Oxygen supply in Irish hospitals ‘a challenge’ as pandemic neared peak

Oxygen supply in Irish hospitals was a “challenge” as the acute system approached the peak of the pandemic in late March and early April, newly released records show.

According to minutes of a subgroup of the National Public Health Emergency Team (NPHET), the supply and management of oxygen was discussed on March 30th. The meeting was told that "supply of oxygen in hospitals was reported to be a challenge, as the maximum flow in hospitals cannot be increased".

On the day the subgroup on acute hospital preparedness met, some 295 new cases of Covid-19 were diagnosed, as Ireland entered the phase of the pandemic that saw the most pressure brought to bear on hospitals.

Dr Brian Marsh, a consultant in anaesthesia and intensive care at Dublin's Mater hospital, told the group that modelling had been undertaken in that hospital "looking at the flow throughout the hospital and tapering the supply as appropriate in some areas".

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At the time of the meeting, there were more than 450 confirmed cases of Covid-19 admitted to hospitals across the country, a figure which would peak in mid-April at more than 850.

Minutes of the meeting show that Dr Vida Hamilton, the Health Service Executive (HSE) national clinical adviser and group lead on acute hospitals, said the focus was on "appropriately managing the flow [of oxygen] to deliver the best outcomes possible to patients".

Among the other issues discussed by the group was the availability of staff, which was “reported to be a particular challenge” necessitating “ongoing training of non-critical care staff in critical care to bolster numbers”.

Ventilators

The number of ventilators available was also discussed, with HSE national director of acute hospitals Liam Woods flagging "considerable procurement challenges faced in this area with most of the supply from China now being absorbed by the US". Mr Woods "outlined the need for an enhanced procurement approach to support the HSE, given the unprecedented volatility of the market".

The notes also reveal in detail how the health service was planning to deal with a significant death toll associated with the virus. A dedicated mass fatalities expert group was set up, the minutes reveal, and "a number of large refrigeration units for storage of the deceased have been procured". The Royal Hospital in Kilmainham "will accommodate 500 bodies with further spaces available in the midwest".

At the time of the meeting, there was capacity available to store 1,500 deceased individuals, the notes record, while Mr Woods “confirmed that body bags have been procured and that postmortems would only take place in exceptional circumstances in relation to Covid-19 deaths”.

A “virtually-delivered chaplaincy service” was also being delivered, the notes show.