The real test for the health service will come when social distancing measures are relaxed, a senior consultant has said.
As politicians consider how to start easing the public out of lockdown, Damien Scullion said Covid-19 will either “proliferate or remain dormant”.
“We’re all concerned about a second peak; we’re also concerned that a second peak may coincide with the seasonal flu, which in many ways could be a lot worse,” he said.
“The real test will come when the isolation measures start to be relaxed and we see how the public react to that and how the virus either proliferates or remains dormant – hopefully it’s the latter.”
The number of people who have died after testing positive for coronavirus in Northern Ireland rose to 387 on Monday, after another six deaths were reported.
Although the true figure is likely to be higher when deaths in the community are factored in, the most recent modelling to be made public suggests the death toll could be 1,500 – a significant reduction from the up to 15,000 worst-case scenario indicated at the start of the pandemic.
Dr Scullion, a senior consultant at Craigavon Area Hospital, paid tribute to the public for those figures.
“I think it’s very important to commend the public in Northern Ireland for the way they have adapted to this … and you can see from the figures that this really has worked because certainly we were not as busy as we thought we could be,” he said.
The Co Armagh hospital has been transformed since the pandemic started, with new signage and a loudspeaker formerly used to announce the anti-smoking policy now giving out symptoms of Covid-19.
There are separate respiratory and non-respiratory emergency departments in operation, and even the staff canteen has been moved into temporary marquees outside to enable social distancing.
Inside the intensive care unit there are strict protocols around the wearing of personal protective equipment (PPE), which must be removed before staff can move into other areas of the hospital.
Consultant Michael Perry urged patients needing medical attention to attend hospital.
“We’re noticing that patients are quite sick when they come in … and a lot of patients have told us that they don’t want to come to hospital, they have sat at home and tried to wait it out, worried they might catch coronavirus, so we’ve been trying to encourage the public if they are unwell or having breathing problems or chest pains they need to come to get seen,” he said.
Dr Maria O’Kane, medical director at the Southern Health Trust, said they are preparing for the next phase.
“What we are starting to see now over the most recent week has been possibly a plateauing of what has gone on, and potentially an overall reduction,” she said.
“We’re beginning to see that, in terms of the numbers of people who present through the emergency departments or respiratory wards, the intensive care units, but what we do know is there are still significant levels of Covid in the community.”
Dr O’Kane said that throughout the pandemic they have had between 6% and 10% of staff off, shielding or with caring responsibilities.
She added that a number of staff have tested positive for Covid-19, but that all have been successfully treated so far.
Dr Scullion said Covid-19 has proved to be “the ultimate challenge”.
“When we first had Covid patients in intensive care, we found that they weren’t responding as other patients did. It took a long time for them to get better and in fact some of our first patients did die,” he said.
“It was very demoralising and quite challenging for the staff, but eventually, as we got patients who were starting to respond to treatment and who did get better, it was a morale boost for all the staff and it was something that was badly needed.”
He said the restriction on visitors, particularly for critically ill patients and those dying, has been difficult, and feels “alien” to both relatives of patients and nursing staff.
“Nurses are there and they are the family’s advocate, they let the family know they are there with them, not just treating them medically but all their other needs as well,” he said.
“They have found it very hard to deal with it, but we have got an excellent psychology team from the trust which has worked very hard with the nursing staff and has some great results.”