Doctor: intensive care treatment could be rationed
A FAILURE to radically reduce Covid-19 cases in Northern Ireland will result in doctors rationing intensive care treatment, it has emerged.
It is understood medics in Northern Ireland are discussing the possibility of reverse triage — where treatment is withdrawn from patients due to a lack of hospital beds and staff.
Patients in intensive care units (ICUS) could potentially be transferred to other wards and provided with palliative care instead to make way for other patients who are more likely to recover as Northern Ireland’s health service buckles under the pressure of the pandemic during the winter months.
Commenting on the development, a leading doctor warned Northern Ireland’s health service is facing the worst period of the pandemic to date and that he is seriously concerned his hospital colleagues may be faced with making unprecedented “ethical decisions” in the coming weeks on how they treat all ICU patients.
Dr Tom Black, chair of the British Medical Association (BMA) Council in Northern Ireland, said rationing of treatment would extend to all patients and would not be restricted to Covid-19 patients.
This means that patients who require intensive care treatment following a traumatic injury or life-threatening illness, such as a stroke or aneurysm, could be affected.
Dr Black said he expects ICUS across Northern Ireland to come under severe pressure within the next three weeks.
“At the moment, you can see that intensive care isn’t under huge pressure but the emergency departments and hospital wards are really struggling, with the numbers in hospital wards still going up,” he explained.
“There is a lag period of about two weeks where Covid patients require inpatient treatment and about 10 days where they need intensive care, so I think we’re going to see the problems start in ICU in about three weeks.
“There is a serious concern that there would be increased pressure on intensive care beds and the system will become overwhelmed and doctors will have to make ethical decisions where they prioritise care on the basis of who will benefit from that care.
“These pressures are already embedded in the system, the number of people infected two or three weeks ago are in the wards now.
“I think the big concern about the decisions intensivists may
have to make, there is going to be more pressure on the health service in the coming weeks than there has been at any other point in the pandemic.
“It is very hard to increase the number of intensive care beds, the limiting factor is the staff, we know it is a struggle to achieve the highly trained intensive care staff.”
Last week, patients were treated in the back of ambulances due to a backlog in Antrim Area Hospital, prompting fears the health service in Northern Ireland was on the brink of collapse.
In response to the concerns raised, Health Minister Robin Swann has urged the public to remain vigilant to the threat posed by Covid-19 and also asked people to adhere to advice relating to visiting over the Christmas period.