Non Covid healthcare

BrianD3 · 13-04-2021 1:39pm #1

This surely deserves its own thread. Today there is a National Healthcare Outcomes Conference in RCSI and some startling figures have come out of it. There has been a 38% reduction in surgeries for breast cancer and 26% reduction for colorectal cancer. All emergency surgery is down about 25%. RTE has covered this in the lunchtime news but it wasn't one of the main stories, top story was, surprise surprise, Ronan Glynn cautious about a 4th Covid wave.

Looks like Covid is going to result in our health service being a wreck on a wreck while if Covid never happened, it would merely be a wreck :rolleyes:

Waiting lists up 31.7%. OK if it was 31.7% of a small number but of course it is not a small number.

These are stark figures IMO. This isn't a reduction in screening, it's a reduction in interventions (which may be a knock on effect of reduction in screening). It's also a lose-lose because even if there isn't an increase in deaths after doing 38% fewer breast cancer surgeries, questions arise about whether over diagnosis and overtreatment has been happening for certain diseases.

https://www.irishexaminer.com/news/arid-40264403.html?type=amp

[Deleted User] · 13-04-2021 1:46pm

Shocking indeed.

Only Covid matters now.

Donald Trump · 13-04-2021 4:29pm

How do you think those numbers would look if we didn't have restrictions keeping the Covid infection numbers down?

Hospitals filled up in January and were under severe strain. It was only the tightening down restrictions that got the numbers back down.

Good luck with getting an appointment for anything else in the country anytime soon if we were still at 8k new cases a day and had overflowed ICU surge capacity months ago.

You points have merit on a standalone basis. People will try to twist them to an anti-restriction argument.

Silentcorner · 13-04-2021 8:00pm

Donald Trump wrote: »

How do you think those numbers would look if we didn't have restrictions keeping the Covid infection numbers down?

Hospitals filled up in January and were under severe strain. It was only the tightening down restrictions that got the numbers back down.

Good luck with getting an appointment for anything else in the country anytime soon if we were still at 8k new cases a day and had overflowed ICU surge capacity months ago.

You points have merit on a standalone basis. People will try to twist them to an anti-restriction argument.

Hospitals are filled up every year....this year was a little milder than most.

The cancers and heart diseases that were missed last year and this year so far are just going to accumulate and be harder to treat....causing an increase in deaths in people of all ages, in fact, it will just mean there are more people who are vulnerable to death with Covid...you know, the virus they have stopped all these screenings for!

GazzaL · 13-04-2021 8:07pm

Donald Trump · 13-04-2021 8:52pm

Silentcorner wrote: »

Hospitals are filled up every year....this year was a little milder than most.

The cancers and heart diseases that were missed last year and this year so far are just going to accumulate and be harder to treat....causing an increase in deaths in people of all ages, in fact, it will just mean there are more people who are vulnerable to death with Covid...you know, the virus they have stopped all these screenings for!

It was a fairly simple question I thought. I am surprised you didn't appear to be able to understand it.

Do you think what we had in January, with ICU in surge capacity and large numbers being hospitalised every day, would be a normal every-day event in the hospitals? Because that would have continued without restrictions. And there would be no elective procedures at all. You think that happens anyway most days/weeks/months/years?

Silentcorner · 13-04-2021 9:11pm

Donald Trump wrote: »

It was a fairly simple question I thought. I am surprised you didn't appear to be able to understand it.

Do you think what we had in January, with ICU in surge capacity and large numbers being hospitalised every day, would be a normal every-day event in the hospitals? Because that would have continued without restrictions. And there would be no elective procedures at all. You think that happens anyway most days/weeks/months/years?

You are absolutely right, it is very simple.

Our health system, comprising of 11,000 beds across the country plus the 350 ICU capacity are placed under massive pressure every year during our flu season...what do you think causes our annual trolley crisis where hospitals often ban visitors....so yes it is a normal year in that sense of the word, the only difference was this year it was a different viral infection.

This thread is not about restrictions whether you agree with them or not, it is about Non Covid healthcare, which has largely been put on hold for over a year now.

Do you think the Cancer or Heart Disease cases that we usually screen for have gone away just because we decided not to screen for them?

What impact do you think the waiting lists, which is over 900,000 now, up from 400,000 last year will have on the health system?

Donald Trump · 13-04-2021 9:34pm

Silentcorner wrote: »

You are absolutely right, it is very simple.

Our health system, comprising of 11,000 beds across the country plus the 350 ICU capacity are placed under massive pressure every year during our flu season...what do you think causes our annual trolley crisis where hospitals often ban visitors....so yes it is a normal year in that sense of the word, the only difference was this year it was a different viral infection.

This thread is not about restrictions whether you agree with them or not, it is about Non Covid healthcare, which has largely been put on hold for over a year now.

Do you think the Cancer or Heart Disease cases that we usually screen for have gone away just because we decided not to screen for them?

What impact do you think the waiting lists, which is over 900,000 now, up from 400,000 last year will have on the health system?

Sure send me the links from previous years where there was sustained periods of hospital admissions like we had in January.

Because without restrictions, those numbers would be worse now today than they were in Jan and we would be after having solid months of it.

And you also have to remember that with no restrictions, regular flu would have been up to normal levels too. The Covid would have been additional on top of that.

I await your links!

drunkmonkey · 13-04-2021 9:36pm

This is unfortunately a public service problem, people with insurance or the means to pay are seen swiftly.

odyssey06 · 13-04-2021 9:39pm

drunkmonkey wrote: »

This is unfortunately a public service problem, people with insurance or the means to pay are seen swiftly.

Private hospitals were taken over by the public system

Silentcorner · 13-04-2021 9:41pm

Donald Trump wrote: »

Sure send me the links from previous years where there was sustained periods of hospital admissions like we had in January.

Because without restrictions, those numbers would be worse now today than they were in Jan and we would be after having solid months of it.

And you also have to remember that with no restrictions, regular flu would have been up to normal levels too. The Covid would have been additional on top of that.

I await your links!

Why should I send you links, go look for yourself, we are all aware of how dysfunctional our health system is...

Here's a start for you...

https://www.thejournal.ie/hospital-trolley-overcrowding-2019-4951069-Jan2020/#:~:text=OVER%20118%2C000%20people%20went%20without,were%20children%20younger%20than%2016.

FintanMcluskey · 13-04-2021 9:42pm

Donald Trump wrote: »

Sure send me the links from previous years where there was sustained periods of hospital admissions like we had in January.

Because without restrictions, those numbers would be worse now today than they were in Jan and we would be after having solid months of it.

And you also have to remember that with no restrictions, regular flu would have been up to normal levels too. The Covid would have been additional on top of that.

I await your links!

Our hospitals aren’t fit for purpose and haven’t been for quite some time, community suppression measures won’t prevent hospital acquired Covid

https://www.imj.ie/wp-content/uploads/2020/07/Airborne-Transmission-of-Covid-19-Implications-for-Irish-Hospitals.pdf

After the epidemic of severe acute respiratory syndrome (SARS) due to SARS-CoV-1 in 2003, many countries reviewed their capacity to control epidemics and potential pandemics. In Hong Kong, the government insisted on a minimum distance between beds and the provision of more than 1,400 isolation rooms with negative pressure ventilation in public hospitals.13 This may partly explain why some Asian countries with prior experience of managing SARS, such as Hong Kong and Singapore, appear to have coped better with this pandemic than countries largely unaffected by SARS.
In Ireland, the Health Information and Quality Authority have published standards for IPC in acute hospitals.14 However, implementation of best practice IPC is challenging because of sub-optimal infrastructure in many hospitals. In 2009 an expert group recommended that newly built hospital in-patient accommodation should comprise 100% single-patient rooms, existing multiple bedded rooms contain no more than three beds, and that there be at least one AIIR per 150 acute inpatient beds with double that for regional or tertiary referral hospitals.15 However, little progress was made in implementing these recommendations since then. In a 2011- 2012 European hospital study, the country median proportion of single-bed rooms was 24.2%, with Irish hospitals reporting between 10-20%.16 Of 60 Irish acute hospitals surveyed in May 2017, the average proportion of single patient rooms in public hospitals ranged from 15% to 29% with 52% in private hospitals. The majority (76%) of single rooms were reported to have en suite facilities, however, there were only 1.8 AIIR per 100 beds.17
The recent pandemic underscores the need for more single rooms with AIIR capacity in acute hospitals to facilitate appropriate patient placement and to prevent cross-infection. While natural ventilation probably suffices for most patients in hospitals, we need to learn from recent evidence, plan for the future, and improve the environmental conditions for all in acute hospitals. This will help control the next pandemic, reduce nosocomial and HCW acquisition, and better prevent more common infections such as seasonal influenza.

Sadly, an obliterated economy like Ireland’s won’t have the necessary spending power to implement the required changes

Paul Reid is on €35,000 a month though which I find amusing, although slightly irrelevant

Donald Trump · 13-04-2021 9:45pm

Silentcorner wrote: »

Why should I send you links, go look for yourself, we are all aware of how dysfunctional our health system is...

Here's a start for you...

https://www.thejournal.ie/hospital-trolley-overcrowding-2019-4951069-Jan2020/#:~:text=OVER%20118%2C000%20people%20went%20without,were%20children%20younger%20than%2016.

Not one mention of surge capacity in ICU.

Nor any mention of regular appointments being postponed.

You have to use facts and logic, not emotion

Donald Trump · 13-04-2021 9:49pm

FintanMcluskey wrote: »

Our hospitals aren’t fit for purpose and haven’t been for quite some time, community suppression measures won’t prevent hospital acquired Covid

https://www.imj.ie/wp-content/uploads/2020/07/Airborne-Transmission-of-Covid-19-Implications-for-Irish-Hospitals.pdf

Sadly, an obliterated economy like Ireland’s won’t have the necessary spending power to implement the required changes

Paul Reid is on €35,000 a month though which I find amusing, although slightly irrelevant

But that is why we have to lock down harder than other countries. That has been clear from the start. We didn't have the facilities to cope with what we have - we wouldn't have the facilities to cope with additional load.

I can't fathom how people could conclude that, given they know that appointments were being postponed already, that the hospitals could have coped better and completed all their elective appointments and procedures if only they could have had thousands more people being admitted every week.

Silentcorner · 13-04-2021 9:50pm

Donald Trump wrote: »

Not one mention of surge capacity in ICU.

Nor any mention of regular appointments being postponed.

You have to use facts and logic, not emotion

You are a gas ticket!!!

WE have never postponed regular appointments as far as I am aware...until this year, where we postponed over 400,000 of them I believe...how will we remedy that one do you think?

Donald Trump · 13-04-2021 9:57pm

Silentcorner wrote: »

You are a gas ticket!!!

WE have never postponed regular appointments as far as I am aware...until this year, where we postponed over 400,000 of them I believe...how will we remedy that one do you think?

Have a think.

Appointments were cancelled or postponed due to the additional resources needed to combat the Covid cases that we had when we have restrictions.

I will try to break it into two steps:
1) If we had no restrictions, we would be having more Covid cases
2) If we had more covid cases, we have more hospital admissions needing even more resources.

Given (2), and it having been explained to you that when extra resources are needed, they are taken away from other things, do you think there would have been more or less cancelled appointments if we had more covid cases needing hospitalisation.

[Deleted User] · 13-04-2021 10:04pm

Donald Trump wrote: »

Have a think.

Appointments were cancelled or postponed due to the additional resources needed to combat the Covid cases that we had when we have restrictions.

I will try to break it into two steps:
1) If we had no restrictions, we would be having more Covid cases
2) If we had more covid cases, we have more hospital admissions needing even more resources.

Given (2), and it having been explained to you that when extra resources are needed, they are taken away from other things, do you think there would have been more or less cancelled appointments if we had more covid cases needing hospitalisation.

Do you have any source to back any of that up?

The disease peaked in December. We wouldn’t have being guaranteed more cases after the peak without restrictions.

Sweden didn’t lockdown. Their hospitals didn’t collapse.

Silentcorner · 13-04-2021 10:05pm

Donald Trump wrote: »

Have a think.

Appointments were cancelled or postponed due to the additional resources needed to combat the Covid cases that we had when we have restrictions.

I will try to break it into two steps:
1) If we had no restrictions, we would be having more Covid cases
2) If we had more covid cases, we have more hospital admissions needing even more resources.

Given (2), and it having been explained to you that when extra resources are needed, they are taken away from other things, do you think there would have been more or less cancelled appointments if we had more covid cases needing hospitalisation.

We see severe over crowding in our hospitals every year, year in year out and we don't as far as I am aware, postpone appointments.

This thread, despite your best efforts, is not about restrictions and whether you agree with them or not, it is about Non Covid Care, because at some point, our health officials are going to have to address the MASSIVE waiting list that is only getting longer...there is no evidence that extra beds were required in any meaningful over the last 12 months given we normally see huge over crowding every year.

The HSE has been handed a cheque book since last March, we have thrown resources at the health system....they pumped €5 million into converting a Sport Arena near me last summer, they took it apart in September.

What do you think the health system is going to do to cope with the waiting lists that are over 900,000 at this stage, what impact will delays have on those people...or have you thought that far ahead yet?

FintanMcluskey · 13-04-2021 10:07pm

Donald Trump wrote: »

But that is why we have to lock down harder than other countries. That has been clear from the start. We didn't have the facilities to cope with what we have - we wouldn't have the facilities to cope with additional load.

I can't fathom how people could conclude that, given they know that appointments were being postponed already, that the hospitals could have coped better and completed all their elective appointments and procedures if only they could have had thousands more people being admitted every week.

What if community suppression had little effect on what happens inside those facilities?

odyssey06 · 13-04-2021 10:07pm

jacdaniel2014 wrote: »

Do you have any source to back any of that up?

The disease peaked in December. We wouldn’t have being guaranteed more cases after the peak without restrictions.

Sweden didn’t lockdown. Their hospitals didn’t collapse.

They cancelled cancer screenings in Sweden.
They were bordered by low density contries that did lock down.
They have more hospital capacity than we do and needed it.

If you think we wouldnt have had more cases without restrictions you are talking utter nonsense without foundation. So where is your source?

[Deleted User] · 13-04-2021 10:23pm

odyssey06 wrote: »

They cancelled cancer screenings in Sweden.
They were bordered by low density contries that did lock down.
They have more hospital capacity than we do and needed it.

If you think we wouldnt have had more cases without restrictions you are talking utter nonsense without foundation. So where is your source?

Plenty of places haven’t locked down and haven’t seen hospitals overwhelmed or bodies piling up.

Restrictions really aren’t much use now when the illness is not peaking and hospitals are empty.

odyssey06 · 13-04-2021 10:26pm

jacdaniel2014 wrote: »

Plenty of places haven’t locked down and haven’t seen hospitals overwhelmed or bodies piling up.
Restrictions really aren’t much use now when the illness is not peaking and hospitals are empty.

Whats the current status on screenings and electives etc in the health service here and elsewhere?

That restrictions have nothing to do with the waiting list and such services as can be seen by the fact that Sweden did not lockdown and did cancel screenings.

And remember private hospitals taken over during first lockdown were used to treat non covid public patients.

Aph2016 · 13-04-2021 10:37pm

38% reduction in breast cancer surgeries is a stunning statistic. The focus on Covid at the expense of everything else is going to be devastating in the near future.

[Deleted User] · 13-04-2021 10:39pm

odyssey06 wrote: »

Whats the current status on screenings and electives etc in the health service here and elsewhere?

That restrictions have nothing to do with the waiting list and such services as can be seen by the fact that Sweden did not lockdown and did cancel screenings.

And remember private hospitals taken over during first lockdown were used to treat non covid public patients.

In over a year, hospitals were only busy once due to Covid in Ireland for a few weeks in Jan. Even then, it was mainly due to people catching Covid while in hospital.

Any treatments or screenings cancelled outside that period is blatant negligence.

odyssey06 · 13-04-2021 10:40pm

Aph2016 wrote: »

38% reduction in breast cancer surgeries is a stunning statistic. The focus on Covid at the expense of everything else is going to be devastating in the near future.

Not focusing on Covid would have been devastating.
The choices were grim.

odyssey06 · 13-04-2021 10:43pm

jacdaniel2014 wrote: »

In over a year, hospitals were only busy once due to Covid in Ireland for a few weeks in Jan. Even then, it was mainly due to people catching Covid while in hospital.

Any treatments or screenings cancelled outside that period is blatant negligence.

Bringing more vulnerable people into the hospitals ... if they were also at risk of catching covid... does not sound like negligence.

drunkmonkey · 13-04-2021 10:43pm

odyssey06 wrote: »

Private hospitals were taken over by the public system

What are you trying to say here in the context of the thread, I stated people with health insurance or who pay for treatments are looked after swiftly through the private system. You think that's incorrect and the public service is running the private hospitals?

Donald Trump · 13-04-2021 10:43pm

jacdaniel2014 wrote: »

Plenty of places haven’t locked down and haven’t seen hospitals overwhelmed or bodies piling up.

Restrictions really aren’t much use now when the illness is not peaking and hospitals are empty.

jac, plenty of places had spare capacity when corona hit. We didn't. We were already playing catch up

[Deleted User] · 13-04-2021 10:45pm

odyssey06 wrote: »

Not focusing on Covid would have been devastating.
The choices were grim.

There was no Covid to focus on outside of January.

Sure we’ve being locked down for most of the last year.

odyssey06 · 13-04-2021 10:47pm

drunkmonkey wrote: »

What are you trying to say here in the context of the thread, I stated people with health insurance or who pay for treatments are looked after swiftly through the private system. You think that's incorrect or you think the public service is running the private hospitals?

In the context of this thread it seemed relevant to point out that for a significant period the private hospitals werent treating private patients quicker than public. In fact for a period were treating non covid public patients as part of the covid deal.
Wouldnt waiting list stats etc be worse if that hadnt happened?

the kelt · 13-04-2021 10:47pm

Non COVID Healthcare.....

Non COVID Healthcare.....

What is this madness you speak off??

Caring for something other than COVID, preposterous, I won’t have it or any talk of such a thing in this country.

Off you with your new age hippie talk of caring for anything other than COVID, heathens the lot of you to even suggest it.

Non Covid healthcare

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