Latest surge blamed on nursing home outbreaks as most vulnerable back in the firing line
As the Covid-19 vaccine was rolled out to older people last March, the death toll from the virus dropped, the burden on hospitals lightened and anxieties eased.
Now new data suggests the country’s older and most vulnerable population could once again be at risk from the latest surge of the deadly virus. And again, those at-risk residents are in nursing homes.
A Health Service Executive (HSE) Covid-19 Data Summary published last Wednesday says there has been a 56pc increase in the incidence of the virus in the over-85 age group in a two-week period to August 25.
While the numbers of over-85s infected with the virus is still small, the 14-day incidence rate in that age group stands at 394 per 100,000 — a 56pc increase on the previous two-week period.
According to the report, more over-85s are now getting the virus than people in their 50s, 60s and 70s. The report says much of the increase in the oldest and most vulnerable of age groups is likely driven by a wave of outbreaks in nursing homes.
The data confirms the suspicions raised by Nursing Homes Ireland two weeks ago, which highlighted a “small but concerning” increase in the virus.
Meanwhile, Paul Reid, the chief executive of the HSE, warned that unvaccinated staff could be introducing the virus to nursing homes.
Sage Advocacy, which advocates for nursing home residents and their families, is concerned older vulnerable people who bore the brunt of the pandemic in terms of illness and death are once again in the firing line.
“We are concerned. We have been monitoring the stats. There were zero outbreaks in nursing homes six weeks ago and there have been 24 to 25 outbreaks reported since,” said Sarah Lennon, executive director of the organisation.
“Visitor restrictions are being imposed again in some nursing homes. We have had reports recently of bans on visitors, and that families are being allowed window visits only. There has definitely been a change in mood,” she said.
“The big question we have is: the decision was taken in May to stop the serial testing of staff and residents for Covid-19. As much as people did not like being serial tested, it was an early warning system and an effective one.
“Six weeks ago we were not in a bad place at all. But given the numbers, is it time to bring that back now? How are these infections being caught at the moment?”
The HSE has been unable to provide a breakdown of whether the rise in deaths is linked to an increase in older people contracting the virus.
The recent cyber attack on the health service’s computer systems has curtailed much of the data gathering, but the Health Protection Surveillance Centre’s latest report says the average age of people dying with Covid-19 was 82.
However, according to public health experts this fifth wave of Covid-19 is different to the dark days of the pandemic that claimed the lives of 2,000 nursing home residents — almost 1,000 during the third wave of the virus.
The vaccine does not offer 100pc protection from infection but it has been highly effective in preventing severe illness and death.
Public health experts have said since the start of the pandemic that the more the virus is circulating in the wider community, the greater the likelihood it will be introduced into nursing homes — by staff, contractors or suppliers, by families and visitors.
Dr Anthony Breslin, the public health director in the North West — a region with some of the highest rates of Covid-19 in the country — said as restrictions eased they knew cases were going to go up.
“Obviously as restrictions loosened we knew that there would be an increase in cases, but we’re seeing a bit more than we would like in all age groups,” said Dr Breslin.
“The largest number of cases are in the 20 to 40 age group. But we are seeing cases in the elderly, among people who are vaccinated.
“Thankfully most are not getting ill because the vaccine does work in preventing serious illness.”
One of the reasons for the current surge in cases is that the success of the vaccine programme has contributed to Covid fatigue.
There is now more than 85pc of the population fully vaccinated, putting Ireland far ahead of many other countries including the UK and Northern Ireland. However, this also leads vaccinated people to relax and let their guard down.
“What we think is happening is that restrictions are lifted, in the community we are having get-togethers and family events — weddings, confirmations, communions, you name it, it’s happening. People are letting their guard down a bit because they think it’s safe,” said Dr Breslin.
“The key message is that if you are vaccinated, you still have to continue with the basics. You still have to social distance, you have to wear face coverings and you have to continue to reduce your exposure.
“We have to realise that the vaccine stops you getting sick but it doesn’t stop you from getting infected.”
Dr Denis McCauley, a Donegal GP and chairman of the GP Committee of the Irish Medical Organisation, said there are “two things” happening: the virus is seeking out the unvaccinated, some of whom are getting very sick, while vaccinated people are contracting the virus and not getting terribly sick, but are potentially spreading it.
“Look at the vaccination numbers and cohorts — 90pc of people who are over 50 have been vaccinated, but there are 10pc of people who are not,” Dr McCauley said.
“We have had a number of cases in the county where older people who didn’t get a vaccine have got very sick and there have obviously been deaths also.”
The National Immunisation Advisory Committee (Niac) is considering the issue of booster vaccines for older people, most of whom were vaccinated eight months ago. Studies from Israel claim that immunity weakens over time.
According to Sarah Lennon, with numbers on the rise again, “we need to start seeing the plan for vaccine top-ups soon”.