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INMO calls for return of mandatory mask-wearing in crowded settings amid record trolley numbers

Over 931 patients are without beds in Irish hospitals today – the highest number since records began in 2006.

LAST UPDATE | 3 Jan 2023

THE IRISH NURSES and Midwives Organisation (INMO) has called on the Government to “make difficult decisions” including the return of mandatory mask-wearing in crowded settings as hospitals struggle to deal with a record number of patients on trolleys.

Over 931 patients are without beds in Irish hospitals today, according to the INMO.

This is the highest number of patients that have been without a hospital bed since the trade union began counting trolleys in 2006.

Thr INMO said that 767 patients are on trolleys in emergency departments and 164 are on trolleys elsewhere in hospitals. Twenty-six children have been admitted to hospital without a bed, the organisation added.

Commenting on the trolley figures, Phil Ní Sheaghdha, General Secretary of the INMO, said: “Today’s numbers require immediate and serious intervention from the government.

“We do not need those at the top to describe how we got here; we need to know what exactly the plan is from today until the end of February.

Just telling people to avoid hospitals is not a plan or indeed safe. The public need to know exactly what type of care they can expect over the next six weeks.

Ní Sheaghdha called on the Government to “make difficult decisions including the return of mandated mask-wearing in congregated settings”.

“We know that one of the main pressure points in our health service is the rise of respiratory infections. Asking people to return to mask-wearing in busy congregated settings is a simple measure.

“Over the coming days we need to see real tangible plans and decisions at a national level about the ensured safety in our acute public hospitals,” she said.

Ní Sheaghdha added that the INMO’s members “are extremely disillusioned by the current set of circumstances they are working in”.

“We are not seeing unsustainable overcrowding confined to a handful of hospitals, each hospital is facing significant overcrowding challenges, a trend which has continued to escalate since late summer. Our members are treating patients in inhumane and often unsafe conditions.”

Jump in Covid and flu cases

The Health Service Executive (HSE) has appealed to members of the public to “consider all care options before going to a hospital Emergency Department (ED) during what is going to be “one of the busiest ever periods experienced by the health service”.

It comes as Covid-19 and influenza cases continue to increase rapidly, while notifications of RSV – which had been declining for several weeks – are also increasing.

Nearly 1,500 people are in hospitals with these viruses today. As of 11.30am, there were 686 patients in hospital with Covid-19, 28 of whom were in intensive care.

Services at several hospitals around the country are under extreme pressure. A consultant at University Hospital Limerick (UHL) earlier today said that conditions in many instances are “inhumane”.

In a statement, the HSE said that some patients will “regrettably” experience long wait times in EDs, but urgent patients will be prioritised for treatment and care.

“Unfortunately, we expect this incline to remain sharply upwards for a number of weeks to come and to continue to seriously impact our hospitals and Emergency Departments,” the statement read.

“While this surge of winter virus infections was predicted and planned for, the trends being seen are following the more pessimistic of predicted models, and also appear to be increasing earlier than had been hoped.”

Damien McCallion, the HSE’s chief operations officer, said in a statement: “As expected, Emergency Departments are becoming extremely busy due to the unprecedented combination of very high levels of flu, Covid-19 and other respiratory illnesses in the community.

“Those who believe they may be seriously ill and require emergency care should of course come to hospital, but we would urge others to consider seeking support from pharmacists, GPs, GP out-of-hours services and Minor Injury Units.

“These services have emergency responses in place for patients presenting with respiratory and other urgent health issues.”

The health service is encouraging people to consider attending a community pharmacy if they feel unwell, or a minor injury unit, which treat injuries that are not life-threatening. A list of these units can be found on the HSE’s website.

The HSE is also encouraging the public to attend their GP or a GP out of hours service. It was announced last week that the Irish Medical Organisation (IMO) has agreed to provide temporary support to GPs to run additional clinics this month amidst rising demand for services due to a surge in winter virus infections.

‘Perfect storm’ of viruses

Speaking on Morning Ireland today, McCallion acknowledged that the situation in EDs across the country is “far from ideal” but that protocols are in place to make sure that the patients in most need get the care they require.

McCallion said that EDs have been experiencing growth in attendances year-on-year but, beyond that, there is currently an “unprecedented spike in relation to the three viruses which has put us into the pressure points that we are in at the moment”.

“So that’s one of the key issues for us as we face into the next number of weeks in terms of trying to manage that in overall terms while we grow capacity in terms of our beds, diagnostics and community staff.

“We are still seeing, I suppose, increased demand year-on-year with growth in population, and also in relation to the increase in aging in our population as well.”

McCallion said there has been investment in the health service in recent years in a bid to deal with these issues, but added there is “no question” that further investment is needed.

Also speaking on Morning Ireland, medical virologist Cillian de Gascun said the current situation is partially due to a “perfect storm” related to viruses post-pandemic.

“Notwithstanding the pressure on the service is that in an ordinary [year], if we look at, say, influenza and RSV, the two sort of big ones that aren’t Cvoid.

Typically, in an average season, we reckon that influenza affects about 15% of the population in any given season. So that’s 15% that wasn’t infected in 2020, 15% that wasn’t affected in 2021, and now 15% [is affected] for 2022. So there’s a far greater susceptible population for influenza.

De Gascun said there are also high levels of two different types of influenza – namely A-H1 (which disproportionately affects younger people) and A-H3 (which predominantly affects older people).

In a typical season, de Gascun said one strain would be more prevalent than the other but, at present, it’s about 50/50.

“The problem is now we’re seeing pretty much a mix of almost sort of 50/50 between those two at the moment, so everybody’s getting infected,” he stated. 

UHL, Mercy and Mater

In a statement issued last night, a spokesperson for the University Limerick Hospitals Group confirmed that the ULHG had “activated HSE operational contingency plans with the National Ambulance Service (NAS) to divert some patients from UHL to other acute hospitals to support extreme levels of demand at UHL”.

The six hospitals in the ULHG are University Hospital Limerick; University Maternity Hospital Limerick; Nenagh Hospital; Ennis Hospital; Croom Orthopaedic Hospital and St John’s Hospital.

The spokesperson said the group “requested that NAS activate those arrangements for a number of hours to support University Hospital Limerick’s response to an internal major incident”.

“Where these procedures are activated, non-critical patients are diverted to the closest alternative appropriate hospital. The most critically ill patients, for example those with suspected heart attack, stroke and those that were medically unstable continue to be conveyed to UHL during this time.”

Screenshot 2023-01-03 07.18.18 University Hospital Limerick (file photo) Google Maps Google Maps

Speaking on Morning Ireland, Professor Declan Lyons, a consultant at UHL, said:

“We’re seeing an accentuation of what we’ve been seeing for the last few years which is chronic and persistent overcrowding in the emergency department.

It’s very difficult, particularly for patients. The conditions in many instances are inhumane, they are not really appropriate for the evaluation of patients who are sick.

“The big worry we have at the moment is that patients who are coming in sick into that environment are not being helped by the environment that we have to assess them in.”

Lyons said that one of his concerns is that it “simply isn’t possible to carry out an optimal clinical evaluation on patients given the extent to the overcrowding” in the ED.

So it’s a very serious situation in terms of patient comfort, but also in terms of patient safety… We’ve been advising our junior doctors to just, as best you can, practice the best type of medicine that you can under the circumstances.

“And I have to say I’m full of admiration for the junior doctors, nurses, attendants, everybody working in the A&E department at the moment in the circumstances that they’re having to deal with,” Lyons added.

The Mercy University Hospital (MUH) in Cork has also renewed an appeal to people needing less urgent treatment to ”avail, where possible, of other care services” as its ED “continues to experience high demand for its services”.

A spokesperson for MUH today said that visiting restrictions are continuing at the hospital “due to a spike in the number of patients presenting at the hospital with flu, Covid and winter vomiting”.

“Visiting will be allowed on compassionate grounds under prior arrangement with the hospital,” they said.

The spokesperson added that while the ED remains open 24/7, it is “regrettable that patients are experiencing significant delays and this situation is being treated as a priority by hospital management”.

“All patients are triaged and treated based on clinical need when they present at the Emergency Department.”

The spokesperson said that patients with less urgent complaints should contact their GP or South Doc, or avail of services at the Mercy Local Injury Unit, St Mary’s Health Campus in Gurranabraher (which is open from 8am to 6pm); the Local Injury Unit at Bantry General Hospital (open between 8am and 7.30pm) or the Local Injury Unit in Mallow General Hospital (which operates from 8am to 8pm).

Yesterday, the Mater Hospital in Dublin city issued a similar appeal for people to avoid its ED if possible, with a spokesperson saying services are “under extreme pressure”.

The HSE previously expressed concern that it expects to see over 900 patients in hospitals with flu in the first week in January, while a higher number of hospitalisations have occurred than had been anticipated in its “more pessimistic projections”.

Last week, the HSE’s National Crisis Management Team (NCMT) said it was “meeting regularly to oversee the health service response to these pressures”, which includes “significant surges of respiratory illness”.

In the last week of reporting, up to 24 December, flu cases increased by 100% from 1174 to 2,329. There was an even greater increase in hospitalisations from flu, increasing 113% from 299 to 637.

With reporting by Jane Moore

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    Mute Paul Dolan
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    Aug 30th 2020, 8:37 AM

    Donnelly way out of his depth

    308
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    Mute Karl Mc Cauley
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    Aug 30th 2020, 9:40 AM

    @Paul Dolan: bring back Harris.

    60
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    Mute M J Flynn
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    Aug 30th 2020, 10:03 AM

    @Paul Dolan:
    Questions were always being asked of NPHET but under Harris they were ignored and the Press did not report it. It’s better for democracy that questions be regularly asked and answered to ensure community wide understanding and buy in.

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    Mute Dave Hammond
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    Aug 30th 2020, 1:44 PM

    @Karl Mc Cauley: yep Irelands HSE was going swimmingly well until this year…….well if you ignore the nurses pay , the 10 year trolley crisis , the cancer screening scandals , the…. …….. ……… , ffs

    23
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    Mute Tom Jones
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    Aug 30th 2020, 3:26 PM

    @Karl Mc Cauley: Jesus no.

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    Mute paul gurney
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    Aug 30th 2020, 6:39 PM

    @Karl Mc Cauley: no….he was also way out of his depth but lucky for him all decisions were made by Tony Holohan so he just had to read the script…he actually admitted this.Bringing him back is not an option…remember it was he that caused the collapse of govt as there was no way he would have survived a vote of confidence.Donnelly is bad and so is Harris…is it not possible we could have somebody that actually knows what they’re doing??

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    Mute Geoff Collins
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    Aug 30th 2020, 8:26 AM

    The question that needs to be asked is why we are basing decision on a PCR test that does not identify live Covid-19 but trace elements of the many strains of coronavirus including the common cold. Forcing masks on ppl and banning gatherings is more about shutting down debate maybe?

    172
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    Mute Tom Bombdadil
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    Aug 30th 2020, 8:28 AM

    @Geoff Collins: or the fact that they haven’t a clue what they are doing.

    187
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    Mute D Mems
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    Aug 30th 2020, 8:31 AM

    @Geoff Collins: can you provide a source to that? As far as I was aware the PCR test is specific to Covid-19, and only responds to live virus. Perhaps you are thinking of the antibody test?

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    Mute Macca Attack
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    Aug 30th 2020, 8:40 AM

    @Tom Bombdadil: I’d rather listen to the experts instead of gemma’s thank you.

    42
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    Mute Kevin Hill
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    Aug 30th 2020, 9:14 AM

    @Geoff Collins: that rumour has been debunked, test is Covid specific
    https://www.thejournal.ie/can-a-cold-or-flu-give-positive-test-for-covid-19-5155807-Jul2020/

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    Mute Thornto84
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    Aug 30th 2020, 9:32 AM

    @Kevin Hill: PCR test is way to sensitive and picks up only trace amounts of the virus, most people aren’t even contagious. In some places up to 90% tested didn’t even have enough virus to be contagious. Have to wonder what the real numbers are? They just seem to be inflating the cases. Just Google “New York Times PCR test”.
    (Sorry journal won’t let me post links)

    36
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    Mute Macca Attack
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    Aug 30th 2020, 9:34 AM

    @Thornto84: back that up with fact.

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    Mute Thornto84
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    Aug 30th 2020, 9:40 AM

    @Macca Attack: did you miss the part I said Google “New York Times PCR TEST”

    34
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    Mute Isabel Oliveira
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    Aug 30th 2020, 9:50 AM

    @Kevin Hill: it is indeed true that the test gives many false positives ( rather than the false negatives all governments were concentrating on on) . It depends on how many amplification cycles a specific lab chooses to set. Anything over 30 cycles is very likely to give you a false positive. The question now is, since the cycles have been calibrated so high in many labs why the suspicion put on negatives rather than positives . Peculiar.

    https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

    https://www.medrxiv.org/content/10.1101/2020.04.26.20080911v3.full.pdf

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    Mute Geoff Collins
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    Aug 30th 2020, 1:51 PM

    @D Mems: https://bpa-pathology.com/covid19-pcr-tests-are-scientifically-meaningless/
    We have about 3000 positive cases in last 30 days and a dozen deaths. Either the test is too sensitive or this virus has petered out in severity. Either way talking of being on the tipping point of another lockdown based on cases is insane.

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    Mute Geoff Collins
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    Aug 30th 2020, 2:00 PM
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    Mute Geoff Collins
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    Aug 30th 2020, 2:05 PM
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    Mute dmcardle
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    Aug 30th 2020, 9:01 AM

    With respect, I think this group are on a hiding to nothing short term regarding Dept. of Health, HSE, NPHET or anyone else saying that larger groups may now congregate. Whether it is for arts, opera, concerts, mass, weddings, GAA or any other sport etc.

    However, they do say, if you read between the lines, that they’re looking for more detailed scientific reasoning behind the current guidelines.

    We need more groups like this and the excellent work Michael McNamara is doing as chair of the Covid Committee to shutdown this nonsensical approach to trying to get our country back up and running again.

    Donnelly & Glynn are still holding the threat of lockdown over our heads and tomorrow as hundreds of thousands of kids go back to school, some who have the sniffles in schools which haven’t been properly equipped will be asked to go outside to some cold, leaky garden sheds to self-isolate.

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    Mute Seamus Hughes
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    Aug 30th 2020, 10:06 AM

    @dmcardle:

    It’s good to see at least one elected representative asking the obvious questions. Political courage in a hysterical world should be applauded

    https://youtu.be/CqTKaVBGcNU

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    Mute Garry Coll
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    Aug 30th 2020, 10:03 AM

    I’m not sure this group will get very far.
    The arrogant and dismissive response from NPHET to a similar request from the GAA shows how little respect they have for the citizens of Ireland.
    One of its members, Prof Nolan went so far last week as to apparently mislead the Dail committee hearing by saying that Irelands approach is different to other European countries because we have a higher population density.
    He said that a look at a map showing the population densities of the countries of Europe would prove this.
    In the link below, Ireland is 43rd out of 54 European countries listed by population density. 80% of the countries of Europe have a higher population density than Ireland.
    We’re being conned.

    https://www.worldatlas.com/articles/european-countries-by-population-density.html

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    Mute Isabel Oliveira
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    Aug 30th 2020, 10:33 AM

    @Garry Coll: isn’t he at least embarrassed to display such ignorance ?

    47
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    Mute great gael of Eire
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    Aug 30th 2020, 10:41 AM

    @Isabel Oliveira: he works in a University. He is used to being top dog and lecture to people firmly believing that he is better that everyone else. He’s not embarrassed.

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    Mute Garry Coll
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    Aug 30th 2020, 11:22 AM

    @Isabel Oliveira:
    He may or he may not Isabel, does that really matter.
    The real question is whether anyone is going to call him out on it.
    I wouldn’t expect RTE or any other national media outlet to do so, they gave up all journalistic functions in relation to Covid long ago. Now they are merely stenographers, repeating and regurgitating government policy and commentary in a way that would make Pravda blush.
    I think the Dail committee is meeting again next week, that is probably the most appropriate place.
    But I wouldn’t hold my breath waiting for it to happen.

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    Mute Isabel Oliveira
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    Aug 30th 2020, 11:30 AM

    @Garry Coll: i think that both government & NPHET deliberately incited the population against each other blaming specific demographics or sectors for the cases. As a result a petrified percentage of the population of many angry informant, curtain twitching types surfaced. It’s very difficult to make any kind of point that goes against this mentality without being fiercely attacked being it the media or just people. The creation or incitement of this mentality was not an accident, it was very deliberate.

    25
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    Mute Isabel Oliveira
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    Aug 30th 2020, 10:09 AM

    Circa 1500 cases have been confirmed as linked to meat processing. We don’t even have the figures for fruit & vegetable processing or the total figure for meat processing.

    To date August registered 2,241 cases totally. If we take only the 1500 figure ( which is higher), we get a result of 741 cases , subtract another 160 healthcare staff infected and we get 581 cases.

    Next time they blame pubs, tourists, those travelling, the arts, young people , next time they give the police more powers or quarantine healthy people or lockdown counties, next time they try to turn people into informants or curtail rights & freedoms : do remember these numbers that are due to pure inaction as the trend was happening in Europe as early as June and mass screening should have been in place then.

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    Mute a
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    Aug 30th 2020, 10:36 AM

    It’s so strange because they are allowing theatres to have 50 people indoors, but outdoor performances of the same show l, by the same company only allows 15. I don’t understand that.

    Many theatre companies who had arranged outdoor performances for when it was 200 people, are now struggling to get back in doors to perform to a quarter of that audience. Indoors. Where it is less safe??!!

    They are right to seek the scientific basis
    for this decision.

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    Mute Anne Kyle
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    Aug 30th 2020, 11:28 AM

    @a: Exactly. I asked the same question. It just doesn’t make any sense. If NPHET will actually engage properly with the sector (who are WELL used to risk management procedures) then maybe there’s a way forward.

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    Mute Anne Marie Kearney
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    Aug 30th 2020, 12:58 PM

    Nothing but mixed messages since this so-called government took over. Confusing figures and being told to wait for the scientific evidence and the only thing that is clear is that they are not communicating with each other either. Such a shame that it could be detrimental to our culture and the livelihoods of genuine artists!

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    Mute Peter Bell
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    Aug 30th 2020, 10:25 AM

    Inept ,should resign

    39
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    Mute Tony Humphreys
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    Aug 30th 2020, 5:15 PM

    I don’t recall anyone voting for members of nphet? Are they not running the country?

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    Mute Declan Brennan
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    Aug 30th 2020, 10:50 PM

    I blame the trampolines!!

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    Mute Kevin Arnold
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    Aug 30th 2020, 9:43 AM

    Turnip.

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    Mute Brian Brennan
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    Aug 30th 2020, 9:40 AM

    Donnelly is out of his depth with his new position as health minister.

    1
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