Young must look after the old
Whole areas must be shut down... as the appeal to keep apart did not get through to some
THE Government needs to urgently put stricter quarantine laws in place to prevent the spread of coronavirus, according to the Irish doctors who are best placed to know of its dangers.
The warning came as medical experts and politicians warned about the shortage of medical staff in our health service, despite the huge response to a plea for retired doctors and nurses, and for emigrants, to come home and help fight the disease.
Dr Eoghan de Barra, of the Infectious Diseases Society, said last night that they supported the Government measures to date but were calling for more stringent measures.
‘It is clear to us that the best way to limit the spread of a disease is to limit contact, we certainly support the Government and we will support them if they take things further.’
The Beaumont Hospital consultant suggested new laws to allow whole areas to be shut down if people are gathering there may need to be implemented.
Dr de Barra said: ‘It seems around the country the message has not really got through in some sectors. Some parts of society are more sociable but they need to play a role and limit their contacts.
‘I think a lot of people have taken this on board, but this is an issue of equity across generations.
We are looking for the young to look after the old at this stage.’
He said doing more testing is vital, and stressed: ‘I am quite sure we still do not know the full extent of the cases.’
Referring to a report by the Health Protection Surveillance Centre on case numbers, this week, he said: ‘We are seeing increasing numbers of healthcare workers who are affected and out of the system, we are seeing concerns over shortages of personal protective equipment and over testing kits. We are concerned.’ Actions taken to limit the spread of any diseases take five to seven days to show an effect, he added.
Meanwhile, experts predict pressure will fall on all healthcare workers not just ICU staff, as the crisis worsens. This is based on the Italian and Chinese experience.
This week, even as about 50,000 volunteers and former medical workers offered to join the HSE in response to the emergency, stark figures emerged about the impact on health workers.
The Health Protection Surveillance Centre said that around a quarter of Irish cases are healthcare workers. Over two-thirds were infected here, including at their workplaces.
In Italy, where another 800 deaths from the virus were reported yesterday, a report published this week showed that 8.3% of cases are health staff, about twice the percentage in China. Professor
Anthony Staines, chair of Health Systems Research at Dublin City University, said: ‘It speaks to the generosity of spirit in the health services that so many are coming back. They are needed, the pressures points are everywhere.’
He said health workers are a priority for testing if they show symptoms, but it is taking three to four days for results, during this time they cannot work.
He said: ‘You can’t do surgery from your kitchen table. Nurses will be out, so everybody else is correspondingly busier.’ Ventilators are vital to keep critically ill patients alive as coronavirus brings on a severe type of pneumonia.
Prof. Staines said it’s not just about having enough machines but training more doctors to know when and how to put a sick person on a ventilator. He added: ‘It is far from obvious how to best ventilate someone, that is a specialised skill.’ And he was shocked this week to read that Italian doctors are now ventilating two patients per machine, which is unheard of in everyday medicine.
He said: ‘The rise in positive tests we see in Ireland was predicted. In Korea they were seeing 300 to 400 positives a day, now that is at 50 to 60. The number of new cases is falling and that is where we need to be. It’s Mother’s Day today, if you love them then please don’t visit them.’
Fine Gael TD for Cork Colm Bourke, previously the party’s Seanad spokesman on health said: ‘Retired nurses would have a lot of skills, they would back up the nurses on the frontline. We will need more health assistants. This isn’t just about medical needs.’
Mr Bourke said that an influx of patients means beds must be made and changed, trolleys moved
‘We are seeing an increasing number of health staff affected’
around by porters and everyone must be fed.
‘One concern raised with me is many of these nurses re-applying are coming from the nursing home sector. There could be attractions in a pension, better benefits. But we know if this virus gets into nursing homes it will be devastating. Nurses are needed everywhere.’
He said there are about 135,000 full and part-time workers in the HSE but the home help systems need to change.
He said: ‘This is a risk situation now. A carer might go into five or six houses, they will need to be briefed on coronavirus but should also have sanitisers and protective clothing.’
Maternity hospitals are worried about staff shortages.
Dr Cliona Murphy, head of the Institute of Obstetricians and
Gynaecology said: ‘We are conscious as obstetricians there are not that many of us, and we are hugely dependent on our midwifery colleagues. One of our big worries is if our midwifery colleagues become sick that would cause potential issues.’
The Rotunda is considering using retired staff to answer helplines, working remotely.
And a spokeswoman for the Coombe said: ‘We have received offers of help from some retired Coombe staff, for which we are very grateful.’
Dr Murphy said consultants are already doubling up for weekend on-call duty so if one person becomes ill there is someone to answer emergency calls.
She said at least one maternity hospital already has a full Covid-19 team.
GPs are the first port of call for people wanting a test.
Dr Michael Harty, previously a TD for Clare said: ‘We are settling into a new reality. Patients have to make appointments now. If they just turn up, we ask them to wait in the car.’
He said access to testing is an issue but that is improving as more centres open up.
On one day this week he needed to order four tests.
He said: ‘Ordering the tests is relatively simply, however there are 2,500 GPs in the country and if every GP orders just four then you have 10,000 a day. I don’t know if the HSE has the capacity for this.’
‘Home carers are visiting five or six houses’