Wednesday, March 18, 2020

OVER the past number of weeks, the Waterford News & Star has been maintaining constant contact with an ever expanding group of contacts within the hospital and wider group of emergency services to ensure a steady flow of relevant, and more importantly accurate information from the frontline.

This week, we spoke to a number of sources, both on and off the record, to discover how our hospital, and the medical teams working within it are coping with the outbreak of Covid-19. A nurse who has provided this newspaper with essential information for the past five years said that in all her almost 30 years as a nurse, she has never seen an atmosphere like the one currently prevailing in University Hospital Waterford.

“At times, the hospital has been eerily quiet, something that takes a lot of getting used to,” she said. “Two nurses from the Emergency Department, who had come into contact with the first confirmed case had to wait over 48 hours for the test results but thankfully they came back negative. I expect a lot more tests to take place over the next few weeks as the number of confirmed cases grow. One thing we are concerned about is where we’re going to put all those patients if things do take a turn for the worse.”

A hospital porter told the News & Star that the Covid-19 outbreak is being handled in the calmest and most professional way by hospital staff, but “couldn’t say the same about some visitors”.

“I’ve witnessed some ridiculous behaviour over the past few days,” he said. “One person came into the hospital reception area with an empty bottle of hand sanitiser and began emptying the contents of our ones into his. He had to be removed by security, as did the people who attempted to steal the gloves and face masks from one of the wards.”

The specially equipped Covid-19 car

Ambulance

The ambulance service are a vital cog in our health service and are playing a particularly crucial role during this outbreak. Special Covid-19 cars have been deployed by the service to administer home swabbing of people with coronavirus symptoms. National Ambulance Service Paramedic Supervisor Clive O’Regan explained the process to the Waterford News & Star.

“We have a number of staff trained to carry out the home swabbing and they use dedicated cars for the work,” Clive said. “A Covid-19 car sounds quite dramatic but in reality it’s just an ordinary car that’s equipped with Personal Protective Equipment (PPE), patient kits (refuse sack, tissues and face mask and a HSE explanation sheet) and Swabbing Kits.”

How National Ambulance Service Paramedic Supervisor Clive O’Regan looks when he is getting ready to swab a suspected Covid-19 patient.

Before entering the home of a patient, the paramedics will fill out paperwork before donning the PPE, which comprises of face masks, eye shields, gown, gloves and the all-important hand sanitiser.

“We have an assessment to carry out on the patient and their home to make sure it’s suitable for them to self-isolate and also that the patient is fit to stay at home,” Clive explained. “We then carry out the swab on the patient, which involves taking a swab sample from the patient’s mouth and nose. This takes less than a minute to do and with little discomfort to the patient. The swab is then placed in a sample tube and further secured in a biohazard box for safety.”

After each swab is taken, the PPE will be removed, placed in clinical waste bags and all equipment will be cleaned and sanitised before the next call.

The Covid-19 swab kits.

“The patient will then have to self-isolate as best as possible until the results of the tests are provided to them by their GP or Public Health,” Clive said.  This can take up to 24 hours at present, although I believe this is to be speeded up. We then move onto the next patient as provided by the team from our National Emergency Operations Centre, which has a Covid-19 desk operated by NAS staff and Public Health doctors and nurses. We deliver the samples to the lab at UHW and they take care of them after that.”

 

Emergency

Clive says that as well as Emergency Department trolley numbers being dramatically down, emergency calls have also decreased.

“I think people are deciding to stay away from the hospital until they really need to be there,” he said. “Call volume for query Covid19 calls has increased in the past few days and these calls will all get a response of an Emergency Ambulance crew who will carry out an assessment of a patient at their home. These crews will also wear full PPE for the time they are dealing with a patient and if they are transferred to hospital the ED is notified in advance so that an isolation room can be made available. If the person is healthy and well, the NAS staff can advise them to self-isolate at home and further contact with the person’s GP and Public Health for swabbing to be arranged. This is why we are likely to see drop in centres be established in the coming days to support the work of the NAS staff in cars.”

The ambulance service, like the rest of us, are not informed of patient results, unless they have been in direct contact with them.

“Patient confidentiality is of paramount importance,” Clive said. “This is a worrying time for many people who may have symptoms or even those confirmed positive, which we believe there is a number of in Waterford. I have to say though, working on the Covid-19 car has been a heart-warming experience for me, to have people being so welcoming of us into their homes and thankful to us for the work we are doing. Of course I have also had to turn down lots of offers of tea and coffee from the families that we have called to as unfortunately we can’t stay in the house for too long. We will all get through this, together.”

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