Medical services under pressure

Medical services continue to be stretched by the current epidemic of viral illness, according to doctors in both general and …

Medical services continue to be stretched by the current epidemic of viral illness, according to doctors in both general and hospital practice.

All planned admissions to Dublin's Beaumont and Mater Hospitals have ceased. Emergency admissions of acutely ill patients have almost tripled in the last week, putting intense pressure on hospital beds.

Dr Shane O'Neill, consultant respiratory physician at Beaumont Hospital, said he had not seen such a demand for hospital services in over 10 years.

"We are admitting 30-40 patients per night to acute medical beds, " he said.

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This is made up almost entirely of people with bacterial pneumonia, secondary to an initial viral infection. Most of these patients are in the "at risk" categories, such as the elderly and people with long-standing respiratory and cardiac disease.

"I believe that the majority of these patients have had a severe viral illness, rather than actual influenza," Dr O'Neill added. His view is backed up by official figures, which still fall short of those needed to label this a full-blown epidemic.

In the last week more cases of influenza have been identified by the Virus Reference Laboratory, and it is possible the numbers will continue to climb. One of the difficulties is the time lag between the onset of illness and the isolation of the flu virus by the laboratory. As things stand, however, the majority of people are suffering from a non-flu virus, but one which is severe in its effects.

Official figures from the UK show increasing numbers of patients with Influenza A. However, these figures, too, fall short of official epidemic levels. The accepted level at which a flu epidemic is declared is 400 people in every 100,000 of the population. The latest UK figures show 144 cases per 100,000.

Whether this "millennium bug" is Influenza A or another virus is largely academic. The effects on medical services are the same. Both types of virus can lead to secondary pneumonia and other medical complications particularly in the elderly and other vulnerable groups.

The treatment for the rest of the affected population is identical, regardless of which type of virus is to blame. This includes bed rest, fluids and paracetamol. Bed rest is especially important - it will ensure a quicker recovery and will also minimise person-to-person spread.

General practitioners report a high level of infection among patients who had received influenza vaccination in the autumn. This is a strong indicator that the current bug is another viral type, albeit with the same symptoms.

The pressure on medical services could not have come at a worse time. A circular from the chief executive to consultant staff at the Mater Hospital in December advised that all elective admissions to the hospital would cease until further notice.

This drastic measure resulted from an acute shortage of nurses. The staff shortage in the Mater and other major hospitals throughout the State will make the current high demand for services even more difficult to cope with.