Northern Ireland

Respiratory experts warn of ‘unprecedented’ impact of Covid-19 on waiting lists

Chest x-ray image showing infection of lungs.
Chest x-ray image showing infection of lungs. Chest x-ray image showing infection of lungs.

Respiratory consultants have warned of longer waiting lists, delayed diagnosis, treatment and care and insufficient bed capacity as among the major issues facing the healthcare system.

A survey of consultants by the Irish Thoracic Society has revealed the unprecedented impact of Covid-19 on respiratory healthcare services.

A reduction in the number of patients being seen and in the number of diagnostic procedures carried out are major issues, according to the survey results.

The society has called for dedicated respiratory units in hospitals and expanded respiratory services to respond to the unprecedented demands on the health system.

The survey was conducted among consultant respiratory physicians working on the frontline against Covid-19 in hospitals in the Republic of Ireland and Northern Ireland across both adult and paediatric respiratory services.

The society’s annual conference of respiratory healthcare professionals across the island of Ireland is taking place on Thursday and Friday.

The overwhelming majority of respondents (95%) said that the respiratory care of patients, excluding those with Covid-19, has been negatively impacted by the pandemic, with 90% citing delayed ongoing care, 73% delayed diagnosis and 59% delayed acute treatment.

Four out of five respondents have seen fewer non-Covid patients with lung problems when comparing March to October 2020 with the same period last year.

One in four say the number of patients they have seen has dropped by half since March.

More than nine out of 10 respondents have carried out fewer procedures such as lung function tests, bronchoscopies and sleep studies in the months from March to October compared with the same period in 2019, with one in two noting more than 50% fewer procedures.

Almost nine out of 10 say their waiting list for routine care has increased due to Covid-19.

The survey also revealed that 72% of consultants were not confident in the resources and capacity of their services to respond appropriately to the needs of patients.

Dr Aidan O’Brien, president of the Irish Thoracic Society, said Covid-19 has presented a “perfect storm” of issues that are having a severe impact on patients.

“Prior to Covid-19, respiratory services were already overburdened and under significant strain,” Dr O’Brien said.

“Now add to this the hugely increased workload of managing patients with Covid-19 in the acute phase, plus the need for ongoing care of those patients dealing with the long-term effects of the virus.

“Together, these issues are combining to have a severe impact on patient care.

“The results of our survey illustrate a large and growing backlog in patients who have missed out on essential diagnosis, interventions and routine care due to the impact of Covid-19.

“This is already having a serious knock-on effect to the health and quality of life of these patients.

“Of particular concern are people with lung cancer who may have experienced delayed diagnosis and, as a consequence, delayed initiation of vital therapy.”

Professor Stefano Nava, from the University of Bologna, is making the keynote address during the conference’s Covid-19 session.

Speaking about lessons from the Italian hospital system, he said: “Despite extraordinary efforts aimed at increasing the availability of ICU resources, the Italian Societies of Respiratory Medicine proposed a protocol to provide ventilatory support outside the ICU in dedicated Respiratory Covid Units, reinforced by a higher number of nurses and non-invasive monitoring.

“This recommendation was somehow in contrast to most of the available guidelines that contraindicated using non-invasive respiratory support (NRS) in these patients due to the major concerns over using bio-aerosol producing techniques, because of possible contamination of the hospital staff.”