The Health Service Executive's weekly briefing heard today that the health service had demonstrated a capacity to deal with the surge caused by Covid-19 but the temporary redeployment of staff from other areas was not sustainable.
Dr Catherine Motherway said intensive care capacity in this country needs to be doubled and more permanent capacity needed to be built but this could not be done overnight.
Staff who had been temporarily redeployed to critical care duties would need to return to their original positions.
Many existing facilities were old, she said and better isolation facilities needed to be built. She said ICUs needed to aim for 70% capacity to be able to cope with surges.
Chief Clinical Officer Dr Colm Henry said the baseline was too low. The redeployment of staff was not a sustainable solution and a new plan needed to be implemented for intensive care.
Chief Executive of the HSE Paul Reid said he was concerned about the capacity of the service for the coming winter. He said they would need extra capacity this winter in a way they had not needed before.
He said the World Health Organization recommended that hospitals stay at 80% capacity so they would have the ability to step up capacity in the event of a surge in demand. But he said the Irish health service was well over that capacity before it headed into winter and this year had to be different.
As of last night there were 79 confirmed cases of Covid-19 in the country's hospital and 147 suspected cases.
There were 27 patients in intensive care with confirmed Covid-19 and five suspected cases. But there are only 91 available critical care beds, and 734 general beds as the number of people being treated for other conditions continues to increase.
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HSE Chief Operations Officer Ann O'Connor said they were examining at the moment whether to continue leasing the facility in Citywest in Dublin beyond October, when the current agreement expires.
Currently only 37 people are using the self-isolation facility in the hotel.
Ms O'Connor said they were looking at using the care facility or temporary field hospital, which has not yet been used, to deal with patients who need rehabilitation after suffering from Covid-19.
She said the preferred option for the HSE was to have as much capacity available as possible. And she said a decision would be made at the end of June if the HSE would continue using the facility past October.
Mr Reid said currently, more than 99% of people were testing negative for Covid-19.
This week 20,500 samples had been taken and tests were taking on average less than two days from swabbing to results. Of the tests, 86% were completed within three days.
In the last week, 1,500 calls had been made in relation to contact tracing, he said, and 255 close contacts of confirmed cases had been identified and only 14 of those had tested positive.
Mr Reid said the health service had to live with the virus and would need a very significant redesign over the next three years. He said they had to recalibrate all timeframes and could not be looking at ten-year plans - instead they had to look at the next 18 months to three years.
They would need to look at measures, such as a new agreement with the private hospitals, to allow capacity to be scaled up as well as using measures to keep people out of hospitals such as online consultations.
Mr Reid said the cost of dealing with the Covid 19 pandemic for the health service was so far around €400m.
Ms O'Connor said the number of people presenting at emergency departments was still down on last year but up almost 3% on last week.
But the number of people aged over 75 was increasing. She said there were still more than 400 people who needed to be transferred out of hospital but were delayed because of issues particularly in relation to transferring to nursing homes. But she said they were seeing more movement in this area.
Ms O'Connor said some really significant work had gone on in private hospitals in relation to treating different types of cancer. And she pointed to the example of Galway where she said the waiting lists for angiograms have been eliminated.
Ms O'Connor said 19 long-term residential facilities still required significant supports and they were at significant risk. There were 209 still deployed to residential care and support to residential care continued to be a key focus.
She also told the briefing that progress had been made in reassigning Special needs Assistants to vulnerable children. Some 693 children in need of support had been identified and 200 had been matched to Special needs Assistants, she said.
Dr Motherway said a crude assessment of mortality rates in Intensive care units compared quite well internationally. Out of 408 covid related admissions to ICU, there had been 78 deaths.
Of those patients in intensive care, 87% had an underlying disease - mainly cardiovascular, obesity, or hypertension related conditions. Of those who died, she said 99% had an underlying disease.
She said several hundred staff had been trained and redeployed to critical care, which would be of benefit if there was another surge in cases.
However she said the country needs permanent, new ICU capacity capable of delivering care in future.
She said Ireland had been able to flatten the curve by temporarily increasing resources but she said intensive care needed to come up to normal European levels on a permanent basis.
Dr Henry told the briefing that masks were important but should not distract from the most fundamental public health measures needed to stop the transmission of the disease. He said it was important that people wore them correctly .
Dr Motherway said Irish people were not used to wearing masks but it was something we would have to get used to over the next couple of years.
