Covid-19 hospital surge expected in ‘very difficult period ahead’

Plans are in place to deal with a surge in Covid-19 hospitalisations as the country faces into a "very difficult period ahead", the Oireachtas Special Committee on Covid-19 will hear on Wednesday.

As the country prepares to reopen its schools following a recent escalation in cases, Health Service Executive chief executive Paul Reid is to tell the committee that a new model for testing and tracing is being finalised to embrace technology changes and to include a permanent workforce.

The scale of the challenge facing the country will also be set out in stark figures – by last Saturday Ireland had experienced 2,580 outbreaks since the onset of the pandemic.

In the last two weeks, there have been 1,269 new cases compared to 264 for the same period in July, a comparative rise of 380 per cent.

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On Tuesday, the National Public Health Emergency Team (NPHET) reported a further 92 cases but no fatalities. Those figures brought total infections in the State to 28,201 with deaths remaining at 1,777.

In Northern Ireland, another 47 people tested positive, bringing the overall tally in the North to 6,823.

Acting chief medical officer Dr Ronan Glynn said while the daily numbers remained high the picture in the Republic has been relatively stable for the last week.

"However, we have seen cases in 25 of the 26 counties over the past 14 days, including 473 cases in Dublin, 332 in Kildare, 120 in Tipperary, 84 in Limerick, 37 in Clare and 36 in Meath and Kilkenny," he said.

Disease trajectory

“Measures introduced last week would not be expected to impact on the trajectory of the disease until early next week. In the meantime, we must continue to follow public health advice.”

In an opening statement to Wednesday’s committee hearing, Mr Reid will explain that while numbers have been on the rise they have not translated to an influx of hospital admissions, probably due to a younger age profile of more recent cases.

There are currently 22 patients admitted to hospital, of whom six are in intensive care and three on ventilators.

“We have plans in place to deal with a surge in hospitalisations,” he says.

“We are facing into a very difficult period ahead in our health services. In an ideal world, the elimination of the virus would make our work somewhat more straightforward. However, this isn’t our reality.

“We must live with this virus in a very new way, and this requires a carefully balanced approach. The health services need a functioning economy and society. Shutting down the economy and society has implications for our health services.”

Stress on economy

Recent debate around how best to confront the pandemic has included calls for the consideration of a “zero Covid” approach that would see a more aggressive pursuit of the virus but one many believe would inflict greater stress on the economy.

On Monday, Dr Glynn said he didn’t believe that it was possible to pursue a strategy to eliminate Covid-19 completely and that NPHET’s strategy was to “keep the cases as low as possible” and to protect education, vulnerable people and healthcare.

Testing has been ramped up to meet the recent increase in cases, and Mr Reid sets out that to date more than three-quarters of a million tests have been completed, including the highest weekly activity rate last week, at 55,000, since April. Similar numbers are under way this week.

The committee will also hear that criteria for the assessment of outbreaks in meat plants have been developed. These will inform decisions regarding their closure but will emphasise that blanket measures “may not be helpful”.

“We have also worked with the Department of Education on similar criteria for responding to outbreaks in schools, which will be a key focus in the coming weeks and months.”

However, Mr Reid explains that while institutional and workplace settings have received much attention, there has also been a large number of outbreaks in private households and among family, sporting and social groups.

Separately, Prof Philip Nolan, chair of NPHET’s Epidemiological Modelling Group, will tell the committee the country is at “an important juncture” in the response to the coronavirus pandemic.

Prof Nolan says that the coming weeks will be critical in showing that the State can meet its three priorities of protecting vulnerable people, resuming health services and reopening schools “while living with the threat of the virus and keeping it at bay.”

“The next few weeks will show if we, as a society, are capable of resuming the most important of our social, economic, educational, healthcare, cultural and sporting activities without spreading the virus between households and into our communities to any significant extent,” he says in his opening statement to the committee.

He will tell the committee that the challenges around increasing Covid-19 cases that led to new public health restrictions announced since the start of August “were detected quickly and that the responses were timely, specific, proportionate and, insofar as we can tell at this time, effective.”

The committee will also hear from Dr Glynn and Minister for Health Stephen Donnelly.