Nphet concerned at scale of testing in units with staff clusters
The National Public Health Emergency Team (Nphet) raised serious concerns with the HSE over the lack of mass testing in hospitals when Covid-19 outbreaks were identified among staff.
The issue was raised directly with the HSE at a meeting of the expert public health group before Christmas.
Chief medical officer Tony Holohan also personally "voiced his concerns" over the speed at which outbreaks were being detected in hospitals.
Minutes of a Nphet meeting on December 10 show the group "expressed concern and sought clarity" as to why mass testing was not being carried out in all hospitals where outbreaks had been detected.
Nphet noted the "criteria for mass testing had previously been identified and agreed".
The HSE responded saying it seeks advice from "local public health departments" when there is an outbreak in a hospital and then decides whether or not to "engage in mass testing".
It said outbreak management is carried out between local hospital management with "involvement by the central executive where necessary".
On that date in December, there were 52 open clusters associated with 21 acute hospitals. About 1,000 cases were linked to these outbreaks, with 48pc related to healthcare workers. There had been 63 deaths linked to these outbreaks.
In the first week of January, there were 158 outbreaks in hospitals. This brought the total to 1,819 confirmed Covid-19 cases in hospitals, of those 37 were admitted to ICU and 147 died.
Nphet suggested the HSE establish a national outbreak control team to "ensure consistency of approach nationally to addressing hospital outbreaks and engaging in mass testing".
At a meeting a week earlier, Mr Holohan is reported to have "voiced his concern about the speed of outbreak detection and response in acute settings".
"The chair also posed the question whether a national outbreak control team has been established and if not, the reasons why?" the minutes of the meeting read.
The HSE responded saying one of the "core challenges" facing hospitals was how best to isolate the virus quickly when detected.
"The HSE pointed to some areas in need of improvement in hospital infrastructure and isolation capacity.
"While some facilities are well-equipped to deal with isolation requirements along with occupational health needs, there are other hospitals that are not. These deficiencies have been exacerbated by the pandemic," the minutes read.
Separately, the HSE "voiced its concern" that many student nurses, who were on placement in acute hospitals, were working in nursing homes at weekends.
They said this movement of student nurses may be "exacerbating transmission in these environments". It suggested that guidance should be developed to address the issue.
The Department of Health said it was difficult to ask student nurses not to work at the weekends as "it is often their only source of income".
Yesterday, Mr Holohan said mass testing in hospitals is not possible at the moment because the level of community transmission is out of control. But said he hoped it could play a role in the future in hospitals.