Children who have flu-like symptoms should remain at home from school when schools reopen next week, the HSE and the country’s three paediatric hospitals have advised parents.
HSE assistant national director for public health Dr Kevin Kelleher said there was a concern that there could be a leap in the number of flu cases next week when schools re-opened for the new term and larger numbers of people began to congregate together.
In joint statement on Thursday the country's three children's hospitals - Our Lady's Children's Hospital, Crumlin; Temple Street Children's University Hospital and the National Children's Hospital in Tallaght said: "Next week schools, crèches and other childcare facilities will reopen and people will be back to work and our advice is any child who gets flu like symptoms should stay at home, rest, drink plenty of fluids and parents use over-the-counter remedies like paracetamol to ease flu symptoms. If parents are worried about their child's breathing or fluid intake or if any young child or infant is in one of the high-risk groups and develops flu like symptoms they should contact their GP."
The Department of Education said it endorsed the HSE’s advice on not sending children to school if they had flu-like symptoms. It said any decision to close individual schools rested with each school’s board of management.
In a statement on Thursday evening the Minister for Health Simon Harris appealed "to everyone to listen to the public health messages of the HSE in the coming days and help our frontline staff by staying home if you're ill".
Up to 14 people per day are presenting at the country’s larger hospitals with flu, the HSE also confirmed.
Dr Kelleher said there had been fewer than 10 deaths directly associated with flu this winter season.
He said details on indirect mortality levels associated with flu would not be known for a number of weeks.
Trolleys
His comments came on a day when overcrowding in hospital emergency departments across the State continued with 592 people on trolleys or on wards on Thursday morning awaiting admission to a hospital bed.
The HSE said 12 children were also on trolleys awaiting a bed in the paediatric hospitals.
Speaking in Budapest the Taoiseach Leo Varadkar apologised to any patient who has experienced a long delay or trolley wait in an emergency departments over the last couple of days.
“Numbers are now coming down and we do expect the situation to stabilise in the coming days, and certainly into next week,” he said.
However he said it was “enormously frustrating” that that the problems in emergency departments persisted. “This is the third year in a row that we’ve had more resources, a bigger budget, more staff, more beds, more home care, and despite all that we haven’t seen an improvement. That is very frustrating for the patients affected most of all, and for the staff and for the government”.
He added: “I’ve no doubt we will have to continue to pump additional staff, additional resources and more homecare into the system but if it’s not making a difference then we have to understand why that is the case, and look to understand better why some places have very few patients on trolleys”.
The three childrens hospitals said any long wait times for children in emergency departments were regrettable but the number of children attending such centres was not unusual for this time of the year.
“What is unusual and of concern is the number of children presenting with the flu as it is anticipated it will continue to peak for the next number of weeks. Some babies and children with this virus can become very unwell requiring supportive treatment and prolonged hospital admissions. We have increased isolation requirements for patients needing admission which is impacting on waiting times in our emergency departments.
“There are a number of strains of the flu at present but the best prevention measure is to get vaccinated now. There is still time to get the vaccine to prevent the onset of flu or to limit its impact. We are asking those people in the at risk groups to get the flu vaccine if they have not already done, people in the high risk group include children with chronic illness requiring regular medical follow-ups such as chronic lung disease, chronic heart disease, chronic neurological disorders, neurodevelopmental disorders and diabetes as well as those with lower immunity due to disease or treatment and all cancer patients.”
They urged families of children with minor and less urgent complaints to see their GP/out of hours service first.
Peak flu season
Dr Kelleher suggested that the peak of the flu season would be reached next week or the week after if the usual pattern was followed. He said while last year the flu hit the over 65 age group hard, figures to date this season suggested the highest rate was amongst children.
He told a press briefing on Thursday that while there had been a significant uptake in the number of healthcare staff receiving the flu vaccine a majority still had not done so.
He said in hospitals the figure for staff taking the flu vaccine was about 38 percent and in long-term care facilities the figure was about 32 per cent.
Earlier the Minister for Health Simon Harris said significant additional funding will have to be provided by Government to increase bed capacity in hospitals.
The Minister said the number of patients waiting in hospitals for admission to a bed remained “unacceptably high” . He forecast there would be a number of challenging weeks ahead.
He apologised to people waiting on trolleys in hospitals and said he wanted to break the cycle of overcrowding.
He said he had held talks with senior health service and hospital officials on Thursday and pressed for greater access to diagnostics in hospitals out of normal working hours and for more senior doctors to be present later into the evening.
He asked them to ensure all the beds that can be opened are opened.
Speaking on the News at One on RTÉ Radio, Mr Harris said avoiding a repeat of the overcrowding crisis next year would involve more bed capacity in hospitals and "real tangible reform" to the health service.
Sláintecare
He said his three building blocs for the health service this year would involve increasing capacity in hospitals, implementing the Sláintecare reform programme and negotiating a new contract with general practitioners.
Mr Harris indicated the size of the health service had to be increased in line with a growing population.
He said he had already begun increasing capacity in hospitals and that 191 additional beds had been provided in recent months.
He said an overall review of hospital bed capacity, which will look at needs in different hospital groups, would be completed within the next few weeks. He said this would then feed into the Government’s overall capital plan.
However the Minister said this “will require significant funds from Government”.
The number of people waiting on trolleys was down on Thursday from the record 677 people on Wednesday.
The INMO said there were 52 patients waiting for admission at University Hospital Limerick and 46 at St Luke's Hospital in Kilkenny.
In Dublin, the largest number of people waiting for admission to a bed was 29 at Tallaght Hospital.
Meanwhile the HSE’s deputy director general has said there is a need to move away from single year planning and instead to adopt the ten-year , long term capacity plan as proposed in the Sláintecare report.
John Connaghan told RTÉ's Today with Sean O'Rourke show the peak in the numbers on trolleys this week was not a unique phenomenon in the western world.
Winter plan
He said the winter plan, which was put together last summer, had an impact in October and November when trolley numbers were reduced.
The plan was to avoid the spike in numbers which was why the HSE made 60 extra beds available in Dublin and 60 outside Dublin, he said.
“The question is were they enough?”
Mr Connaghan also said there was a question why some hospitals were performing better than others.
He maintained that the HSE “rostered effectively” over the Christmas period and that there was a full complement of staff working over those days.
Mr Connaghan, who is also head of operations for the HSE, said he apologised to anyone who was waiting too long on a trolley.
“That is not acceptable. I take it personally.”
He pointed out other countries prioritised investment in primary care resources and maintained it might not be possible to discharge some patients to nursing homes as has been proposed.
National emergency
The overcrowding crisis has been strongly criticised by nurses, doctors and the Opposition.
The general secretary of the INMO, Phil Ní Sheaghdha, said the situation now represented a national emergency, and some locations could not cope.
The Irish Medical Organisation (IMO) said the country’s hospitals were effectively running an emergency service only on a year-round basis, with elective procedures now down to a trickle.
It said in the UK – where hospitals are also reporting chaotic scenes partly attributed to a rise in flu cases – it was seen as an option of almost last resort to cancel elective procedures, while in Ireland this happened routinely, and about 80 percent of admissions were emergencies.
“We need a range of sustainable solutions to alleviate this shameful situation including increasing the bed capacity in our acute hospitals and in community settings, an increase in consultant numbers, and an investment in general practice which is now operating at full capacity on very limited resources.”
The Irish Association for Emergency Medicine said it was gravely concerned but not surprised at the current situation. “This was always going to be how 2018 started in our EDs [emergency departments]. Everyone, from the Minister for Health to the clinician at the frontline knew it, yet little of substance was done by the Department of Health and the HSE to address it.
“There are now large numbers of patients on trolleys throughout the 12 months of the year. EDs are operating all year round at 100 per cent capacity, with any increase in workload, such as the predictable ‘flu season’ and the surge in respiratory admissions at this time of the year, causing an even worse crisis.”
It said HSE plans to solve the crisis were “unambitious and token, and are either not implemented or are too slow or too feeble to respond.
