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Updated 7 hours ago
IN RECENT DAYS, reports of Covid-19 outbreaks have emerged in nursing homes in Laois and Donegal counties.
This comes after the medical director, Dr. Tony Holohan, wrote to the government on Sunday recommending that the entire country move to level 5.
The letter was reported to indicate that the National Public Health Emergency Team (NPHET) is concerned about the increase in the number of cases among people 65 and older and about 31 outbreaks open in nursing homes. The OCM reported that seven outbreaks had been reported in the last week.
It is understood that at NPHET’s meeting with the government on Monday, questions were raised about the mention of the 31 outbreaks. It was noted that a nursing home must be 28 days free of Covid-19 cases before the outbreak can be closed.
The government rejected the advice to implement Level 5 restrictions and instead chose to move the entire country to Level 3.
Speaking at tonight’s NPHET briefing, Dr. Holohan said, “If we don’t keep community transmission low, we won’t be able to keep this out of nursing homes.”
With NPHET’s concerns regarding nursing homes and reports of outbreaks in Laois and Donegal, let’s take a look at the current situation.
Sprouts
At midnight on September 26, according to the Center for Health Protection Surveillance, there were 26 outbreaks / clusters open in nursing homes in Ireland.
A cluster / outbreak is defined as two or more cases of laboratory-confirmed Covid-19 infections regardless of symptom status, or one laboratory-confirmed case of Covid-19 and at least one additional case of illness with symptoms consistent with the virus.
As noted above, a nursing home must be 28 days free of Covid-19 cases before the outbreak can be closed. So in theory, some of those 26 nursing homes could be Covid-19 case free.
Several nursing homes across the country have confirmed in the past two days that they are dealing with major outbreaks.
Kilminchy Lodge nursing home in Portlaoise, Co Laoise, confirmed yesterday that it is dealing with an outbreak involving 31 confirmed cases, 21 of which are among residents and 10 among staff.
Earlier today, Brindley Manor Nursing Home in Convoy, Co Donegal, said there have been 30 confirmed cases of Covid-19 at the location.
Residents who tested positive for the virus in both nursing homes are isolating themselves in their rooms.
In his letter to the Minister of Health on Sunday, Dr. Holohan expressed concern about the increasing number of cases among people over 65.
The 14-day incidence in this age group has increased from 6 per 100,000 in early August to 67.3 per 100,000 on October 3.
Are regular tests done in nursing homes?
Yes, but not as often as in early summer.
Serial testing of staff working in residential care facilities (RCFs), which include nursing homes, began in June following a request from NPHET.
The third round of these serial tests, cycle three, began on September 16 and the tests are carried out every fortnight. NPHET determines the frequency of testing.
The first round of serial testing (cycle one) of all RCF nursing home staff began on June 24 and ended on July 26.
This round involved testing all staff at RCF for Covid-19 once a week, for four consecutive weeks.
During Cycle One, the HSE conducted 99,705 tests on staff in 563 nursing homes, of which 132 cases were identified.
The second round of serial testing, cycle two, began on August 10.
During this round, staff were offered to test biweekly, rather than weekly, for four consecutive weeks.
The HSE conducted 56,675 tests in 562 nursing homes during Cycle Two, of which 111 cases were identified.
The third round of serial testing, cycle three, began on September 16 and continues.
This round involves offering tests to all RCF personnel every two weeks.
As of October 6, some 41,867 tests had been completed in 581 nursing homes, of which 138 cases have been identified so far.
Are the new outbreaks worrisome?
As mentioned above, Dr. Holohan’s letter to the government over the weekend indicated that NPHET is concerned about the increasing number of cases among people 65 and older and about open outbreaks in nursing homes.
On Monday, Tadhg Daly, CEO of Nursing Homes Ireland, said TheJournal.ie that it is “worrying” that there have been seven new outbreaks in nursing homes in the last week, but noted that a few weeks ago the number of open outbreaks was 36.
“Fortunately, that means some are coming off that list of outbreaks,” he said. But seven new outbreaks is a worrying fact and the fact that the CMO mentions it in its letter to the government is also worrying.
We know that there is a direct correlation between high incidence in the community and transmission in nursing homes – that’s the bottom line. The government has to control it in the community to keep it out of nursing homes.
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Daly said the nursing home situation is more secure than it was at the start of the pandemic, with better access to personal protective equipment and serial testing, helping to detect asymptomatic cases among staff.
When asked by TheJournal.ie Today, if serial testing needs to be done again on a weekly basis, Daly said, “Public health would inform us about that, but I think it’s something we need to continually monitor.”
Whats Next?
Speaking today at the Dáil, Sinn Féin leader Mary Lou McDonald questioned Taoiseach Micheál Martin on whether Ireland’s nursing homes are “ready now for this second wave of Covid-19.”
“What is the plan to get this right, and most of all, what is the plan to protect the residents and staff in our nursing homes?” McDonald asked.
In response, Martin acknowledged that as Covid-19 cases increase in the community, “obviously there will be a consequential danger in terms of the virus spreading to nursing homes.”
The Taoiseach confirmed that “the tests will continue with the same intensity.”
He added that NPHET has been asked to appear again before the Covid Oireachtas Committee, which will meet on Friday, to discuss “any additional measures we need to take to protect nursing homes.”
“We are very concerned about them. Obviously, they are a clear priority for all of us, ”said Martin.
With reporting by Michelle Hennessy
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