The number of patients in hospital with confirmed Covid-19 is relatively stable, according to the latest figures from the Health Service Executive.

There are 108 confirmed cases in hospitals, with 17 of these in intensive care, the overnight figures show.

It compares with 110 confirmed cases and 18 in ICU the previous day. There are also 102 suspected cases in hospitals with six of these patients in ICU.

Overall the health system has 48 critical care beds free, out of 272 which are currently staffed and open.

However, Lead Perio-operative Director at Tallaght University Hospital in south Dublin, Professor Paul Ridgway has said the hospital is able to undertake just half of its planned procedures at the moment, due to capacity issues.

Speaking on RTÉ's News at One, Prof Ridgeway said the hospital has been experiencing pressure on acute beds for some time, but this has been brought sharply into focus since the onset of Covid-19, and now "this second surge".

"We were only really getting back to speed, trying to deal with the backlog of procedures since the first surge of Covid-19, when this second wave started, and now we are 50% down on our capabilities for elective work now."

He explained that during the first surge of the virus a significant portion of the hospital, such as Children's Health Ireland, devoted their space to Covid-19 patients, and Tallaght also saw a significant reduction in the number of people presenting at its emergency department, but Prof Ridgeway said this is no longer the case.

"This time around we don't have that space, and people are still presenting with non-Covid related illnesses, and we are pleased that they are, but it has added extra pressure to system that is creaking at the seams."

He said Tallaght hospital does not have sufficient critical care isolation capacity.  In the hospital's intensive care unit, 13 of the 14 beds are occupied. 

He said doctors have learned a lot about how to treat Covid-19 since the first surge in March, but that the hospital is in need of critical care space to treat those with non-Covid illnesses, and to care for the elective patient population, "who cannot be forgotten in all of this".

Prof Ridgeway said the HSE's plan to add 12 extra critical care beds at Tallaght will require more space to be built on the hospital.

"It will be some time before those beds are activated and available for use."

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A consultant in infectious diseases at St James Hospital in Dublin, Professor Cliona Ní Cheallaigh said the rising number of new cases and hospitalisations from Ireland is really worrying.

Professor Ní Cheallaigh, who works at St James hospital in Dublin, said that the virus had been circulating at a low level in the community, and the hospital experienced a few months without any Covid related admissions.

"Now it's really starting to make people very sick again, or starting to infect enough people that the proportion of those getting sick is significant", she said.

"Hospitalisations are what worry us, because they are people who are sick. They're people who are at risk of getting sicker, of dying, or having severe problems afterwards when they do recover. It's also worrying because we work in a system that's already overstretched during the winter period, we never have enough beds, enough staff, enough consultants, enough places to discharge people", she said.

Professor Ní Cheallaigh said it takes about 2 weeks for any changes in how we live our lives to show up in hospital admissions and the number of people becoming sick and that hopefully the Level 3 restrictions introduced around two weeks ago in Dublin "will start to show benefits soon".

Concern over deferral of non-Covid cases

Meanwhile, Intensive Care Specialist in Limerick University Hospital and former President of the Intensive Care Society of Ireland Dr Catherine Motherway has said she would like to know how many ICU beds are currently funded so that recruitment can begin to staff the units.

At the beginning of the pandemic, she said, 257 adult beds were open and that capacity was increased to around 280/285 beds.

However, she added, the funding for these additional beds was temporary.

Dr Motherway said it is unclear if the 17 extra beds announced in the Winter Plan last week are part of the 285 beds or in addition to them. She said it is difficult to recruit the specialised nursing staff needed for ICU and opening a bed takes a long lead in time.

The HSE responded: "The 17 extra ICU beds across the system, announced as part of the Winter Plan and referenced by Catherine Motherway on Morning Ireland, are new beds."

The HSE said this breaks down to 12 funded this year, and five funded next year.

Dr Motherway said health services must be funded so scheduled care can continue. This, she said, involves high risk services and deferring of procedures, which creates significant anxiety and stress and poor outcomes for patients.

She said scheduled care is deferred almost every winter and unless extra services are provided to deal with Covid-19, there could be a difficulty over this winter.

What controls a surge in Covid-19, she said, is following public health guidance and urged the public to follow guidelines by social distancing, wearing a mask and practising hand-hygiene.

Dr Motherway said that there are currently 12 ICU beds and 1O HDU (high dependancy unit) in Limerick with three of these beds vacant at the moment.

She explained that it is preferable to have a vacant bed in both units because delays to admission can adversely affect the outcome for Covid-19 patients.

There is currently one Covid-19 patient in the hospital - yesterday there were two, she said.

The chair of the Irish Medical Organisation's consultant committee has called on everyone to redouble their efforts and follow public health advice over the next two weeks in order to reduce the spread of Covid-19 and reduce pressure on hospitals.

Dr Clive Kilgallen said society must move quickly and work together to stop the spread of Covid-19 through social distancing, mask wearing and avoiding crowded places.

He told Morning Ireland that we have have a better understanding of how to treat the coronavirus as we head into the second phase, but we also know that following the health guidelines really does make a difference.

What we do over the next two weeks, he said, will have a disproportionate effect in a month's time.

Dr Kilgallen said there are initiatives coming into play for the Winter Plan but all of this will take time and we need to move quickly.

Dr Kilgallen, who is a consultant pathologist at Beaumont Hospital, said that health services have been getting back up to speed on elective care over the last couple of months and he is hopes that there won't be cancellations over the coming months.

He added that winter situations are difficult at the best of times. 

Earlier, the acting Chief Medical Officer Dr Ronan Glynn has warned that the situation with Covid-19 in Ireland will continue to deteriorate unless every individual, workplace and organisation plays their part in curtailing the spread of the virus. 

Dr Glynn has again appealed to all households to reduce the number of people they meet. 

His comments came after the highest daily figure of new coronavirus cases was announced in five months.

The 430 new cases of Covid-19 confirmed yesterday evening represent the largest daily figure since late April.

It took the total number of cases for the last week to 2,084. 

Dr Glynn said there is absolutely no room for complacency.

With Dublin and Donegal now on Level 3 restrictions, Minister for Health Stephen Donnelly said four other counties, Cork, Galway, Louth and Wicklow are being monitored very carefully by the National Public Health Emergency Team (NPHET).

People in Cork warned against complacency

A Cork-based GP has said there are no grounds for complacency by people in Co Cork as the case numbers of Covid-19 have risen rapidly and the capacity of local hospitals to cope is extremely stretched.

Dr Ronan Boland told RTÉ's Today with Claire Byrne that just three acute beds were available yesterday between Cork University Hospital and the Mercy Hospital to treat any acute case among a population of half a million people in the greater Cork region.

Dr Boland said that the capacity "is not there to deal with any surge of normal illness, let alone Covid-19".

He said he would be "very surprised" if Cork is not moved to level three alert phase in the short term.

Dr Boland said that both CUH and the Mercy Hospital have been operating at full capacity throughout the summer months and in the last two weeks the number of positive cases of the virus has risen from single figures to 54 cases.

He said his medical colleagues in Cork are concerned about what he called "an upsurge of small fires breaking out" in the city and surrounding towns, which he said has happened rapidly over the last ten days.

He said that each one of these small outbreaks has the capacity to spread like fire and become a bigger problem.

He said public health colleagues in Cork are understaffed and are struggling to deal with the number of new cases to be contact traced and this is worrying.

Dr Boland said that there is concern about the behaviour of those congregating in groups both indoors and outdoors and their behaviour being disinhibited with alcohol.

He said that many patients of his who are taking care and looking after themselves are very worried about others being complacent.

He said that people tend to forget they may be relatively safe, but they are going home to vulnerable households with uncles, aunt, parents and grandparents who are doing everything they can to stay safe.

In relation to travel, the number of countries that people can travel to from Ireland without restricting their movements on their return dropped from seven to four from midnight. 

The countries on the updated Green List are Cyprus, Latvia, Finland and Liechtenstein.

But in three of those countries, people coming from Ireland will face restrictions on arrival.

Additional reporting Fergal Bowers, Fergal O'Brien