Hospital staff are having to delay admitting patients into intensive care due to the sheer volume of serious coronavirus cases they are seeing.
Dr David Southern, a critical care consultant at Wrexham Maelor Hospital, said the hospital is currently dealing with double the normal number of patients in critical care.
He said the new, more infectious strain of coronavirus, which is thought to have originated in Kent, has led to a huge surge of Covid-19 positive patients in the region over recent days.
The experienced medic confirmed people in their late 30s and 40s, some with no previous underlying health conditions, are now becoming dangerously unwell with the virus and need to take up invasive ventilated beds.
Wrexham currently has the highest number of coronavirus cases per head of population in Wales at 867.9 per 100,000 based on the seven-day average between January 4 and 10.
“There is currently a very large intake of patients into the hospital who, within a couple of days, become critically ill,” said Dr Southern, speaking on Friday afternoon.
“The numbers of patients in intensive care expanded quite rapidly within a matter of days. We would normally run an ITU with a peak occupancy of 13 patients, and the last number I saw today was 24, so we’re running at approximately double the size.
“It’s becoming extremely difficult to ‘flex up’ (staff any more beds) in critical care. We have a respiratory ward which is now coping with patients who would ordinarily be admitted to intensive care. The last time I checked there were around seven people there who, under normal circumstances, would have come into intensive care already – but we really cannot run an intensive care unit of 31 beds.
“We are having to keep people in areas where we cannot provide them with the medical care that we would wish to because there isn’t a bed in intensive care for them.”
Dr Southern said Wrexham Maelor Hospital had already transferred “a good number” of non-Covid patients to other intensive units across Betsi Cadwaladr University Health Board including Ysbyty Glan Clwyd, Bodelwyddan, and Ysbyty Gwynedd, Bangor.
“Covid patients are so sick and their breathing is such a problem that they are very difficult patients to transfer,” he said.
“It’s a logistical nightmare and the Welsh Ambulance Service is rushed off its feet as it is. Their first priority is to respond to 999 calls, however they understand that we want to bring patients into a critical care area and that they need to be transferred.
“Everybody is doing the best they can but we wish it wasn’t like this.”
Dr Southern said the new strain of coronavirus appears to be impacting younger people more frequently. Is is understood that around 70% of all positive cases in Wrexham and the surrounding areas are now being infected with the new variant.
“What is quite noticeable is we are getting people in their late 30s and early 40s now, whereas a month ago before the new variant we were seeing very few of those,” he added.
“These people in some cases had no, or very minimal, other diseases other than Covid, so it is affecting people who we would consider fit and well.”
In terms of staffing levels, Dr Southern admitted trying to keep safe numbers in critical care felt “very strained indeed”.
He said intensive care nurses had a very particular set of skills and training which meant nurses in other areas of medicine could not be redeployed to carry out their roles.
He said: “I feel very sympathetic to my nursing colleagues in particular who have been under enormous strain this year. I think they feel it more than the doctors do.
“They are the ones who see patients when they are getting more unwell, when they are scared and when, unfortunately, they die.
“Particularly early on in the pandemic, staff felt threatened whenever they came across a Covid patient as they knew they were at risk [of catching coronavirus] – and they remain at risk to this day.
“I have seen some of my nursing colleagues develop sore patches on their head and face from wearing PPE all the time.
“They have taken a battering both physically and mentally, and one year on we’re now at a point where staff are having to cover more patients than they normally would, and so they are having to work even harder around patients.
“They fear they won’t be able to give safe care to patients because they’re running around so fast to deal with everyone, and they fear potentially making errors which can harm patients.”
Before he completed his medical degree, Dr Southern said he took a degree in immunology. He praised the decision by the Welsh Government to delay offering the second dose of the Pfizer coronavirus vaccine from three or four weeks to 12 weeks so that more people could be given the first dose.
“There is little, if any, difference between having two vaccinations three weeks apart or having two vaccinations 12 weeks apart. However, there is an enormous difference between having one vaccination or no vaccination at all,” he explained.
“I think it’s completely sensible of the government to give one vaccination as soon as possible. It’s essential that people who are offered a vaccination take the opportunity to have the only real protection that can be offered at the moment.”
Betsi Cadwaladr UHB said it is continuing to provide cancer and urgent care and treatments to its patients but is having to pause more routine appointments and treatments.
Dr Southern, one of two clinical leads for the Welsh National Critical Care and Trauma Network, said while this would undoubtedly cause upset to many thousands of people waiting for procedures like hip or knee replacements, it was the only sensible option.
He added: “This pandemic has affected me very closely. In the last month both my wife and daughter have had Covid and I’ve spent days hoping that they would not become unwell just like many of my patients on critical care.
“I’m very fortunate that they have recovered from it. I’m fortunate that I had the vaccine 10 days before Covid entered our household, and I think that vaccine stopped me from getting it.”