When ambulances started queueing outside hospitals across Northern Ireland, revealing a health system overwhelmed by Covid-19, Sean Brophy was not surprised.
Weeks earlier the 52-year-old hospital transport worker had himself been hospitalised with the virus and saw how even then the system was cracking under pressure.
“When someone died or was discharged the bed was filled within an hour – they were already at capacity. Staff were brilliant but they looked as fatigued as those of us with Covid. It was just wrong. I could see where it was heading,” said Brophy.
He spoke on Wednesday, a day after ambulances had to queue outside all 11 of Northern Ireland’s hospitals because emergency departments were at full capacity.
At one point 17 ambulances lined up outside Antrim Area hospital, engines running to keep crew and patients warm. Doctors treated patients in the vehicles. A chronically overstretched health system had snapped because of failure to contain the pandemic. Similar scenes unfolded in Wales.
On Wednesday, the situation in Northern Ireland eased, with hospitals admitting new patients, but with hospitals at 105% capacity and infection rates rising, health experts made dire predictions about coming weeks.
“The die is cast on this … there is going to be a nightmare within the health service in the next three to six weeks,” Tom Black, the chair of the British Medical Association in Northern Ireland, told RTE.
He worried that doctors could face moral and ethical decisions they had not been trained for, and said Northern Ireland may need help from the Republic of Ireland.
Gabriel Scally, a visiting professor of public health at the University of Bristol and a member of the Independent Sage committee, was scathing about his home region. “The handling of Covid-19 in Northern Ireland beggars belief,” he tweeted. “The health service is on the brink of being overwhelmed, but efforts to prevent growth in cases have been relaxed. Shops, coffee shops, restaurants and bars serving food all open. Disaster looms.”
Authorities on Wednesday recorded eight deaths, bringing the overall death toll to 1,143. There were 510 new cases, the second highest number of daily cases, raising the total to 59,631.
The rate of people who have tested positive in the past fortnight is 3,169 per 100,000 of the population, lower than the UK average. But Northern Ireland has just 108 intensive care beds, a symptom of an underfunded health system. Of 457 hospital patients with Covid-19, 32 are in intensive care and 25 on ventilators.
A patient surge is common during winter flu season but now each patient must be isolated and swabbed pending a Covid test result, stretching resources.
Michelle O’Neill, Sinn Féin’s deputy first minister, promised “intervention” after Christmas to contain infections. She pledged to support whatever restrictions the health minister, Robin Swann, presents to the Stormont executive on Thursday. There are rumours of another lockdown.
Critics say it will be too little too late, and blame politicians and the public. Sinn Féin flouted restrictions at an IRA funeral in June and the Democratic Unionist party initially thwarted tougher restrictions when the second wave began in autumn. Public compliance over masks, close contacts and social distancing has been patchy.
“This Christmas is going to bring so much tragedy,” said Brophy, who is now at home recovering from the virus. “People will meet up and then be attending funerals in the new year. People are underestimating this virus.”
A similar scenario appears to be unfolding in Wales, where hospitals are under severe pressure with some ambulances having to wait for hours before transferring patients to A&E departments.
There are more than 2,100 people with or suspected of having Covid-19 in wards – about 300 more than last week and equivalent to five full general hospitals. There are 98 Covid patients in intensive care, the highest number in this second wave.
Some hospital boards have stopped non-urgent procedures while others are considering such a move.
Three hospitals are at “CritCon status 3B” – CritCon 3 means they are at full stretch with critical care expanding into other areas of the hospital and routine procedures suspended. The B highlights that staffing levels are down.
If a hospital reaches CritCon 4, resources are being overwhelmed, with the prospect of staff having to choose which critically ill patients to treat.
Despite soaring rates of Covid-19 the first minister, Mark Drakeford, said 16% of acute beds in the Welsh NHS were not occupied. He said physical capacity was “stretched” but not to breaking point.
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