We continue to experience severe pressure on our hospital beds due to increasing numbers of Covid patients needing admission.
Staff are working hard to discharge patients who are well enough as quickly as possible.
Our Deputy Medical Director Dr Damian Gormley explains how we are managing this latest surge and how patients and relatives can help.
We continue to experience severe pressure on our hospital beds due to increasing numbers of Covid patients needing admission.
Staff are working hard to discharge patients who are well enough as quickly as possible.
Our Deputy Medical Director Dr Damian Gormley explains how we are managing this latest surge and how patients and relatives can help.
Hello and welcome to trust tv I'm Ruth from your communications team so regrettably we're continuing to experience severe pressure on our hospital beds due to increasing numbers of Covid patients being admitted and our staff are working hard to discharge patients who are well enough as quickly as possible but why is this happening again especially as restrictions in our communities are easing so much. We're joined today by our deputy medical director Dr Damian Gormley Damien you're very welcome thank you very much. Why is this happening again why are we facing so much pressure on our wards the pattern of covid missions throughout the pandemic has followed a very very predictable pattern um and maybe it's as easy for me to show you that on a graph as it is to just talk about it so what we know throughout the pandemic is that community transmission impacts on hospital attendances which then impacts on hospital admissions and this is really our full pandemic right back to the start of April 2020 the purple line at the top is the Northern Ireland positive rate per hundred thousand of the population and the blue line is looking specifically at the southern trust local government districts and councils and what we see is that as the purple line increases we then see underneath this in the green line hospital admissions follow thereafter so what we saw in surge one was an increase in community transmission hospital numbers increasing to a point where we were getting 10 to 12 admissions per day and we had a take 62 people in hospital at that stage and then as we got into surge two and three again we see these very high community transmission rates driving hospital admissions we had a little bit of respite but never got back to baseline and then we had a huge surge that happened around Christmas and the early part of new year restrictions obviously then were put in we went into lockdown etc we had a very very successful vaccination program starting and we drove down community transmission and as we drove down community transmission we drove down uh hospital attendances and hospital admissions but then if I go into what you're seeing now which is really going into the more recent uh period of time you'll see that things have changed a little bit in terms of both hospital attendances community transmission as well so I'm just going to home in on this little section here which is really the period of time in May and that leading into June July and over the summer time so again purple community transmission rate we've seen a very very high rate thankfully not quite as high as before but still a rate of over 500 and the southern trust following a similar trend and then if we home into hospital admissions and hospital occupancy we see again a very similar pattern of this escalation and hospital admissions 12 to 15 admissions per day and hospital occupancy then cranking up along with that as well so we've seen the same pattern nothing that we're seeing here is surprising it's all driven by who within our community gets infected because for every 100 people that get infected there's a predictable number of people who end up getting very sick a predictable number you end up in hospital smaller numbers obviously you end up in intensive care and very regrettably some people who do not survive I think it makes it very clear and very stark when you show us this Damian and our staff then are in the position where they're trying to keep and the flow of patients through the hospital and they're having to make those difficult decisions around discharge how are they doing that safely and quickly I always try to approach it from the patients we were looking after point of view and every piece of research has ever been done in medicine has shown us that prolonged hospital stays result in poor outcomes so there is no doubt that if you're unwell and you're sick and you need to be in hospital that's a good place to be however once you point past the point of needing to be in hospital before then you all you're doing is exposing yourselves to the known risks of being in hospital and that's particularly a problem for our frailer older people and particularly a problem if you've just recovered from an illness you then become very prone to the things that we do our best to we're just happening in hospital but still happen things like hospital-acquired infections confusion that happens in our older people falls etc so I always ask myself the question is it in this patient's best interest to remain in hospital and if the answer to that question is no then I must do utmost within my control to make sure that that person is discharged from hospital in a safe and a timely way as possible I also then risk the responsibility to those patients who are not seeing right in front of me as well I do have a responsibility to ensure that we manage our beds as efficiently as possible so i can't sit there and make a recommendation that somebody who doesn't need to be in hospital when it's not in their best interest to remain in hospital should do so perhaps to the detriment of somebody else who might need either emergency medical treatment emergency surgical treatment or life-saving surgical treatment who needs a bed as well and how can patients or relatives help us with this but I think we always need to be thinking about discharge almost as soon as we come into hospital the vast majority of older patients that I wantI meet don't want to be in hospital they want to get out of hospital as soon as possible so we need to be thinking about discharge arrangements as soon as the person comes into hospital and we need to start making those care plans very early for our older people but we also probably do need a help and support from our community we ask for families all the time to help to support discharges as well safe in the knowledge that a discharge home is often the safest and best environment for an older person so it is a combination between what the professionals within the healthcare service can do by thinking about discharge early planning safe discharges with the support of both our community teams and our community and as a whole as well and if we try to maintain this flow and we do it we are able to achieve that we've been hearing so much for the past couple of weeks you know the very difficult stories about patients who have had their surgeries cancelled right across Northern Ireland does this help us keep surgery and elective surgery going it definitely does so there are many things that require somebody to have an operation there's obviously having the staff there to do the surgery there's all the support staff including the critically important nurses that are there as well and theatre space etc etc but one of the other dependencies is often a hospital bed particularly for complex surgery sometimes that might need to be an intensive care bed as well so if there is not access to that then that can often be the difference between somebody getting a surgery and not getting a surgery at other times in the pandemic where we saw covert at a much higher level we had to redeploy staff so it was no longer at that stage just about a bed it was about all of the other things currently as we said it's mostly about do we have a bed for this patient to manage it and a bed that meets the needs of that patient as well so Damian what about the vaccine and all of this of the patients that are coming in now some of them will have had the vaccine some of them won't are we seeing any difference in terms of the severity of their illness we do you know I've spoken to my respiratory colleagues and those who are more frontline than I am with and they have relayed to me some of their experiences within this as well so we have definitely seen a very very significant shift in the type of person that's come through the most obvious one of that is the age profile of the patient that's coming through so in surges one two and three it was often older individuals who hadn't any immunity at that stage you were very susceptible to the condition but we've seen a very significant shift to a much younger population that has come in now and undoubtedly from speaking to my colleagues there are some people who come in who have had the vaccine who are getting covered however most of those patients are either not very unwell or sometimes are coming in and called it as just a coincidental finding so they may come in having suffered a full perhaps and broken their head they are swabbed at the point of admission and fine to have covert but are asymptomatic however unfortunately that the vast majority of people who are in our hospital who are sick including those individuals who are within intensive care the vast majority have not received the vaccine so what would your message be to younger people now who maybe haven't had their vaccine what do they need to do I can always understand people's right to question and so they should I'm an inquisitive person myself and the first thing I always ask myself is am I likely to be at more risk by getting this vaccine or not getting the vaccine to me as a doctor this is one of the simplest questions that we ask in that for the vast vast majority of people the risks associated with the vaccine are tiny the risks associated with getting Covid although smaller when you're younger can still be really really significant including life-threatening so i would have no hesitation in endorsing the recommendations that I've made before about all of those people who are currently eligible for the vaccine to get it and to get it as soon as possible it will protect you it may protect the vulnerable people around you as well and if you do get Covid it will more likely than not make that illness much milder and make it much less likely for you to get really unwell and ultimately to suffer from long-term complications or even ultimately not to survive doctor Damian Gormley thank you very much thank you you