroduce compulsory mask-wearing in congregated settings in order to reduce the spread of respiratory infections.

INMO general secretary Phil Ní Sheaghdha called for “immediate and serious intervention” from the Government. Telling people to avoid hospitals “is not a plan or indeed safe. The public need to know exactly what type of care they can expect over the next six weeks,” she said.

Sinn Féin health spokesman David Cullinane called for an urgent meeting of the Oireachtas health committee to discuss the overcrowding crisis. He has written to the chair of the committee asking it be reconvened “as soon as is possible”. The HSE’s winter plan is clearly insufficient to deal with the scale of the problem, he said.

Record numbers of patients attending UHL on Monday prompted the hospital to declare a “major internal incident”, which remains in place. Extra staff have been drafted in to work, and other have been redeployed to the ED. No elective surgery was scheduled for early January, in anticipation of a surge in ED presentations.

For a number of hours on Monday, ambulances were diverted from UHL to other hospitals, aside from those carrying critically ill patients such as those with stroke or heart attack.

Other badly affected hospitals include University Hospital Cork with 74 patients waiting, St Vincent’s University Hospital in Dublin with 56 patients, and University Hospital Galway and Letterkenny University Hospital, both with 52.

According to the INMO’s Trolley Watch count, 767 patients are on trolleys in emergency departments and 164 are on trolleys elsewhere in hospitals. The figures include 26 children admitted to hospital but waiting for a bed.

A separate count by the HSE recorded 749 patients on trolleys in hospitals. The HSE’s TrolleyGAR count is confined to patients waiting for admission in EDs, whereas the INMO’s count includes admitted patients waiting in EDs and wards.

HSE chief operations officer Damien McCallion said that there were nearly 1,500 people in hospital on Tuesday morning with respiratory illnesses, and this is putting the system under significant pressure.

“Unfortunately, we do anticipate that that will continue for a number of weeks. We haven’t yet hit the peak of the flu season, but thankfully on the paediatric side we are starting to see some drop-off in the RSV virus.”