New variant making people less sick but numbers presenting at the hospital are huge, says head of emergency medicine
St Vincent’s is in a “doomsday scenario” in terms of the number of Covid patients presenting at the busy Dublin hospital, at a time when 400 staff are out of work as a direct consequence of the virus.
However, on a positive note the Omicron variant is making people less severely ill and the numbers in ICU at St Vincent’s is far lower than this time last year, according to Professor John Ryan, head of emergency medicine at the hospital.
He said hospital staff nationwide are being “really challenged” and the next few weeks will be tricky in terms of dealing with the sheer volume of people who are presenting at the hospital with Covid.
“We are seeing numbers like never before. It’s a doomsday scenario, in terms of numbers. The next few weeks will be very challenging. The volume of patients is very high but the disease is not as bad. A big issue is that we have 400 staff out either with Covid, or being a close contact,” Prof Ryan said.
“Patients are entering a stagnant river, it should be free-flowing. It is not just medical staff who are out of work. It’s porters, administration and lab staff, it’s across all sections of the hospital. The next two to three weeks will be very tricky at the coalface.”
The high prevalence of Covid-19 in the community is naturally leading to an upsurge in hospital presentations, he added.
“Because it is circulating so widely in the community, it is expected there will be 1,000 Covid patients across our hospitals. A couple of weeks ago, that figure was between 300 and 400. So staff are being really challenged.
“There are two groups of patients in St Vincent’s. Those who come in because they have Covid, and others who come in to the emergency department with another problem, are then screened on admission and have Covid unbeknown to them. It’s the volume of patients coming into the hospital that is killing us. We also need to continue to isolate patients in advance of knowing whether they have Covid.”
Prof Ryan said he is seeing a lot of unvaccinated patients. “We ask the unvaccinated: ‘Would you take a vaccine now if you could?’ They say no. Most of them are belligerent. Some of them say they just haven’t got around to it. The reality is that most of them are not getting hugely sick with this variant.”
He said St Vincent’s ICU is not overwhelmed with seriously ill Covid patients, particularly in comparison to this time last year.
“Our ICU is full but then, it’s always full. This is not the same illness as last year. The people are not as sick. Last year we had really sick patients in ICU, we had 20 Covid patients at one stage. Right now we have four in ICU with Covid. Last year a much larger proportion of people who were admitted were really sick. The hospital is at capacity again.
“There are not as many doctors around to discharge patients. Also, nursing homes can’t take patients. So there are still a lot of problems.”
In terms of the impact of Omicron on the reopening of society, Prof Ryan said he expects restrictions will ease further next month. He believes Ireland will let larger countries like the UK and US take the lead on decisions on fully reopening society and then follow suit.
“We’re moving towards lifting all restrictions. Ireland has not been a nation of leaders in making these decisions first. The decision makers here seem to sit back and watch how these decisions go in other countries like the UK and US.”
Among Covid patients at St Vincent’s emergency department last Friday was a 16-year-old and, at the other end of the spectrum, a 77-year-old on Thursday.
“We are seeing all age groups. Many patients are not admitted but need to be seen,” Prof Ryan said.
While vaccines have played a significant role in protecting people from serious Covid-related illness, the fact that Omicron is at present a far less dangerous strain is also a major contributing factor, the professor added.
“It’s not just the vaccines which have played a big role. It is also that Omicron is less severe. We’re still living in legacy and fear of Delta, there are still a lot of people very ill with other variants in ICU.
“But we shouldn’t forget that Omicron is only six weeks old. It’s not time to say, ‘it’s not that serious’. We should remember it is still a very new variant and we don’t know its full potential. In terms of new variants, we don’t know what is coming down the line. Caution is still needed.”