Current COVID-19 safety arrangements in The Rotunda Hospital are in place to help keep the women and babies attending our services safe. It should be noted that the Rotunda is by far the busiest maternity hospital in the country, with a 20% increase in births in the last year, exceeding 9,000 mothers to give birth in 2021.
Recently, there has been a significant increase noted throughout Ireland in pregnant patients with severe COVID-19 illness. COVID-19 infection in pregnancy increases the likelihood of admission to hospital, needing additional breathing support (including being placed on a ventilator), as well as increasing the likelihood of pregnancy complications such as preterm birth or stillbirth.
In The Rotunda it is our responsibility to keep our patients safe. We do this through Infection Control interventions, such as mask wearing and other PPE, hand hygiene, and physical distancing. More recently, COVID-19 vaccines have become a vital tool in the fight against COVID-19.
We have tried to minimise the impact of COVID-19 restrictions on our patients’ birth and pregnancy experience, however there are some maternity-specific and Rotunda-specific issues which have resulted in us needing to maintain some restrictions
Two of the most challenging aspects have been:
- Low Vaccination Uptake Rates
We have regularly surveyed inpatients in The Rotunda as to their vaccination status in order to give us an overview of vaccination rates in our patient cohort. Only 39% of inpatients are currently fully vaccinated, and only 41% of partners. Therefore, with 60% of our patients and their partners not fully being vaccinated, this represents a very serious risk and a very different setting to that seen in other general hospitals and the wider community. COVID-19 still poses a serious risk to our patients, their babies, and their partners. We continue to urge our patients and their partners to get vaccinated by signing up at vaccine.hse.ie. Vaccination protects you from COVID-19, and may also help protect your baby when they are born.
- Challenging Physical Infrastructure
The Rotunda Hospital building is 275 years old, and it is not possible to ensure the minimum 1 metre physical distancing in many of our inpatient and outpatient areas. Providing safe physical distancing in areas like the Outpatients Department, Emergency Department and our multi-bed rooms is impossible. The current restrictions on some attendances by companions in certain areas of the Hospital is an attempt to reduce the footfall in these areas and to reduce the amount of people our patients come into contact with while in the Hospital.
Currently, the rates of COVID-19 infection in the community are high, and rising, specifically in the under 30 age group. This age group comprises a large part of The Rotunda’s patient population. Therefore, not only are our patients more likely to be unvaccinated, and less likely to be able to physically distance while in the Hospital, they are also disproportionately more likely to be affected by COVID-19 infection.
Over the course of the pandemic, we have sought to ease our COVID-19 restrictions as it became safe to do so. We are committed to these efforts, but presently it is not yet safe to ease our restrictions fully at the Rotunda.
The HSE and HPSC have issued revised guidelines for visiting in acute hospital settings, including maternity units. This guidance recognises the unique infrastructural challenges in some hospitals. The Rotunda abides by these guidelines, including access for partners at Early Pregnancy Assessment Unit visits, the Anomaly Scan at our Ultrasound Departments, on Inpatient wards and the Neonatal Intensive Care Unit at certain times, and for the entire duration while the patient is in labour on the Delivery Suite. Currently, while we are able to facilitate partners access for early pregnancy scanning in the Early Pregnancy Assessment Unit and for the anomaly scan, we do not have the capability to accommodate unrestricted attendance at other times. We always strive to accommodate partners if there are individual extenuating circumstances, as we have done throughout the pandemic.
However, given our unique challenges, we will continue to make individual risk assessment decisions that are specific and appropriate to the Rotunda, even when these may appear to differ from guidelines that suit other smaller, less busy, and more modern hospitals.
Our restrictions are reviewed every week. We constantly re-evaluate the role of testing, vaccination and infection prevalence, and, at all times, decisions are based on patient safety given our overcrowded campus.