The sacrifices made by the public’s adherence to social distancing, hand hygiene and other measures during the pandemic to reduce the pressures on acute hospitals, will be for nothing if we continue to have multiple occupancy rooms in hospitals, warns Professor Hilary Humphreys, Emeritus Professor of Clinical Microbiology at RCSI.

Speaking ahead of World Health Day today, Professor Humphreys said that the COVID-19 pandemic exposed the poor state of infrastructure in our acute publicly funded hospitals and the challenges faced by hospitals in trying to prevent the spread of infection among patients and staff.

"We have spent the last two years talking about social distancing and clean air and filtering systems in schools and workplaces. Why then do we admit patients to over-crowded, often poorly ventilated wards with four to six beds or more, often sharing the same toilet and shower? We have to move to a place where patients admitted to Irish public hospitals are admitted to single rooms to prevent the spread of infection and to afford them privacy and dignity when they are at their most vulnerable," said Professor Humphreys.

A 2021 HIQA study found that over 4,700 antibiotic-resistant infections occurred across all 50 public hospitals in Ireland in 2019. These antibiotic-resistant infections resulted in the deaths of about 215 patients, and almost 5,000 years of full health lost. Providing hospital beds for these patients cost approximately €12 million extra in 2019. Many of these are preventable with the resultant cost savings.

In hospitals, rooms that are naturally ventilated through doors and windows are currently used for most patients with infections that are spread by droplets such as influenza. Air-controlled rooms with specialised artificial ventilation systems are used for patients with an infection spread by aerosols like measles and for patients especially vulnerable to infections such as those with leukaemia. Single-occupancy rooms with natural ventilation are generally used for other patients at risk of infection, such as those on cancer treatment or those who pose a risk to other patients, for example those with MRSA.

Hospitals and healthcare facilities responded to the spread of COVID-19 with cost effective measures such as social distancing and by opening doors and windows to increase airflow. More costly solutions include air controlled or purification systems and monitors that can present logistical and financial challenges to implement.

Professor Humphreys said: "We must learn the lessons from the pandemic in terms of how and where we house hospital patients. The over-crowding in emergency departments and on wards, the clutter, and the absence of sufficient patient isolation capacity results in the spread of infection among patients and staff.

"We need more acute hospital beds and we must move to better-ventilated single-room occupancy throughout our hospitals to prevent the spread of infection, which will bring long term cost benefits to the health service, improve patient outcomes and give them the dignity they are entitled to."

Professor Humphreys is using World Health Day to highlight the issue and is calling on the government to consider his recommendations to help reduce all infections in hospitals, as well as in planning resilience for ongoing COVID-19 management and future pandemic preparedness.