No timescale for elective surgery deferrals

HOSPITAL waiting lists look set to increase significantly again following the cancellation of the majority of scheduled surgery and outpatient appointments in public acute facilities amid concern from a local senator Covid-19 is spreading in Clare like “wildfire”.

UL Hospitals’ Group has confirmed the deferral, until further notice, of the majority of scheduled surgery and outpatient appointments across the group.

This includes University Hospital Limerick, Ennis Hospital, Nenagh Hospital, St John’s Hospital and Croom Orthopaedic Hospital.

University Maternity Hospital Limerick is unaffected by the reductions.

The number of Clare and Mid-West public in-patient and day case waiting lists soared from 4,198 in January 2020 to 6,612 last November, while the numbers on outpatients’ lists jumped dramatically from 47,134 to 55,088 during the same period.

There has been an increase of almost 3,000 confirmed Covid-19 cases in the Mid-West from December 19 to January 3.

According to official statistics, the number of positive cases in Clare jumped from 1,546 to 2,135; Limerick cases soared from 3,195 to 5,138, while Tipperary recorded a hike of 464 from 1,682 to 2,146.

The group regrets the distress and inconvenience these restrictions cause patients and their loved ones, but notes they are being implemented for the safety of patients and staff and to ensure essential services continue to operate for the sickest patients.

Patients affected by the cancellations will be rescheduled at the earliest opportunity. The group hasn’t given an estimated timeframe for the resumption of elective services.

Group CEO, Colette Cowan outlined the group are now at a critical juncture as its expects the volume of Covid-19 patients admitted to hospital will soon exceed the numbers treated during the first wave.

“This will present tremendous challenges for our hospitals and for our communities across the Mid-West. Since the start of the pandemic the group have significantly increased staffing levels and bed capacity. Staff have upskilled and gained valuable experience on how to treat patients ill with this terrible disease.

“The group are currently under considerable pressure but managing. However, no healthcare system could continue to cope with the current rate of increase in community transmission; hospital admissions and ICU admissions.

“The current rate of growth is unsustainable and the group are depending on the public to again follow the public health advice as they have done in the past. It is imperative that people stay at home, that they keep their distance, wash their hands and take all the simple precautions to help us through this most challenging phase yet.”

Senator Martin Conway said the situation with Covid-19 had reached such a critical level that all resources have to be concentrated on dealing with it.

“The anecdotal evidence I have from my own community is Covid-19 is spreading like ‘wildfire’. People are now genuinely afraid of picking up the virus. People were talking in the abstract for a long time about the virus, now people are talking about it in a real sense.

“Christmas was an absolute disaster. The government did their best in terms of following National Public Health Emergency Team NPHET advice. HPHET advice was to leave the hospitality sector closed but allow house visits.

The government opened the hospitality sector but didn’t allow house visits until December 18. There was breaches of Covid-19 guidelines in every parish in the country.

“We always knew the Christmas period would be a problem but I don’t think anyone including NPHET realised the consequences would be as dire as they are now.

“We are now dealing with a very angry aggressive third wave of Covid-19 that is spreading like ‘wildfire’. It is clearly out of control. There was a cocktail of Christmas, pandemic fatigue and people letting their guard down.

“I don’t think people realise how easily this disease is spread. It is easier to catch than the common cold.

Senator Conway described the cancellation of elective surgery as the “lesser of two evils” to keep people at home and reduce the risk of contracting the virus while freeing up capacity for people who require ICU.

Despite some progress reducing waiting lists in 2019, Senator Conway acknowledged they increased again last year to very high levels after surgery was cancelled due to the pandemic, which the government couldn’t control without prioritising capacity for very seriously ill Covid-19 patients.

He hopes people will learn lessons from the Christmas period and revert to following public health guidelines.

“My heart goes out to people who forfeited the chance to see their loved ones during Christmas to protect them. I know many people in London and abroad who didn’t come home because they were advised not to do so.

“About 30,000 people came home from England. Some of these followed public health advice to self-isolate for 14 days but many others didn’t.”

He believes that significant investment in health services will be prioritised once the pandemic is under control to tackle spiralling waiting lists.

Dr Yvonne Williams recalled some of her patients, who were due to get scopes in March or April, had this investigation delayed for months, which didn’t lead to a better outcome.

However, the Shannon GP acknowledged the group had no alternative as hospitals will come under serious pressure in the coming weeks.

“The group has to ensure there is an ICU bed available for those that need it and they have enough staff to look after the ill patients who are coming into the hospitality

“If someone is stable at home, that is probably a safer place than going into hospital, if it was overcrowded or above capacity. Nobody wants to see that happen.

“It is inevitable there will be a knock impact for patients, which makes it so important for everyone to stay at home as much as they can in January.

Acknowledging the deferral of elective procedures will result in increased waiting lists for public patients, she said the government could embark on a recruitment campaign to fill some of the hundreds of unfilled consultant and other healthcare posts including general practitioner.

“We should never have started the pandemic with waiting lists of years for patients to see specialists. There is also an increasing number of people on waiting lists to see general practitioners as well because there are not enough of doctors, nurses, physiotherapists or occupational therapists to provide the type of service that people deserve.

Dr Yvonne Williams expects the number of Covid-19 cases to continue rising over the next two or three weeks before a gradual fall and believes it could be mid February before they return to more manageable levels.

She warns the current figures is an underestimation of the real extent of the virus because everyone with symptoms doesn’t get tested, every patient who should be tested doesn’t turn up and close contacts are not being tested at the moment unless they are symptomatic.

She said general practitioners saw an increase in the number of infections and symptoms in the week before and after Christmas and were aware of the greater level of mixing amongst the general public.

Dan Danaher