Healthcare officials are mulling a revised contingency plan to ensure hospitals can cope with rising admissions of Covid-19 patients so to keep providing adequate care for other inpatients.
Senior administrators from all the state hospitals held a video conference to assess the state of play island-wide, as the number of people requiring treatment for Covid-19 continues to increase, and as the health ministry announced one new death, an 84-year-old man, plus 220 new cases out of PCR tests.
The man who died was being treated at Famagusta general hospital, the referral facility for coronavirus patients. He had been suffering from underlying conditions, but the final cause of death was attributed to Covid-19, authorities said. That brought the coronavirus death toll since the start of the outbreak in March to 48, with the average age of the deceased at 75 years.
The figure for new cases is broken down into 175 new positive PCR tests, plus 45 positives from rapid tests taken in previous days and since confirmed via PCR. The latest 175 PCR positives came about from 5,935 tests. Significantly increased testing has consistently yielded positives in the triple digits over the past few weeks.
On Thursday, 109 patients were receiving treatment for Covid-19: 60 at the Famagusta hospital (of whom four in the high-dependency unit); 17 at Nicosia general hospital’s ICU (of whom 14 intubated); 11 more at Nicosia general’s dedicated Covid-19 ward; 17 patients at Limassol general hospital; and four at the Makarios hospital.
It’s understood, though, that the latter four at Makarios hospital were women in the natal care department who happened to have tested positive for Covid-19 but did not require treatment.
Under an already established contingency plan, public hospitals could generate up to around 200 beds for coronavirus patients. That does not include ICU beds.
Although current occupancy is nowhere near that threshold, authorities are planning ahead for any eventuality, particularly as susceptible individuals – for the moment asymptomatic – may require treatment in the coming days.
To date, 206 elderly people in care homes have tested positive for the coronavirus. Whereas the majority of these are not currently sick, that could quickly change, said Pambos Charilaou, spokesman for the state health services organisation (Okypy)
“It’s something we need to keep a close eye on,” he told the Cyprus Mail.
With coronavirus, the experience in Cyprus shows there’s typically a delay of seven to ten days between diagnosis and the onset of symptoms.
“So we anticipate an increase in admissions soon, and meanwhile the rate of admissions continues to exceed discharges.”
Charilaou explained that the Nicosia general hospital has two ICU units: one for Covid-19 patients exclusively and with a capacity for 28 beds; and a second ICU unit for non-coronavirus patients with a capacity of 17 beds.
Nicosia general handles all Covid-19 patients requiring ICU – with or without mechanical ventilation.
Under an extreme scenario, wards in the Nicosia hospital could be reconfigured to host up to 115 people in ICU. That eventuality is already ‘baked into’ contingency planning, said Charilaou.
Okypy has also suggested that elderly people who test positive but who are asymptomatic or have very mild symptoms, stay at their care home if the facility in question is able to isolate them.
If the care home is not outfitted to separate these cases, the elderly would be transferred to ‘interim facilities’.
The idea is to refrain from automatically admitting into hospital any elderly individual with Covid-19 if that person tested positive but doesn’t need treatment.
“It’s a recommendation designed to take some stress off hospitals and free up beds that may otherwise be unnecessarily taken up. But it’s up to the health ministry to take it on board,” said Charilaou.
In a related development, it emerged on Thursday that Hadassah University Hospital in Jerusalem, Israel will be accepting patients with serious and life-threating medical conditions from Cyprus in a bid to relieve hospitals under strain from Covid-19.
“Due to the increasing number of Covid-19 cases and hospitalised patients in Cyprus, the Hadassah University Hospital will be accepting cases of Cypriot patients,” the hospital said in a statement on Thursday.
Coronavirus cases will not be accepted and patients travelling from Cyprus will need to obtain special permission from the Israeli health ministry as well as present a negative PCR test on arrival.
On Friday, the government is expected to announce additional restrictions to movement.
Reports spoke of a tightening of measures in all districts, with a potential lifting of the partial lockdown in Paphos.
The measures will be made known after a meeting between President Nicos Anastasiades and the team of scientific advisors.
Media reports said Health Minister Constantinos Ioannou would present two packages of measures, one more stringent for the period before the holidays and the other with relaxations from December 23 until Epiphany on January 6.
The night-time curfew, the restriction on gatherings in houses and the earlier closure of restaurants are expected to remain.