Situation in nursing homes ‘very precarious’ with 193 open outbreaks – Tadhg Daly
Hundreds of nursing home residents are still without their Covid-19 vaccination after being hit by another wave of infection as the virus spiralled out of control in the new year surge.
The virus struck several nursing homes last month claiming the lives of 369 elderly residents.
One in three of the Covid-19 deaths in January was a nursing home resident.
The extent of the death toll in such homes, reaching 1,543 since the start of the pandemic, was revealed at the Oireachtas Health Committee yesterday.
It comes after the first wave last year when nursing homes suffered high levels of infection.
And they are still continuing to battle outbreaks with 4,300 residents and staff infected.
However, health officials said yesterday that due to the outbreaks, four homes have yet to be offered the Covid-19 vaccine and another 117 are only partially vaccinated because so many had the virus.
Health Minister Stephen Donnelly said early in the new year he hoped all residents and staff would be vaccinated by the end of January but that target has not been met.
Tadhg Daly, head of Nursing Homes Ireland, said the situation in nursing homes remains “very precarious” with 193 open outbreaks.
He said: “Staffing is a predominant emergency that presents across our health service.”
There are around 1,800 nursing home staff who are out due to infection or being a close contact. HSE and Department of Health officials said the very high levels of community transmission meant it was inevitable nursing homes would not escape in the third wave.
The spread was also accelerated by the more infectious UK variant.
However, the committee was told that a key recommendation of a top level review of nursing homes – following last spring’s devastation – was still not in place. It called for a proper system of clinical oversight of nursing homes pointing out that residents had their own GP but were without an overarching medical lead in many cases.
The committee was told that the HSE is still “scoping the model” on this and working with GPs.
Yvonne O’Neill, HSE director of community operations, said 100 homes are affected by staff shortages.
Mr Daly said a “critical window of opportunity was missed” in the roll-out of the Covid-19 vaccine.
He said: “With nursing home residents the most susceptible to the virus, just 10pc of the initial 77,000 Covid-19 vaccinations administered by mid-January were within nursing homes. It is appropriate to remind people that the National Immunisation Advisory Committee agreed nursing home residents and staff would be a priority.
“The first vaccines arrived in Ireland on December 26 yet the first was only administered in a private or voluntary nursing home on January 7, 2021.
“Every day is vital for our nursing home residents and staff.
“We are grateful that our representations for vaccine administration to be expedited, entailing utilising every available day, were heeded and implemented.”
There is also now concern that patients who are discharged to nursing homes need to receive the vaccine.
Dr Kathleen McLellan, of the Department of Health, said the level of infection overall was lower than in April following a series of measures implemented in the meantime.
Health officials said €66.9m has been given to nursing homes by the HSE in temporary assistance payments.
Around €100m had been invested in protective equipment, cleaning and other supports.
The committee heard of concerns among relatives who complained of not being able to get information about loved ones and the level of distress this caused.
HSE official Sandra Tuohy said complaints had been made about the lack of answers to some families.
Concerns were also raised about the impact the outbreaks are having on supports for residents.
Professor Seán Kennelly, a consultant geriatrician in Tallaght Hospital, has said that for some nursing homes, this wave has been just as bad as the first wave, in which over 50pc of all deaths were in long-term care homes.
At least 1,543 nursing home residents have died from Covid-19 and 369 of those deaths were in January alone, new statistics have revealed.
“It's terribly sad and reflective of the impact we’ve seen in our hospital and community services. We always anticipated there would be a lag in deaths and that has been evident in previous phases.
“For some nursing homes, they are as bad. What we know is that for some nursing homes that see outbreaks, almost half of residents become infected and a quarter of those may unfortunately die.
“What we are seeing this time around is that while it was largely an east coast phenomenon first time around, this time around it is very much a national spread,” he told RTÉ’s Morning Ireland.
Prof Kennelly said the nursing homes that have experienced the biggest outbreaks this time around are the ones that “kept Covid out” for the last 10 months and then saw large outbreaks just weeks before they were due to be vaccinated.
He said that nursing homes who have had previous outbreaks are now proving to be more resilient due to familiarity with infection controls and knowing what to expect when an outbreak occurs.
The geriatrician said it will be weeks before we know the effect the vaccine will have on the spread of Covid-19 within nursing homes but said now that people across nursing homes are receiving their second jab, it should confer a greater level of protection on them.