Last weekend, a close friend and I had a serious discussion. Should people be encouraged to take their loved ones out of nursing homes? Should the Government say this? We discussed the panic such a statement might cause. The distress to people in no position to care for loved ones. The high-dependency cases who couldn't be moved anyway. And the cases where it would be too late, because Covid-19 has already taken hold.
But the question was real for us. My friend is worried about a relative living in a home with many elderly people, some of whom are sick. There are many different carers and other staff coming in and out of the place, a source of huge anxiety.
She is upset that people weren't aware of the danger in nursing homes until it was too late. Journalists have only recently started asking, and are only now being told, about the number of Covid-19 deaths in the homes. I am not blaming the media.
All of us have wondered how to behave in this war against Covid-19. Should the Health Minister and Dr Tony Holohan face hard questions about their decisions? Or would that weaken their ability to lead the national struggle? Must we accept that the experts are in charge and that the best possible decisions are being taken?
Three weeks ago in the Oireachtas, we agreed unanimously to give the Government emergency powers. The Government must be given its head, even if mistakes would be made - that was the consensus. But in light of the horrors that have unfolded in nursing homes, that needs to be revisited.
I understand that the decision to effectively countermand the call by nursing homes to stop visitors going in might have reflected the best expert thinking about not imposing too many restrictions, too soon. But was it fatal for some?
I am not alleging negligence or stupidity. We must accept that some things were beyond the capacity of our health leaders to control. NPHET can't be faulted for the lack of personal protective equipment (PPE) in the State, at least not up until January. But did it move in time to access the equipment once the news of the coming crisis emerged? And in its planning, did it attach sufficient weight to the welfare of our elderly?
When it placed acute patients from hospitals into nursing homes, when it issued a directive that PPE was not necessary in nursing homes, when it failed to ensure there was an adequate supply of oxygen in the nursing homes - in all these areas, did the elderly get overlooked?
The Government has tried to balance being upfront about the bad news with regular messages of reassurance. But I worry that things might not be so bad by now if certain facts had been made public. Over a fortnight ago, we learned four patients had died in a nursing home from Covid-19. Within a few days, I learned that the figure had risen to 17 deaths. All in the space of 10 days. In a home that usually sees one funeral per month.
Responding to this, I called for hotels currently closed to offer emergency accommodation to healthcare workers, nursing home staff and, critically, home-care personnel. This would prevent the spread of disease from families at home to care settings and vice-versa, and help keep much-needed staff in these homes.
Though other announcements have been made, no measure on that front has been taken by Government.
It would help to know if a comprehensive study of staffing levels and needs in nursing and care homes has been carried out. Is there a clear pathway to access more staffing if needed? Have all staff in nursing homes been trained in the correct safe use of PPE? Are there sufficient staff and communications resources in nursing homes to enable communication between families and residents as often as they need?
These questions need to be addressed and we need to ensure the level of resources available to nursing homes is reflective of the great value we put on the lives of those who have contributed so much to our country in the past.
The big decisions are not behind us. And so a way must be found to challenge and assist the apparatus of State and public health management without hindering its ability to lead.
Even experts, especially when they are tired and pressurised, must be asked continually about whether the decisions they take continue to be the best ones. The media must ask these questions. So also must the Oireachtas. Even before a Taoiseach is elected, an ad-hoc public health support committee, assisted by experts, should be convened to liaise in private session with the Government and NPHET.
Holding leaders and experts to account is not hurling on the ditch. It's about making doubly sure that the people have the information to make rational decisions.
Recently, a friend travelled across the country to Dublin to get her uncle out of a nursing home. Maybe she was one of the lucky ones who could. Many elderly or sick people are far beyond the possibility of that. But people are entitled to know what their Government thinks of the idea. And then make the best decision they can.
Rónán Mullen is an Independent senator representing the National University of Ireland