Altnagelvin at a ‘critical juncture’ as COVID spikes says director of acute services Geraldine McKay

Geraldine McKay issued the warning as the number of positive coronavirus patients at Altnagelvin Hospital rose to 31 yesterday with five of those patients in intensive care.

She said: “Going over thirty positive cases on one site has brought us to a bit of a critical juncture in terms of our service provision and given the number of staff. Our numbers today will probably influence our decision-making over the next number of days.”

Altnagelvin is now at a high ‘red’ level of its surge plan with a contingency in place to move to ‘extreme red’ if the numbers continue to increase.

This would be triggered if there was a ‘very high number’ of admissions and the hospital was unable to provide any care other than for COVID-19 patients, said Mrs. McKay.

“Altnagelvin and South West Acute Hospital (Enniskillen) have had increasing numbers on a daily basis and increasing at pace over the last eight to ten days,” she added.

“It appears that our numbers are doubling every three to four days in terms of our patients who are positive. As a response to that we have reviewed our surge plans. We have put back in place the pathways that we had talked about in phase one,” she said.

Mrs McKay outlined how community transmission of the virus in Derry and Strabane was having a knock-on effect on the Trust’s staffing levels.

“In terms of staff that are not available to us at this minute in time at Altnagelvin, we have 345 staff that are not available to us due to various reasons, for self-isolation, etcetera,” she said, referring to the position on Friday.

“About a third of those staff are not available to us because of community contacts. So, it’s not only hospital impact that is causing our staff to self-isolate - it is the high transmission rate in our communities that is also impacting on our staff,” she explained.

Mrs. McKay said the Trust was now in an ‘extremely challenging’ position and she indicated that difficult decisions may have to be made about standing down or curtailing some services if the number of admissions due to COVID-19 continues to rise.

She has appealed to the public to follow the public health advice, to wear face coverings, to reduce their contacts and to practice good nasal and respiratory hygiene in order to decrease the spread of the infection.

“This morning, I see that there’s only one county in the south that has a higher rate of transmission than Fermanagh and Omagh and that’s Cavan. Derry and Strabane has actually a three times higher transmission than anywhere else in this region.

“That’s concerning me. The Derry and Strabane transmission is concerning me for all the reasons that we talked about earlier: number one, the impact on our health service but, actually, the impact of the community transmission on our staff and their availablity to work for us,” she said.

At present, there are a maximum of 18 ICU beds at Altnagelvin and six to ten in Enniskillen depending on the level of surge.

“We are monitoring it on a daily basis. We also have a lot of non-COVID patients that require a lot of support and care so we have to balance the risks between both. It’s a daily and hourly challenge for us at this minute in time.

“The biggest constraint is staffing and staff being unavailable to us means we can’t provide everything.

“I think we are coming close to a decision about what we can provide across our sites in the next day or two if the numbers continue to rise.”