Stop ‘tinkering’ with circuit-breakers and return to full lockdown, top doctor urges NI Executive amid warning of patients going without ‘proper’ treatment due to coronavirus pressures

A top Northern Ireland doctor has said a return to a “full, unambiguous” lockdown is the only way to get a “consistent way out” of the coronavirus crisis facing the health service.

Dr Alan Stout
Dr Alan Stout

Dr Alan Stout, the chair of the British Medical Association’s GP committee in Northern Ireland, is the latest in a growing line of health representatives expressing concern about the situation facing hospitals.

In an interview with BBC Radio Foyle, he said medics could soon be forced to choose who is admitted to hospital.

“We are worried about after Christmas, but actually we are really, really worried about right now,” he said. “Our hospitals are over-capacity, our infection numbers, our positive tests are far, far too high.

“This virus is circulating, it’s circulating very, very quickly in the community and we’ve got a situation at the moment where we can all see it - we have so many contacts, we have such increasing contacts that it’s only to continue to spread.

“I do not see any kind of downward trend from what we’re seeing in the community at the moment.”

Asked about the response of the Stormont Executive, Dr Stout said: “We’ve been tinkering with lockdowns. I fully sympathise with hospitality and with retail and so on. The only thing that works is a really full and unambiguous lockdown - drive the numbers down. That’s when our test and trace works best, that’s when we can then open things in a confident and a controlled manner. But when we tinker with lockdowns?”

He continued: “To be honest, the last two weeks I found it hard to tell whether we were in a lockdown or not. There were still so many things open and there were still so many contacts. We have to commit. That’s the only way we’re going to get a consistent way out.”

Dr Stout was speaking after his colleague in the British Medical Association, Dr Tom Black, had said a return to lockdown would be the “logical” thing to do in Northern Ireland.

And the chief executives of each of the six health and social care trusts in Northern Ireland had also issued a stark warning that the health service could be “overwhelmed” by another spike in infections in the New Year.

Dr Stout said another spike would be “terrifying”.

He told the BBC: “Unbearable pressure is just that we cannot treat the people that we need to treat. We’re already hearing stories of the waits for beds - I believe last night in one hospital there were 50 patients waiting on admission, which is just terrifying.

“If those numbers are increasing, we just simply do not have the beds, we do not have the staff, we do not have the places to put patients. It’s going to become unbearable, it’s going to become so, so difficult to deliver a service for the patients that need it.

“There’s going to be some incredibly difficult decisions that are going to have to be made to ensure that we can manage.

The one thing that we can reassure everybody is that every single doctor, every single nurse, every single healthcare worker will do their absolute best, their absolute utmost to help anybody who needs it. But you just cannot underestimate the pressure that that puts on them.”

Asked what that could mean in practical terms for patients, Dr Stout said: “It’s prioritisation and it’s rationing - it’s as simple as that. Who gets the bed? Who gets the intensive care bed? And so on. It’s difficult decisions like that. And it’s even beyond that because it’s not proper and appropriate treatment. If we can’t get a very sick patient into a bed then they have to be managed, they have to be nursed and they have to be cared for somewhere else, and that then creates a whole knock-on effect on every other part of the system as well.

“What we’re actually seeing at the moment is taht the level of very sick patients not requiring intensive care is where the real peak has come, and that’s put a lot of pressure on the wards and the covid wards. The real pressure point is on the wards.

“What we want to do is then be able to discharge those patients to some of the facilities that have been set up as part of the surge plan, but even that is proving difficult because these are very sick patients.”