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Lisa Smyth

Has the focus on tackling Covid-19 in Northern Ireland led to lives being lost from other causes?

Lisa Smyth



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Health staff put on their PPE masks, gloves and gowns in Belfast (Justin Kernoghan/PA)

Health staff put on their PPE masks, gloves and gowns in Belfast (Justin Kernoghan/PA)

PA

Health staff put on their PPE masks, gloves and gowns in Belfast (Justin Kernoghan/PA)

Is the cure worse than the disease?

That question is being increasingly asked as the lockdown to prevent a massive surge of Covid-19 deaths remains in place.

As the health service in Northern Ireland braced itself for its greatest challenge, there were early warnings that doctors would have to ration intensive care beds.

Even before the novel coronavirus claimed its first victim in Northern Ireland, the medical director at the Northern Trust warned that there was no guarantee there would be enough critical care capacity to deal with a surge in coronavirus patients.

Dr Seamus O'Reilly explained in early March that, under worst case scenario plans being drawn up by health bosses, doctors would be faced with the potential life and death decision on which patients would be allocated an intensive care bed.

He also revealed that it was likely that outpatient appointments and elective surgeries would be affected.

While the warnings were grim, it was difficult to imagine the extent of the impact Covid-19 would have on the NHS in a few short weeks.

The health service in Northern Ireland is particularly fragile.

For many years funding has not matched demand, workforce planning has been woefully inadequate, while crucial reform of the system has not materialised - mainly due to political antipathy.

The result is a service that has survived largely due to the dedication and resolve of staff, determined to provide the best care possible to their patients.

Of course, there is only so much that goodwill can achieve and so we have become accustomed to exorbitant waiting times for even potentially life-saving services.

We are also familiar with the redirection of resources during times of increased demand, particularly when it comes to winter pressures.

Each year, as the NHS prepares for an influx of patients suffering from respiratory conditions and trauma injuries, a proportion of elective procedures and outpatient appointments are cancelled to make way for an increase in emergency cases.

So, as the number of Covid-19 cases in Northern Ireland grew and we watched as hospitals in Italy were overwhelmed by the virus, it became increasingly clear that radical action was required to help the health service cope with what lay ahead.

This was underscored further when the Health Minister, Robin Swann, warned in mid-March of the possibility of 15,000 coronavirus deaths in Northern Ireland.

Less than a week later, the Belfast Telegraph revealed that the emergency department at Daisy Hill Hospital would close on a temporary basis to ensure best use of health service resources.

At the same time, an increasing number of operations and hospital appointments were cancelled to free up beds and allow staff to work in Covid-19 wards.

Such was the threat to our health service that officials took the unprecedented step of asking people to drive only when absolutely necessary, in part to reduce the number of people injured in road traffic accidents.

Parents were asked to keep their children away from trampolines and there were calls to take extra care when doing DIY as medical professionals and even Mr Swann warned that injuries from accidents "may not receive normal levels of care".

In the weeks that have followed, the number of people turning up to casualty units has plummeted significantly. This has led to concerns that parents are keeping children away from hospital even when they need medical attention.

Meanwhile, the number of people presenting with stroke and cardiac conditions is down.

As there is no evidence to suggest that fewer people are suffering from these conditions, the assumption has to be that people are putting themselves at risk by not seeking emergency treatment.

And last week it emerged that cancer services across Northern Ireland have seen more than a 60% decrease in the number of urgent referrals from GPs for suspected cancer in the wake of the Covid-19 crisis.

Family doctors have said this is as a result of a decrease in the number of people coming forward with red flag symptoms.

It comes as screening programmes for cervical, breast and bowel cancer, which result in an earlier diagnosis for hundreds of people every year, have also been paused.

Screening for another deadly condition, abdominal aortic aneurysm (AAA), has also been suspended.

Given that most people with the condition rarely experience symptoms, the screening programme undoubtedly saves lives, with 759 men found to have an AAA between 2012 and 2018.

At the same time, countless people are struggling with their mental health as a result of the strict isolation measures.

Northern Ireland has so far escaped the trauma of doctors rationing intensive care beds and the predicted death toll has been revised to an expected 1,500 in the first 20 weeks of the pandemic.

However, make no mistake about it, Covid-19 is lethal.

There is still so much about this virus that we do not know - not least who will escape with a temperature and cough and who will become another statistic in the growing death toll.

As talk turns to lifting the lockdown, the experts will be carefully assessing how this can be done without a surge in Covid-19 cases.

To date, the virus has claimed 299 lives here. What we do not know is the number of lives that have been lost and the number of people suffering today with agonising and debilitating conditions because of the coronavirus crisis.

However, the loss of every life as a result of Covid-19 - whether directly or indirectly - is nothing short of a tragedy.

Belfast Telegraph