Rory O' Hanlon Profile picture
Cardiologist, Cardiovascular Magnetic Resonance, Heart failure, Sudden cardiac death, Cardiomyopathy

Sep 22, 2020, 13 tweets

We must look after all parts of the health needs despite COVID19 @HSELive @DonnellyStephen @SusanMitchell_ @ciarakellydoc

1/ It’s absolutely clear that we don’t have the ICU capacity we need in Ireland. This has been shown in multiple reports going back years.

2/ The numbers are less now than they were, and 20% of the current ICU beds in the public system remain closed. In the times of a pandemic, we have to ask why.
We have to also ask why in the last 7 months the capacity hasn’t been improved.

3/ Regardless of any opinion of pursuing a zero Covid island vs living with the virus, our stated objective from March was to flatten the curve and avoid overwhelming our public healthcare system

4/ And to ensure that doctors and nurses didn’t have to make horrendous decisions to choose which patient would get an ICU bed and ventilator if there was a shortage.

5/ We achieved this. We did well. Perhaps we forgot that Covid would return, that outbreaks would definitely recur, and need “flattening” once again.

6/ So we are following the course we anticipated from day one. The previous months have, I hope, been used by those in NPHET and government as time to work out the best strategy to manage the virus

7/ And to balance managing the virus with the need to maintain an economy and all the other healthcare needs.

8/ Already today there has been talk of needing more ICU beds for a resurgence of COVID. To paraphrase @SimonHarrisTD favourite term “let us be clear” - to use all our ICU beds for COVID means that an ICU bed is unavailable for every other health issue that would need that bed

9/ Open heart surgery, aneurysm repair, cancer surgeries, head trauma, road traffic accidents, overdoses, neurosurgery, sepsis etc.

10/ So I’ll come back to my concerns from recent months- if we end up again directing all our healthcare capacity to COVID, we will sadly lose many more patients to non-COVID illnesses.

11/ Studies from all over the world have already shown increases in deaths due to heart attacks that haven’t presented to hospital, increased suicides, self harm, delayed diagnosis of cancer through lack of screening services, domestic abuse

12/ Many of these tragic deaths will increase further during the pending recession.

13/ So let’s do our best to keep all the fires burning - all parts of healthcare must continue, work hard to avoid any more lockdowns, let’s try and open up businesses, and let’s try to just apply common sense to how we behave.

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