By: Michael O’Farrell – Investigations Editor.
IRELAND has a much higher death rate from coronavirus than other affected countries among nursing home residents, it has emerged, as questions were raised over when authorities here knew that the disease was killing the elderly at an alarming rate.
It comes as the Irish Mail on Sunday also reveals that private hospital nurses in commercial facilities taken over by the State are being paid to stay at home despite a desperate need for staff in nursing homes and frontline hospitals.
New figures this week showed that in France one in four Covid-19 deaths were in nursing homes, in New York City it was one in four, in Spain it was one in three, while in the Italian region of Lombardy at the epicentre of the outbreak there, half of deaths were among nursing home residents.
After two weeks of repeated questions from the MoS, the HSE finally admitted this week that more than half of coronavirus deaths in Ireland so far were among residents of nursing homes or other residential care settings.
On Friday, HSE chief medical officer Tony Holohan revealed that of the 288 people who had died by that point in the outbreak, 156 had been living in nursing homes prior to their deaths (54%).
And yesterday Health Minister Simon Harris defended the HSE’s response amid growing concern about the high number of 135 clusters and deaths in the country’s 550 nursing homes.
The Irish Mail on Sunday put it to the minister that on March 11 Dr Holohan suggested nursing home visiting restrictions should be relaxed and whether this was a matter of regret.
‘In terms of visitor restrictions, Dr Holohan was very clear that at that stage there wasn’t a blanket visitor restriction in place for everybody in relation to every nursing home or every hospital,’ Mr Harris said yesterday at an event launching mental health supports amid the outbreak.
‘But he was also clear on March 12 in terms of necessary recommendations that visiting restrictions should be in place in long-term care facilities, where appropriate.
‘What they’re always trying to do is strike a balance between compassion; remember many people haven’t seen their mam or dad in many weeks but they also need to protect public health.’
Asked how long ago the HSE knew of the large proportion of deaths in nursing homes, and whether it ignored it or simply did not know, Mr Harris said he did know off hand when the figures were known.
Asked why the clusters in nursing homes took the HSE by surprise when the normal flu season is well known to significantly affect nursing homes every year, Mr Harris said: ‘Every year whether it’s the flu, whether it’s the winter vomiting bug has disproportionate impact when it comes to older people.
‘We’re working really hard to try and protect older people, we also do have to recognise that if you look at the figures presented last night in terms of the median age of the deaths in Ireland yesterday was, sadly, 82. We are seeing younger people dying, we had someone die at 32, we’ve seen someone die at 105.’
Mr Harris added that the Government was providing supports to nursing homes in a package of measures announced last week.
‘We have been working with HIQA this week to risk rate the nursing homes that need particular supports and to put those supports in place,’ he said.
‘You are entirely correct – one of the big flashing red lights now in terms of trying to get this virus under control is the residential care facilities, but I think if you look the world over we are seeing similar trends.
‘A lot of the measures we’re putting in place have to be about protecting those working in the homes as well.’ According to the latest Government figures, there were 135 clusters in nursing homes as of Friday – meaning more than 20,000 patients, staff and careers are affected.
Clusters in nursing homes are now more than twice as frequent as those in hospitals (55), with representatives of the sector saying staff are struggling to deal with the surge.
Yet, the MoS has learned that private hospital nurses in commercial facilities taken over by the State are being paid to stay at home despite staff shortages elsewhere.
‘If there are people out there, whether they’re public, private or voluntary, retired or whatever – they should be in at the front line,’ said Nursing Home Ireland (NNI) chief executive Tadhg Daly.
‘It shouldn’t be beyond our capability to mobilise all those resources – not just those in private hospitals – to the pinch points.’
One such facility is the St Francis Private Hospital in Mullingar which has a capacity of 77 beds. It is one of 19 that the State took over on March 30 in a deal agreed with the Private Hospitals Association (PHA).
Sources close to the deal confirmed the normal running costs of the hospitals – including nurses and ancillary staff – are now paid by the State.
Private consultants working in these hospitals, meanwhile, were offered a locum contract with the HSE for the duration of the crisis though complications with this have also resulted in many of these doctors being unable to work.
Last night the HSE and the Department of Health did not directly answer MOS questions about the number of private nurses that have not been redeployed in any way and whether these could be sent to help out at nursing homes.
Instead, the Department of Health issued a statement to say the additional capacity at private hospitals ‘is a critically important part of the plan to deal with the pandemic’.
In total the private hospital sector has an estimated bed capacity of 1,900 inpatient beds, 600 day beds as well as 47 ICU and 54 HDU beds. Private hospital sources confirmed that there was evidence of their facilities being underused to date.
‘They have to have that capacity there ready – so there’s probably a bit of standing around going on in anticipation of that,’ said one insider.
In the meantime though, acute hospitals are short of staff.
‘The biggest need there is actually staff – it’s not ICU or ventilators,’ the source said. ‘Some of them have serious concerns about staffing.’
Today’s revelations come as the nursing home sector is fast becoming the real epicentre of Ireland’s battle with Covid-19.
‘We have the surge that was probably expected in the acute hospitals already,’ said NNI’s Tadhg Daly.
Despite this pressure, support measures for homes announced by the Government a week ago have not always materialised.
‘The testing is still a huge, huge issue across the sector,’ Mr Daly said. ‘It really is impacting very heavily on nursing homes in terms of results.’
The continued delays mean nursing home residents awaiting tests are likely dying from Covid-19 in nursing without being included yet in daily fatality figures.
‘There may be a question mark over the cause of death. Yes, that could be happening,’ Mr Daly said.
Trinity College Professor of Ageing and Community Nursing Amanda Phelan said she feared nursing home cases may be ‘going under the radar.’
