CONCERNS HAVE BEEN raised about the level of hospital acquired infections of Covid-19 after the HSE confirmed that there has been 6,627 Covid cases linked to hospital outbreaks.

The new figures reveal that hundreds of patients who were admitted to hospital for other conditions, but contracted Covid-19  while in hospital, subsequently died.  

In total, Ireland has recorded 542,146 Covid-19 cases since the onset of the pandemic.

According to data supplied by the HSE there were 841 deaths of people whose cases were linked to acute hospital Covid-19 outbreaks, a figure that represents 15% of all Covid-related deaths.

In response to Aontú’s Peadar Toíbín parliamentary question, the HSE said data was extracted from the Computerised Infectious Diseases Reporting (CIDR) system at the Health Protection Surveillance Centre (HPSC) from dates between 1 March 2020 and 15 November 2021. 

The data shows that a total of 6,627 confirmed cases of Covid-19 “have been linked to Covid-19 outbreaks in acute hospitals since the beginning of the pandemic in Ireland”.

This number contains a mixture of patients and healthcare staff. 

The statement went on to say:

“This number contains a mixture of patients and healthcare staff. A total of 841 cases linked to acute hospital Covid-19 outbreaks have died (836 confirmed COVID-19 cases; 5 possible COVID-19 cases).”

The HSE noted that it is not possible to identify sporadic cases that may have contracted Covid-19 in a hospital setting. The data supplied only relates to outbreaks – which is classed as one or more cases that are linked.  

“The following response relates to Covid-19 cases that were linked to Covid-19 outbreaks that occurred in acute hospitals, but it is also not possible to confirm that all cases linked to these outbreaks contracted Covid-19 while in the hospital setting,” said the HSE in their statement.

In response to a query about hospital acquired infections recently, the Department of Health said it is important to note that the primary rationale for collating data around such figures is to monitor, identify and respond to the problem, stating “it is not an epidemiological or surveillance tool”.

‘Inevitable and unavoidable’

“It is important to note that when community transmission rates are at the level they are, it is inevitable and unavoidable that there will be outbreaks in hospitals,” said the department’s spokesperson.

The department also noted that hospital-acquired infection – both in staff and patients – is recorded in the weekly reports by the HSPC. 

“The information we have indicates the number of new, probable and confirmed hospital acquired cases each week – it is not possible to determine from the data that we have what percentage of the people in hospital on a given day are people with hospital acquired infection,” they added.

The department noted that the HSE uses a standard definition of hospital-acquired Covid-19 that takes account of the ECDC case definition. 

“This definition excludes most cases of community acquired Covid-19 and includes most cases relating to inpatients with hospital acquired Covid-19.

“There is extensive testing of people on admission to hospital and while in hospital to help find people with infection as quickly as possible so that measures can be taken to reduce the risk of spread of infection to others,” they added. 

Hospital numbers

In January, Tánaiste Leo Varadkar raised concerns about the level of infection occurring in hospital, stating that third of patients with Covid-19 in hospital contracted the virus while being cared for in the hospital.

At that time, when Ireland was experiencing its third wave, there were 1,949 confirmed cases in hospital, with 219 in ICU.

Speaking in the Dáil in January, Varadkar said the government had “real concerns” about the clusters emerging in Irish hospitals. 

“It seems that as many as a third of patients in hospital got Covid in hospital, they didn’t come in Covid positive, they picked up Covid while in the hospital. Now some of them may not be sick as a result, they may be sick for a different reason.

But it still is a matter of real concern that so many people are acquiring Covid in our hospitals.

Today, there are 611 people in hospital who tested positive for the virus, down 27 on yesterday. There are 132 in ICU, up two. 

INMO General Secretary, Phil Ní Sheaghdha, referencing HPSC figures on the number of Covid infections in healthcare settings, said infection rates had increased amongst healthcare workers, with nurses and midwives representing the highest cohort of those infected.

HSE boss Paul Reid has said previously that the levels of Covid infection in hospital – whether contracted inside or outside the hospital – have an impact on the services that can be delivered by the health service. 

Government sources have said that they are aware of the levels of hospital acquired infection, stating that it has been presented to them that as many as 200 the of 600 in hospital were admitted for another reason, other than Covid. 

Given the level of virus in the community right now, this is inevitable, they said. 

Toíbín has called for a full scale public investigation into the government’s handling of the pandemic in hospitals and nursing homes, stating that he will bring forward legislation in the coming days and weeks seeking to set up an independent investigation.

“The frontline staff are not to be blamed, they were abandoned by the government and HSE. Staffing appeared to be the major issue in both settings – outbreaks in wards saw huge numbers of staff self isolating and situations where a handful of staff were left looking after entire wards on their own,” he added. 

Taoiseach Micheál Martin confirmed to The Journal in September that an evaluation of the State’s handling of the pandemic will take place early next year.