Cork University Hospital“If numbers continue to deteriorate as it appears that they are, it’s going to have knock-on consequences.”

As heard on Today with Claire Byrne

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There are many worrying takeaways from Brian O’Connell’s report from Cork University Hospital for Today with Claire Byrne on Thursday, the first of which is the fact that just four weeks ago, CUH had no Covid-19 patients in the hospital. When Brian visited them on Wednesday, they had 20, two of whom were in Intensive Care.  

“Everyone I met in the CUH, nurse managers, physios, mental health specialists, they kept saying to me again and again yesterday, the message needs to get out that hospitals like the CUH are under enormous pressure. There were no ICU beds available at many hospitals, including the CUH yesterday.” 

Brian told Claire that he met some incredible staff during his visit to the CUH, all of them working under extremely trying conditions. 

“They’re working in circumstances, Claire, that they may never have expected to deal with, making moral decisions, as they told me yesterday, which run contrary, in some cases, to what they’ve been trained for.” 

During his visit, Brian went behind the scenes of the fight against Covid, seeing first-hand what conditions are like in the CUH’s Emergency Department, the Covid wards and the ICU. He spoke to staff, starting with Dr Carina Sadlier, one of the CUH’s Infectious Disease consultants, who acted as his tour guide in the hospital. She told him that all patients attending at the ED are swabbed for Covid: 

“What we are starting to see is patients who are not symptomatic from a Covid perspective, but who are swabbing positive for Covid coming in.” 

CUH, with over 800 beds, is an extremely busy hospital, and Dr Sadlier told Brian that, although there are only about 20 patients with Covid in the hospital, that does add an extra layer of complexity to patient care for the whole hospital. The ED in particular has had to be revamped, as the traditional picture of many patients packed into a small waiting area is not an option during the pandemic. 

“These open waiting areas, which often were packed to the point of having people standing, having people gathered outside, are just – they’re just not fit for purpose now. So, we’re, I suppose, working in a very different environment.” 

Brian stopped outside a sealed room with a nurse standing looking at a video screen outside it. Dr Sadlier explained: 

“This is just to allow us to monitor closely patients who are in isolation for suspected Covid, or with Covid. Each time a member of staff has to go in, they have to don and doff PPE. We need to be in contact with patients, but just that someone has eyes on them when they’re not in the room.” 

Brian then spoke to Rory O’Brien, who told him that the hospital often has patients waiting in the waiting room who need urgent treatment and this leads to moral dilemmas on a daily basis. But this, he told Brian, is nothing new: 

“This is what we’ve been doing before Covid. Covid has changed the way we’re streaming and it’s putting, I suppose, more pressure on the people who are trying to put patients in beds. There’s definitely extra pressure.” 

If Covid infections keep climbing, Rory told Brian, it will have adverse effects for patients attending CUH: 

“If numbers continue to deteriorate as it appears that they are, it’s going to have knock-on consequences. And I think it’s not so much for the patients with Covid, actually, it’s for the patients who don’t have Covid, will suffer.” 

It’s a chilling assessment. Next, Brian was taken into the Covid ward. Treating Covid patients is logistically challenging, as staff have to don and doff PPE for each patient they see. Isolation is distressing for patients, particularly the elderly. Dr Sadlier put the hospital’s status in the context of rising numbers of Covid infections: 

“We’re the last line. We’re really, I suppose, dependent on the community to take this seriously, to try and push this virus back or the hospital will start to flood with sick patients.” 

You can hear an extract from Brian’s report by clicking above, but it’s well worth listening to it in its entirety and you can do that here. 

Niall Ó Sioradáin 

© The Listener 2020

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