There will be up to 30 unnecessary coronavirus deaths in Northern Ireland in the coming weeks due to government inaction, an infectious disease expert has warned.
It comes after Health Minister Robin Swann ruled out the possibility of purchasing an extracorporeal membrane oxygentation (ECMO) machine for use here.
Dr Michael Donnelly, a clinical epidemiologist, has called on Mr Swann to make the service available in Northern Ireland to save as many lives as possible during the Covid-19 surge.
And he has rejected claims by Mr Swann that the equipment is too specialised and that highly infectious patients here will be transferred to hospitals in England for the life-saving treatment.
Dr Donnelly said: "The coronavirus attacks the lungs and after a few days it attacks the bottom of the lungs, where oxygen gets out into the blood stream.
"The ventilator simply pumps air in and out of the lungs, it doesn't get the oxygen into the bloodstream, so when the lungs become too damaged you can ventilate a patient all you want but it won't make any difference.
"The ECMO is attached to the patient and the blood is oxygenated in the machine and returned to the patient.
"It gives the lungs a chance to repair and recover from the damage caused by the virus.
"Robin Swann has said patients who need ECMO will be transferred by air ambulance to England but that simply won't happen.
"Can you imagine at the height of this that a patient from Northern Ireland will be taken to England?
"All the ECMOs will be in use for English patients, and as we have seen with the testing and personal protective equipment, Northern Ireland has to look after itself.
"If there was an ECMO in the Nightingale Hospital at the City in Belfast, it would make all the difference."
Dr Donnelly, who may be rediverted to work in a Covid ward at Belfast City Hospital, said he and his colleagues will be faced with harrowing conversations with the families of patients in the coming weeks.
"We will be telling them that there was nothing more we could do for their loved one when that isn't the case," he continued.
"If we had an ECMO in Northern Ireland, there is no doubt that lives could be saved.
"Between 27 and 30 patients in Northern Ireland could be saved by an ECMO, it is all too easy to get carried away in the abstract of all this, but these are people.
"They will not be very elderly people at the end of their lives, they will be young, in the prime of their lives, they will be economically active, with young families.
"They will die unnecessarily because we know there is something that could help them.
"ECMO machines have been used very successfully in the likes of Thailand, South Korea and China.
"It isn't enough to say it is a very specialised treatment. Everything in medicine is specialised but we still learn how to do it. Are we saying this treatment is too sophisticated for the medical profession and their patients in Northern Ireland?
"Following on from the Hyponatraemia Inquiry and the comments of Mr Justice John O'Hara that there is a requirement for a duty of candour from doctors, Mr Swann must now be honest.
"The politicians have a duty of candour to tell people in Northern Ireland that because they will not buy an ECMO machine, they are willing to let 27 to 30 people die.
"For my part, I would tell relatives that we did all we could in the circumstances.
"Actually the duty of candour is with the commissioners and the politicians and their decisions about testing, PPE, staff, ventilators, drugs, and public advice."
Alliance Party health spokeswoman Paula Bradshaw said Mr Swann must ensure that coronavirus patients in Northern Ireland receive the same treatment as patients elsewhere in the UK.
"I asked Mr Swann how many ECMOs he has ordered at the Assembly Health Committee last week and was disappointed to be advised that he had not ordered any," she said.
"I very much share the concerns of Dr Donnelly - these ECMOs are in wide use around the world during this pandemic and I believe that we should be providing our Covid-19 patients with the optimal treatment, to ensure that we prevent as many deaths as possible."
A spokesman from the Health and Social Care Board said: "The provision of ECMO is a highly specialised service provided at a small number of hospitals across the UK.
"If people in Northern Ireland require ECMO they are normally transferred to one of these specialist centres. There is no local ECMO service in Northern Ireland."