|Title:||Mercy University Hospital Covid-19 “First Wave”: Management Strategy, Demographics and Outcomes March 20th – May 12th 2020.|
|Author(s):||KF Deasy GA Kavanagh B O'Connor J McKiernan P Unnithan A Jackson DR Curran TM O'Connor|
|Institution:||Mercy University Hospital, Cork City|
|Poster:||Click to view poster|
|Abstract:||SARS-CoV2 is a significant public health dilemma for countries worldwide. The first wave of cases in Ireland evolved over 6 weeks beginning in the latter weeks of March 2020. Parallel approaches emerged in its management in hospitals throughout Ireland.|
The Mercy University Hospital serves Cork’s inner city. It is also the regional TB centre. Patients with severe emphysema phenotypes, drug misuse and homelessness present regularly along with the broad regional demographic.
There is limited critical care capacity with 6 ICU beds, 4 CCU beds and no HDU. However, with the Mercy’s history of managing complex respiratory and TB patients, routine experience managing respiratory failure and transmissible infectious disease exists across all wards.
We developed and managed a streamlined admission process which encompassed 2 streams: our Covid-19 Pathway (“Covid Resus”/“Covid Pathway”) and a parallel ”Non-Covid” Pathway.
We created a Covid-19 service and restructured our inpatient services into a
7-day roster with all medical staff, including consultants, assigned to specific hospital areas and groups.
A dedicated ED room was converted into a negative pressure resuscitation area. A dedicated ward with negative pressure rooms was assigned exclusively for Covid-19 patients. A separate ward with 15 single rooms was used to isolate suspected patients awaiting swab results.
We performed a retrospective review of definite Covid-19 cases admitted to our Covid-19 Service in the Mercy University Hospital over an 8-week period from March 20th to May 12th 2020. SPSS 24 was used for statistical analysis.
Cluster outbreaks were experienced in Endoscopy Staff (April 6th) and Radiographers (April 9th) but there were no known in-patient outbreaks.
2 patients (5.6%) died of Covid-19 infection. A third patient died at 90 days due to complicating sequelae of Covid-19.
Our case fatality rate (CFR) of 5.6% during the examination period compares favourably to the national average CFR of 17.8%, Northern Ireland’s CFR of 16.8% and England’s CFR 18.9% (hospitalised patients).
No patients died in our ICU (0 of 6) compared to the Irish ICU CFR of 22%.