CONCERNS ABOUT A “national catastrophe” happening in Ireland’s nursing homes have been raised by TDs in the Dáil today.

This is the first time the Dáil has sat in two weeks. A restricted number of TDs are in the chamber today due to social distancing.

Social Democrat’s co-leader Róisín Shortall said it is a “huge concern” that one of the country’s leading experts, Professor Jack Lambert, professor of infectious diseases at the Mater and Rotunda hospitals, has said the spread of Covid-19 in nursing homes is “a catastrophe in the making”.

He told RTÉ radio’s Today with Séan O’Rourke show that nursing homes need to be a priority, stating that under-utilised staff should be sent to “every single nursing home in Ireland”.

Sinn Féin’s Pearse Doherty said the most regrettable thing is the crisis in the residential care setting.

“In fairness to nursing homes, they saw some of this happening and they introduced visitor restrictions in nursing homes off their own back on 4 March… let’s remember
they were criticised by the Department of Health for moving too fast,” he said, stating that ten days later the department moved on the matter.

“I think it’s important that there is an acceptance here today that the decision of the Department of Health in this regard has proven to be the wrong one. And I think we need to have full clarity in relation to exactly what is happening within our care home settings and nursing home settings,” said Doherty.

Speaking in the Dáil today, Health Minister Simon Harris said the Chief Medical Officer Tony Holohan’s advice on nursing home visits was trying to strike a balance between protecting patients and ensuring there was no immediate isolation from their loved ones.

Fianna Fáil Micheál Martin: “Unfortunately I have to report to the house that I know of at least one case where a person in a nursing home has been informed that the nursing home has been told by the department that it should not give out information about the number of cases.”

He said families need reassurances that their loved ones are being protected.

Martin said nursing homes did not get the same focused approach from government with a bigger focus instead being placed on ICU beds.

“It seems to me that nursing homes were left behind significantly,” he said, adding staffing seems to be a core issue. 

Nursing homes at the forefront

Taoiseach Leo Varadkar said nursing homes are at the forefront of the government’s mind, stating that they won’t be the forgotten frontline. He said help is not getting to them as quickly as he would like it to, such is the scale of the problem.

He said the virus will take a significant toll on nursing homes, stating once a virus gets into a setting it is very hard to contain it.

Varadkar said just under 70% of the deaths are happening in hospitals, but acknowledged that many older people move from nursing homes to hospital and subsequently die in hospital.

Independent TD Mattie McGrath said “it is appalling what is going on” in the nursing homes around the country. He said nursing home managers he has spoken to are not getting support from the HSE.

McGrath said there are two things going on, “one is PR and one is spin”. He said if answers are not given the government will lose support of the public. 

Fianna Fáil health spokesperson said today that the Health Information and Quality Authority (HIQA) have said that almost one-third of nursing homes in Ireland have a Covid-19 cluster.

“Many nursing homes are trying to manage on a skeleton staff while dealing with multiple COVID cases. To date, very few staff have been deployed… We are also learning now of a care home in Laois where nearly a third of the residents died over the Easter weekend,” he said.

Donnelly said:

“Last night the Chief Medical Officer said that the nursing home and other residential sectors continued to pose a challenge and that they are now a priority area for Irish public health officials.

“Where is the support. On 4th of March Minister Harris announced a package of financial supports. To date, not only has not one euro been released, but the nursing homes haven’t had any communication for how this might even be done. They need the help now, not in future weeks or months.

“Nursing homes are also reporting that supplies of PPE are patchy, with one telling me what they receive is a ‘lucky dip’.”

Asked if he should declare the situation with Covid-19 as an emergency in nursing homes, Varadkar said: “I don’t think the emergency is confined to nursing homes.

“It is a national emergency, that emergency exists not only in care homes but in hospitals and the community as well. It is a health emergency, an economic emergency and it could become a fiscal emergency.

“As is the case in most countries, we have a mix of nursing homes in Ireland – some are voluntary, some private or for profit and some are HSE.

“I have yet to see any evidence that indicates that the number of cases or proportion of cases in private nursing homes versus public is higher or vice versa or the number of deaths is higher in private homes compared to public ones.

“I like to base my opinion on facts and I have yet to see any facts that show private or public ones are performing worse or better than each other when it comes to the number of deaths.

“I would ask people not to jump to those conclusions if the facts are not there and be responsible for the commentary. There are people in nursing homes and care homes who are terrified of getting the virus and lots of people who are worried for them.”

Not statistics

Varadkar today expressed his condolences to the families and friends of the 444 people who have died as a consequence of coronavirus in Ireland today. 

He said these are not statistics but citizens.

He paid tribute to the two HSE staff members in St. Luke’s Hospital who passed away in recent days.

“I don’t yet know if we’ll be able to relax restrictions on 5 May. But I do know that if we can at all, it’s going to be gradual and will happen over a number of months,” said Varadkar.

He said in Asia, restrictions have had to be re-imposed.

“Only a scientific breakthrough, a vaccine, or an effective anti antiviral medicine will truly allow life to go back to being as it was. Other breakthroughs, like a reliable antibody test could really help them,” he added.

When the restrictions will be lifted and when the public will be told about the government’s exit strategy was a concern that was also raised today by a number of TDs.

The Fianna Fáil leader said “the public can be trusted with the full truth”.

He said if the public are not given all the information, that is when public confidence will be lost, and the refusal to follow advice will grow.

“That’s why I believe in full transparency… in response to an unprecedented and rapidly moving emergency there will always involve errors,” he said.

Labour Leader Alan Kelly called for the plan to be made public in the next ten days, stating that people need hope. Grandparents need to know when they will be able to hug their children, and businesses need to know when they can expect to go back to work. 

“What is the exit strategy going to be? asked Shortall, who said a cost-benefit-analysis must be carried out.

Striking a balance 

She said clarity must be given as to “who is going to take those key decisions” about lifting the restrictions, stating “we do need to strike a balance of getting people back to work” while also ensuring people’s health is protected.

These decisions need to be made in a “public forum” and not just in a “health forum”, as has been the case to date she said.

She called for a high-level task force to be established to consider those issues and to plan an exit strategy.

This task force should listen to the advice from a range of disciplines, not just health experts.

Varadkar said any lifting of restrictions, such as allowing children back to school and people back to work are made on the advice given by the chief medical officer and health experts.

“I do think we should support them and trust them,” he said, adding “they might not always be right” but they are making recommendations based on the scientific evidence they have.