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HEALTH OFFICIALS HAVE said there is ‘no single reason’ for the high level of infection in nursing homes, but they are considering the various ways it may have entered and spread throughout these settings.
When asked about the issue at this evening’s Department of Health briefing, Chief Medical Officer Dr Tony Holohan said “the reality is any form of movement of people in and out of any setting increases the risk of transmission of this infection”.
“And if there’s movement of individuals in and out of nursing homes and longterm residential care facilities happening, that can increase the risk of transmission.”
He has previously stressed that officials do not believe, based on the data, that visitors brought this disease into nursing homes.
Holohan said he wanted to “stay away from” attaching any blame to anyone in relation to the introduction of Covid-19 into nursing homes.
“Clearly staff have to go in and out of work in these settings and nursing homes are places that have to be visited by other categories of workers who move in and out and so on.
So it’s impossible to attach blame to that, that’s vital activity for the operation of residential nursing home facilities. And they’re amongst the means through which the highly transmissible infection gets around the community, it gets around through the movement of people.
Dr Colm Henry, HSE Chief Clinical Officer, said in the early days of the outbreak in Ireland, there was a lot about this virus that health officials did not know, including the high levels of asymptomatic transmission.
“Also, the atypical presentation, just about a third of older people have any kind of typical presentation. Many of the, even severe cases, the illness is a very unusual presentation compared to younger people.”
He also pointed out that the care in nursing homes is “very close” as many of the residents have mobility issues.
“The very nature of the model of care for older people which involves congregation of older people, involves a form of care that is expert but also hands-on, means it doesn’t lend itself well to a pandemic.”
‘A better understanding’
Earlier today, HSE boss Paul Reid said there is “no evidence whatsoever” that Covid-19 infection spread into Ireland’s nursing homes by the discharge of elderly people into nursing homes in March.
Speaking at the Special Dáil Covid-19 Committee today, Reid said how the virus got into residential and nursing homes is still something the National Public Health Emergency Team (NPHET) is “trying to get a better understanding of”.
The issue of elderly patients being discharged from acute hospital settings was raised by Sinn Féin’s Louise O’Reilly today, stating she had heard references that it could have been the reason for the virus in nursing home settings.
With Reid stating that NPHET is still trying to ascertain the cause of the spread in nursing homes, she said the HSE boss could not state that he is confident that discharges from hospitals was not one of the reasons.
Reid said he did not state he is confident, but said there is no evidence.
He added that in early March the health service was predicting a “massive surge” on hospital settings.
“Where we needed to provide massive supports also was the acute settings. We would have had an ongoing process of what we would call delayed transfers of care where people are deemed clinically fit and not suitable to be in an acute hospital setting for the transfer of those patients, and in most cases elderly patients, out of that care.
“That is a process we would have done, and that was the right thing to do at the point in time of doing it,” he said.
Hiqa compliance
In the Dáil earlier, Fine Gael’s Fergus O’Dowd also raised the issue of clusters in nursing homes.
Published data from August 2019 shows there was 31,000 residents in 581 homes.
Only 128 of those homes were fully compliant with the Hiqa regulations – that is 128 out of 581.
“That percentage of compliance was down from 27% in 2017 to 23% in 2018,” said O’Dowd, stating that compliance with Regulation 27, which deals specifically with infection control, was also inspected by Hiqa in only 215 of those homes.
“Only 215 out of 581 were inspected for compliance in 2018. Of those, 37 were found to be non-compliant, therefore, there is an 18% level of non-compliance in the very basic protection for all of those residents in terms of infection control,” he said.
O’Dowd said the hands of nursing homes were clearly tied.
“We knew that nursing homes were the most vulnerable. We knew from the evidence that this would be the case,” he said, asking if proper infection control is in place.
Secretary General of the Department of Health, Jim Breslin said a huge range of supports have been put in place to try to help the nursing home sector.
“The sector is a mix of publicly operated and privately owned facilities. It is not line managed in its entirety by the HSE; much of it is outside the HSE,” he added.
- With reporting by Michelle Hennessy.
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There choice to get sent there….
@Paul: Is it a choice to have the neurological disorder ADHD, a condition that affects impulsivity, causes those affected to act first and think later (32%). Is it a choice to have a mental health problem (55%)? Is it a choice to have a learning disability (36%) or learning difficulty (22% i.e. an IQ below 70)? Is it a choice to be at risk of neglect or abuse (47%)? Is it a choice to be born into a background of poverty or criminality?
@David Jordan: all very well but the vast majority of people in the world diagnosed with these issues and have steered clear of the wrong side of the law. So by your reasoning does it mean that the other ones in there are just simply bad people or shall we draw up an excuse for each and everyone. If it were the case that their mental health problems/learning disabilities/learning difficulty reduced their mental age capacity or hampered it in a way they could not differentiate between right and wrong they tm would not be in a facility like Oberstown. Oberstown is for criminals under the age of 18. Would you be signing off the same hymn sheet if they had robbed your car or held a knife to your mother’s throat and took her pension?
@Paul: absolutely, just like it was your choice not to be educated. The word is spelled ‘Their’.
I’ll elaborate…. look at those vulnerable children over (there)’. (They’re) alone in (their) rooms without any parental guidance through no fault of their own.
3 versions of the same sounding word.
Seems your lack of education is not solely limited to poor spelling. Perhaps research what the potential effects of broken homes, abusive parents, alcohol related issues, lack of parental support etc have in young children.
Hope you receive the help you need (Night classes perhaps?), just as I hope these children receive the help they themselves need.
@David Jordan:
And just so we are clear ADHD can sometimes (not always) affect impulsivity. It’s more to do with an inability to maintain persistent attention to tasks etc along with hyperactivity, hence the name. It’s far too easy nowadays to throw out a few letters and dismiss people’s actions as a result.
@Paul: *their
@Paul: “Their”
@David Jordan: The most serious well known disorder that these kids suffer from is BOLD.
@David Jordan: oh and to your last line maybe we should start looking at that and that decisions should be taken brfore the birth of a child to determine whether prospective parents(s) have the required “where with all” to safely bring up a child.
Never ceases to amaze me that people can be so sympathetic to children in abusive and non-loving homes but as soon as those children reach an age of about 14 all that sympathy goes straight out the window.
Small children that don’t get the same start in life that others take for granted WILL grow up to be potentially criminals. They don’t just suddenly “learn” the right way to function in society if they’ve never been taught.
And yet there seems to be a distinct reticence by many to fund early intervention and parental assistance. There seems to be a feeling that the parents don’t deserve help with the added bonus of the child grows into an adult that “doesn’t deserve help”.
And so the wheel turns.
@Tricia Golden: Many of these teenagers come from criminal homes. Grandfather’s, Fathers, Brothers, Uncles and Cousins, many been have and are involved in criminal activities. For them crime is as natural as going to work is for you.
@Tricia Golden: The percentages are frightening. Travellers represent 23% of the inmates but are only 0.6% of the general population. This is a huge figure and it’s screaming at us to get this “Culture” removed with education and good role models. This way of life costs us taxpayers tens on millions a year but we are still not addressing the problem !
@Ser Barristan Selmy: Well done missing my point.
I am specifically pointing to early intervention, supplying good role models and providing advice and assistance to parents long before these children reach the stage where the penal system needs to “teach them”.
I will concede that “will” versus “potentially” but I suspect it doesn’t detract from my overall point beyond giving you something to focus on apart from my main argument.
@Richard Wright: Did I say that or is it that what you yourself are thinking?
@Richard Wright: Firstly you are assuming that I am Christian yet know nothing about me, secondly you are assuming I am writing anyone off instead of making a factual point. Anymore assumptions you would like to jump to?
@Ser, did you even read the article? No, at 14 if the “scrotes” as you call them, have NOT learned social norms. If they’re living with parents who couldn’t give a cr*p about them, where drinking or doing drugs, neglecting them, then of course they’re never going to learn what’s ok because they’ve never seen it. As for the penal system teaching them, you are out of your mind. None of this addresses the issues or fixes the problem. Does this mean we should have group hugs and candlelight vigils? No. But perhaps putting in better structures, early intervention and a social care system that works beyond 5pm on a Friday, May be places to start.
No, Ser, they don’t. If they’ve never been taught it, and shown it, they can’t pick it up by osmosis
@Richard Wright: A discussion between a mental health expert (West Cork Lad) and Mick Jordan,on this very topic..Maybe this will give you a better insight into Micks thoughts on these children…
http://www.thejournal.ie/special-care-unit-hiqa-2302413-Aug2015/#comments
@Ser Barristan Selmy: Read that article in the link that I just put up,as It might help to answer the question that you just asked of Jeannette…
Ser, early intervention and a well staffed, proper social services Dept that opens beyond 5pm on a Friday. As to knowing right from wrong and it’s full implications, we wouldn’t expect a child who was never spoken to, to be able to speak.
@Ser Barristan Selmy: My bad.I asked you to read the article.I should have said the comments section of it…
Think a free hug session is over due.
The poor darlings
Plenty of kids and adults with adhd successful in life and not robbing backsterds and burglars and car thief’s….. And I’ve no doubt the state did all it could for them by giving them free access to doctors medication councillors. Unlike the ones who pay for it
Where is Paul Murphy’s contribution on all of this ?
We’re in the process of creating our own home grown terrorist problem.
This chaos has to stop. Reopen St. Pats for god sake…..
have your say