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Transmission of coronavirus in a nursing home in Dublin has become widespread in recent days and now affects more than a fifth of the 200 residents, according to an internal memo.
There is evidence of coronavirus outbreaks in almost every unit at St Mary’s Hospital in Phoenix Park, which has seen 11 Covid-19-related deaths in a two-week period.
The internal note, dated April 13, says that apart from one section, all units in the home have “more than 20 percent evidence” of confirmed or suspected coronavirus infection.
“It is reasonable to assume that transmission is widespread. Therefore, in the context of widespread transmission, all of the unit’s clinical areas are designated as a contaminated area, ”said the memo, which was circulated to staff in recent days.
A source at the facility, which is run by the Health Services Executive (HSE), said the number of cases was likely even higher due to delays in testing.
The house, which has 198 residential locations, confirmed Thursday night that 10 residents who had tested positive for Covid-19 and another suspect of having the condition had died within two weeks.
The memorandum to staff established measures to try to contain the spread of the virus by creating “clean” and “dirty” areas.
He advised all personnel to wear personal protective equipment (PPE) when entering a “contaminated area” with suspected or confirmed cases. Staff treating patients in these areas were instructed to provide care to all residents “who use the same PPE for each period of care.”
Healthcare workers must switch gloves between patients, but were instructed to remain in the same gown, surgical mask, and eye protection.
Medical gloves
The Health Protection Surveillance Center (HPSC) guidance for residential care centers dealing with Covid-19 outbreaks, state staff should “ideally change their PPE” after each contact with a positive patient .
The HPSC council outlined that in “exceptional circumstances” this may be limited to a change of medical gloves only if staff care for a group of patients with Covid-19.
To prevent the spread of the virus, staff should start by providing care for asymptomatic patients first, then for suspected Covid-19 patients, and finally for confirmed cases, according to the St Mary memo.
The instructions stated that the “clean area” in the nursing home should include, if possible, staff office space and restrooms. “Residents should not have access to the clean zone; this last point can be difficult to manage,” says the memo.
The memorandum referred to asymptomatic patients as the “cleanest”, those suspected of being “dirty” cases, and confirmed coronavirus cases as the “dirtiest patients”.
The memo was written after a visit to the facilities of Professor Martin Cormican, HSE’s national clinical leader in infection control.
In a statement, a HSE spokeswoman said the memo was written internally within the hospital, but was issued “without any formal approval.”
She said the memo, which stated that the measures were based on Professor Cormican’s recommendations, was not written with her input.
“Our preference is that this unapproved memorandum and the information contained in it are not published.”
However, she did not dispute the figures in the memo and confirmed “that a significant number of residents have been affected by Covid-19 at the Hospital de Santa María.”
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