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Chief medical officer Dr Tony Holohan Leon Farrell/Rollingnews.ie

'It wouldn't be a failure': Why there may be more clusters as Ireland re-opens and the plan to manage them

Dr Tony Holohan said this week we’re “better placed” now to deal with an outbreak or cluster now than we may have been in February.

IRELAND IS JUST over a week away from potentially progressing to Phase Two of re-opening the country. 

The stringent measures in place since March led to Covid-19 being “effectively extinguished from the community” by mid-May

Phase One saw a section of the population returning to work on Monday 18 May, and public health authorities said then that with each round of restriction easing comes an increased risk of the coronavirus spreading again. 

People mixing again, and being in closer contact with others more than they had been before, increases the chance of Covid-19 emerging in the community at a greater level.  

Dr Tony Holohan said as much in the first of the Department of Health’s daily briefings this week. 

“One of the things that’s going to happen as we ease restrictions, and increase the amount of economic activity… we are going to see more clusters of this,” the chief medical officer said. 

These clusters could see a number of people affected in a workplace, a school or a club, according to Dr Holohan.

“We have to be in a position to both identify that and to take action in relation to it,” he said. “The fact that that might occur isn’t necessarily a sign that we haven’t succeeded in terms of applying our measures.

I think we’d be much better positioned to deal with that than we might have been in February had that occurred in that way.

In England, health authorities have said that there could be “flare-ups” of Covid-19 in schools and workplaces which would see them subject to “local lockdowns”.

Government minister Robert Jenrick told the BBC that such measures would allow “greater freedoms to millions of other people across the country”, while the intervention at that specific local level may be “restrictive on the individuals who live and work there”. 

So what are the plans in place if – or when – clusters of Covid-19 break out in specific sections of the country, or within specific workplaces?

Covid-19 clusters in Ireland

A cluster of Covid-19 is defined as three cases or more being diagnosed within a particular setting in 72-hour period. 

According to data (correct as of midnight on 25 May), there have been 846 clusters of Covid-19 identified in Ireland. 

The majority of those (430) have been in either a nursing home or a residential institution. Over 1,000 of the 1,600 people who have lost their lives so far, died in nursing homes. 

Another specific section of society that has seen significant numbers of cases are among those who work in the meat processing industry. There have been 925 confirmed cases among staff in that line of work so far, with outbreaks reported at 16 plants.

Speaking to TheJournal.ie on issues across meat plants, Siptu divisional organiser Greg Ennis said the lack of physical distancing at these kinds of facilities and conditions within them around ventilation and staff taking breaks together made it a “perfect storm” for the virus to spread.

“These were concerns we had from the start,” he said. “It’s very concerning that as of mid-May there’d been no inspections done [by the Health and Safety Authority] at these plants.”

Ennis said there’d been a “commonality of purpose” among employers and trade unions among other industries with the goal of keeping workers safe while also continuing/going back to work but this wasn’t the case at meat plants.

In the most recent update from the Department of Health, a further 100 cases of Covid-19 in meat plants had been confirmed and Ennis labelled these still-rising figures as “absolutely shocking and most disturbing”.

In a statement, however, Meat Industry Ireland said its members had “acted promptly” to the threat caused by Covid-19 and put in place a range of protective measures to help mitigate the spread.

Where there are clusters, the representative body said companies worked closely and openly with HSE officials. “Communication with the workforce has continued throughout and advice and guidance updated,” a spokesperson said. 

National outbreak control team

To help combat this situation and reduce spread specifically at meat plants, a HSE-led national outbreak control team is in place and guidance had been issued to all facilities.

This team has the aim of controlling the spread of the virus, mitigating the effects of the outbreak and stooping the outbreak by preventing further cases of Covid-19. 

A recently published document by the Health Protection Surveillance Centre (HPSC) outlines the guidance for the management of outbreaks of Covid-19 within particular settings.

It is similar advice that is being followed right now to try to manage the meat plants situation across the country. 

“The aim of this plan is to ensure a rapid, effective and coordinated approach to the identification, investigation and control of an outbreak of COVID-19, regardless of setting,” the HPSC says. 

It adds: “An outbreak of Covid-19 can happen in a variety of settings e.g. the home, community, residential care facilities, hospitals and the workplace.

Due to the variation in settings of outbreaks, the vulnerability of those involved or potential for increased transmission, a more sensitive definition of an outbreak may be used for public health action. For example, in residential care facilities (RCF) a single suspected case of Covid-19 should prompt immediate public health action.

An outbreak control team would have a number of people assigned to it with specific roles. A medical officer of health would lead the team with the authority to detain and isolate persons in certain circumstances.

The team would also have an epidemiologist, a microbiologist, an infectious diseases physician and nursing staff all with dedicated roles to help mitigate the effects of the outbreak. 

The HPSC suggests a number of actions that must be taken to manage the outbreak, from an investigation and risk assessment of the situation to reporting and monitoring of those who’ve been confirmed as having Covid-19. 

A specific investigation is required into how cases were exposed to Covid-19 to inform how they aim to control the spread. 

In the risk assessment phase, it should be determined if there is an “ongoing significant threat to public health”. 

It says: “Conclusions derived from the risk assessment are principally a matter of professional judgement. However, for reasons of public accountability and understanding, it is essential that this process is as transparent as possible.

Once the risk has been assessed, a decision should be made on how the risk is likely to be perceived by the public. This should inform the development of specific public communications about the risk and how it is being mitigated.

All confirmed cases will be monitored and updates provided on their condition. There should be daily surveillance for fever or respiratory symptoms on an ongoing basis, and this should persist for 28 days after the last person shows symptoms. 

People affected by the outbreak should be delivered the healthcare they need, and those potentially affected by the outbreak given advice on hand hygiene and PPE. 

In order to declare an outbreak over – regardless of setting – that site must not have experienced any new cases of infection over two incubation periods, again that’s 28 days.

Speaking about meat plants, Dr Holohan said the outbreak control team had considered a “full gamut of measures” that needed to be thought out to try to prevent the disease spreading both in the workplace setting and in the wider community.

“I think we have evidence that the rate of infection is dropping [as a result],” he said. 

Close down specific settings

On Tuesday, Dr Holohan was asked specifically what would happen in the case of an outbreak in a school and if it would be the case that the school would close down at a local level.

The chief medical officer said: “If that’s the right response at a point in time, then that might be the response exactly. 

All I’m really doing is trying to sort of raise people’s awareness and understanding of the fact that we will have events or circumstances in which we see transmitting of the virus occurring, either in an outbreak or cluster form in particular settings.
We will have to be in a position as quickly as we possibly can to pick that up either locally or nationally, and make interventions we think are necessary in relation to that. 

Dr Holohan emphasised that as Ireland re-opens, it is likely we will see such instances of clusters breaking out. 

He stressed it would be important for the public not to interpret this as that the “whole strategy had failed”. 

He highlighted examples of social activity such as nightclubs in Asia and restaurants in parts of Europe that have presented challenges to authorities seeking to stop the spread of the virus. 

“But for the most part, the authorities there have been able to contain that,” he said. “That’s what I’m pointing at to is an expectation that there is a pattern we might expect to see here that wouldn’t necessarily represent failure.”

However, all of this is not to say that health authorities here will deem it acceptable if we have a significant increase in cases.

They have emphasised that it is likely we’ll have clusters over the coming weeks and months, but it is essential that people do all they can to prevent the spread of the virus. 

Ireland’s re-opening is contingent on factors like the number of hospitalisations, and the number of admissions to intensive care. 

It is an extremely delicate balance. If they rise sharply, then that will be a cause for concern.

Here’s what Dr Holohan had to say on Wednesday: “By increasing the amount of activity, whether it’s economic or social or cultural, or whatever it may be, the increased interaction between people, all things being equal, can lead to an increased risk of transmission of infection.

And we look at some of the figures today that we’ve seen in the last 24 hours: five people admitted to intensive care and 15 people admitted to hospitals overall.
That’s an increase that’s… we’re going to watch that, we’re worried about that.

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31 Comments
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    Mute Liam O'Reilly
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    Mar 21st 2017, 11:26 AM

    What Natrium did was absolutely disgusting. They broke Clearys up into two pieces: The loss making commercial part (IE the shop) , and the very valuable assets, (IE the building) and quickly closed the shop, stating it was not making money. They then said they had no money to pay the staff, as the actual part worth the money had been transferred to another company.

    Thats not even to mention that the whole reason the shop was not profit making is that the separate building owning company (Part of the Natrium group) put the building rent through the roof to cause all of this to happen.

    They should not be allowed to make a single cent of profit and should be driven from the country.

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    Mute Fred Jensen
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    Mar 21st 2017, 11:44 AM

    @Liam O’Reilly:

    If the shop was making money, they would have kept it open. They are the owners, they can do what they like with their property. They don’t owe the workers there a job for life as though it was a birthright. Grow up would you.

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    Mute Ben McArthur
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    Mar 21st 2017, 11:55 AM

    @Fred Jensen: It should have been that simple, but it wasn’t.

    If the business wasn’t viable in 2012, which it probably wasn’t, it should have been liquidated. Some property investor would have bought the building. The proceeds would have gone to pay down debt, and the employees’ redundancy payments and unpaid taxes would have been near the front of the queue.

    Instead, a very smelly deal was done by the highly dubious mechanism of a shrink-wrapped administration to get the property out to investors, give a cut to the bank, a nice juicy slice for the advisors, and stick the liabilities onto the taxpayer. This is somewhere between a grotesque abuse of insolvency law and downright criminal.

    The proper outcome wouldn’t have been any better for the workers, but the rest of us have every right to complain that our taxes are subsidising millionaires’ schemes.

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    Mute Ben McArthur
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    Mar 21st 2017, 11:57 AM

    Also: I am no friend of the unions, but if they want to use some other entirely legal mechanism to try to put pressure on Natrium, then good luck to them.

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    Mute Fred Jensen
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    Mar 21st 2017, 12:01 PM

    @Ben McArthur:

    They have every right to let all the workers go at any point. It’s their business and their property. All that’s required is they pay redundancy as per the law. If they haven’t done this then they should be pursued for it..

    But that has nothing to do with the new redevelopement. And the workers looking for preferential treatment for jobs in the new development should be told to take a hike. They can apply on the same basis as everyone else.

    11
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    Mute Brendan Mason
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    Mar 21st 2017, 12:30 PM

    @Fred Jensen: If you were one of the Clery workers would you have the same opinion?
    Fair play if you do. Hold your head up high, broke to the ropes and then say ” Well its their business and they can do what they like, they don’t owe you a job for life”.
    There such a thing in life as doing the right thing by the people.

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    Mute Brendan Mason
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    Mar 21st 2017, 12:33 PM

    @Fred Jensen: Grow up yourself. Spoilt right wing capitalist speak like that.

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    Mute Benjy Mooney
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    Mar 21st 2017, 12:54 PM

    @Brendan Mason: It’s revealing to let Fred and his ilk have their say to show the true face of neoliberal capitalism. This is the ideology of the 2 largest parties in the state, FF and FG. Any ordinary person who votes for these parties is complicit in their own exploitation.

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    Mute ray.farrelly
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    Mar 21st 2017, 1:16 PM

    Fred jensen. Get a life or better still get a job.

    12
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    Mute Darren Tully
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    Mar 21st 2017, 2:00 PM

    @Fred Jensen: So you’re ok with footing the bill as a tax payer while these sleeveens walk off scott-free suffering no loss at all from the self engineered collapse of the business? Would you mind telling me what lube you use as you seem to relish the thought of being told to bend over

    14
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    Mute Dietrich Död
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    Mar 21st 2017, 2:09 PM

    @Fred Jensen: Fred, I think you’re missing the point here. Gordon Bros split Clery’s into two legal entities, a property holding company, and a management company that ran the shop – OCS Operations Ltd. At least that’s my understanding of it. You say that if staff weren’t paid their redundancy then they should ‘pursue’ the currents owners, but the whole point here is that they can’t. The property, where all the value lies, was completely decoupled from the management company, which was bought by Natrium, swiftly declared insolvent, and sold for €1 to an insolvency specialist, how can you pursue a debt-laden firm with no assets for your redundancy? You can’t, that’s the point, and so not only are Clery’s workers screwed over by Gordon Bros/Natrium, but the taxpayer is screwed over because these redundancies need to be paid out, in some diminishing form, from something like the social insurance fund. It’s disgusting.

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    Mute Fred Jensen
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    Mar 21st 2017, 2:48 PM

    @Dietrich Död:

    What has that got to do with this redevelopment?

    And what has that got to do with them demanding jobs in the new development?

    See there’s a lot more going on here isn’t there.

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    Mute Benjy Mooney
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    Mar 21st 2017, 11:24 AM

    Good to see the worker’s force some reparation from the corporate vultures who gorged themselves on the carcass of Clery’s. The looting of Clerys is another example of the Irish state protecting the interests of domestic and international capital over the welfare of the majority citizens as it has always done.

    The sellers Gordon Brothers (OCS) engineered the corporate and legal structures for efficient asset stripping the company. This involved separating the operations side of the business from the valuable property.
    OCS properties which owned the building was making substantial profits. OCS operations which ran the department store was making a loss primarily because it was paying the €300,000 a month rental to it’s sister company OCS properties. If the 2 companies were not deliberately separated then there is no rent payable and the business is viable and the workers still have their jobs.
    Instead the operations business was liquidated leaving the employees and creditors with little or nothing while the property is then sold for a massive profit. The statutory redundancy for the workers of course was paid for by the state as the vultures swagger off with the loot. It’s a neat little corporate ruse designed to facilitate the asset stripping of the company, exactly as occurred.
    The buyers Natrium have organized their tax affairs nicely and use hedge funds based in tax havens like Cayman and Guernsey so that they can avoid making any contribution to the society and workers that they prey on.
    Meanwhile insiders like KPMG work for both sides and acts as liquidators on one hand and auditor for the buyers Cheyne Capital Management on the other. Cheyne Capital Management is one half of the joint venture Natrium which also consists of D2 Private owned coincidentally by a former KPMG employee. KPMG executed the sale at 2.30 am on the Friday morning just in time to avoid paying over the estimated €2 million owed to the concession holders.

    This ransacking of the company, employees and the citizens was all perfectly legal as the law designed largely to protect the interests of capital and to control the working class.

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    Mute Liam O'Reilly
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    Mar 21st 2017, 11:28 AM

    @Benjy Mooney: Boils the blood doesn’t it?

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    Mute Benjy Mooney
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    Mar 21st 2017, 11:37 AM

    @Liam O’Reilly: Thankfully we have those paragons of virtue KPMG to oversee the Lotto draw to ensure everything is above board. Still it’s no worse than having Commissioner O’Sullivan oversee the investigation into her own alleged corruption………..

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    Mute Paudi Onail
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    Mar 21st 2017, 12:57 PM

    @Benjy Mooney: that’s it exactly, criminal really but the corrupt rulers have the law setup for themselves. Will never set foot in it and everyone should be aware of what’s going on here and elsewhere. Siptu should not have let up.

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    Mute Dietrich Död
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    Mar 21st 2017, 2:20 PM

    @Benjy Mooney: the multilayered corruption is quite sickening. Let’s not forget also that Clery’s was an attractive prospect not just because of the shop, but because the original company bought up a load of parcels of land around Earl Place/Marlborough Street in the hopes of cashing in on its future redevelopment, overextending themselves massively, and losing focus on its retail business, which ultimately failed. That’s how it’s been explained to me anyhow (source: my father worked in Guiney’s for 42 years, and was shut out of the shop abruptly when the original Gordon Bros. deal was announced – those workers tend to be forgotten in this whole saga).

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    Mute Fiona Fitzgerald
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    Mar 21st 2017, 11:48 AM

    At long last, they have done something reasonable for many of the people affected. Despicable tactics. Glad to hear that this much was done at least. As a Dubliner, I hope never to have any dealings with this company, or the people responsible, in any way. I sincerely hope that all the new hotel staff join a union, because it seems that they are going to need support in the future.

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    Mute Ger Murphy
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    Mar 21st 2017, 11:19 AM

    Does this cover concession store people as well or just the direct former employees?

    43
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    Mute Jimmyjoe Wallace
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    Mar 21st 2017, 12:57 PM

    Loads of the concession owners and suppliers were massively out of pocket also and they are not all big multinationals who can take the hit, some were small time operators.

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    Mute Gerry Fitz
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    Mar 21st 2017, 11:27 AM

    Clery’s to become a hotel, the irony…. Heart Break Hotel.

    40
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    Mute June Rose-Sommer
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    Mar 21st 2017, 1:14 PM

    I’m so glad for them!! Great news!!! At least some recognition for all the years of service to Clerys.

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    Mute Fred Jensen
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    Mar 21st 2017, 11:42 AM

    What an absolute joke. It’s stuff like this that makes this country a laughing stock at times.

    What right have these workers to new employment? They can apply for the new retail jobs in the same manner as everyone else. Now we see them having to be bribed to quit their whinging.

    Then we hear them say “O’Connell street should be for decent working class people”. Hmm. What we have here is child like insecurity stemming from reverse snobbery. They don’t want gentrification of this street. That’s what this is about.

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    Mute Joe Conlon
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    Mar 21st 2017, 1:40 PM

    @Fred Jensen: Are you having a bad day Fred, were you told to make the coffees for your boss again? No wonder you’re taking it out on the Clerys workers, maybe you could apply there yourself, they’ll need coffee made there too!

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    Mute Darren Tully
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    Mar 21st 2017, 2:01 PM

    @Fred Jensen: So you’re ok with footing the bill as a tax payer while these sleeveens walk off scott-free suffering no loss at all from the self engineered collapse of the business? Would you mind telling me what brand of lube you use as you seem to either be indifferent to or relish the thought of being told to bend over

    23
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    Mute Darren Tully
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    Mar 21st 2017, 1:25 PM

    Better late than never. It’s disgusting that previous owners got away with selling the business it to a liquidator for 2 euro and leaving the workers to foot the bill

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    Mute John King
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    Mar 21st 2017, 2:52 PM

    Natrium are the type of businesses that give capitalism a bad name.
    As an Irish tax payer I am not happy to end up paying the bill for Natriums pursuit of shareholders profit at any cost .
    The Government need to ensure that companies like this can not get away with getting the taxpayer pay for their lack of business morals!

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    Mute Neal, not Neil.
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    Mar 21st 2017, 12:17 PM

    Wait. SIPTU was lodging a planning objection as a tactic? So they were prepared to hold up redevelopment of a whole block of O’Connell Street, just as negotiating tactic? How is that okay?

    18
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    Mute Ger McCarthy
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    Mar 21st 2017, 12:25 PM

    @Neal, not Neil.: RED THUMB

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    Mute Neal, not Neil.
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    Mar 21st 2017, 12:46 PM

    @Ger McCarthy: Red flag, maybe. If we’re supposed to he okay with a union putting a whole street on hold for years, when that street is already in dire difficulty.

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    Mute Ciaran Dunne
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    Mar 21st 2017, 1:54 PM

    Natrium found out at last ! Shocking , mean, underhanded treatment of a loyal workforce. Finally receiving a just redundancy payment and maybe a chance of re employment hopefully,
    This smacks (somewhat) of Tesco bullying for me !

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    Mute Derek Moean
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    Mar 21st 2017, 11:26 AM

    Thank God for that…

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    Mute shits ville
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    Mar 21st 2017, 1:08 PM

    Solidarity with the vocal left who never shopped in Clerys

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    Mute Robert Tedders
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    Mar 21st 2017, 5:44 PM

    Hmmph; well I am NOT impressed with that woman who gave the press conference; YOU might not care about the past, Ms. Foley, but some of the rest of us do!! #arrogant #uncaring

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    Mute Dermo Germ
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    Mar 21st 2017, 12:37 PM

    Now hopefully the redevelopment can go ahead

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    Mute Robert Tedders
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    Mar 21st 2017, 5:56 PM

    @Dermo Germ: How about we fire you with nothing but statuory redundancy, or in some cases – i.e. concession owners in the old Clery’s – not even that(due to being self-employed), and we’ll see how you feel then?!

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    Mute Dermo Germ
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    Apr 7th 2017, 9:35 PM

    @Robert Tedders: I’m not talking about that. I’m talking about a much needed development going ahead. Find an argument elsewhere

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