Dr Marcus De Brun resigned from the board of the Medical Council, where he was appointed by Health Minister Simon Harris two years ago, over the handling of nursing homes during the coronavirus crisis.

Dear Editor,

There are presently circa 25,000 people residing in Irish Nursing Homes. The vast majority of whom are elderly, have underlying illnesses, and as such are at a significant risk of dying, as a consequence of Covid-19 infection.

The mortality of covid-19 among those over 80 yrs is estimated to be in the region of 7.8%(1). Risk increases in respect of age and underlying medical conditions.

At the Nursing Home that I provide care for, Covid-19 infection has resulted in a 12% mortality.

If we (for the sake of numbers) estimate mortality in Irish nursing homes at 10% and apply this figure to the population of Nursing Home residents (25k) this would give us an expected mortality of somewhere in the region of 2500 deaths within the sector.

At the time of writing, roughly half of the reported deaths to date have occurred within the Nursing Home sector (500), and this leaves us with an expected mortality of some 2000 people, presently residing in Irish Nursing Homes.

The Government has recently begun swab-testing for nursing home residents and staff. This is helpful in the management of cases within the Home as it allows for; isolation of residents, efforts at containment within the home etc.

Testing also provides GP’s with a confirmed diagnosis, and allows GP’s to inform families, attempt to protect staff and put essential measures in place.

However, Government measures MUST amount to more than simply providing a test and secondment of Nursing staff.

Spread within a Nursing Home setting is entirely inevitable. Confining Covid-negative residents within a Covid-positive Nursing Home exposes that resident to a significant risk of mortality.

At the Nursing Home that I provide care for, Covid-19 infection has resulted in a 12% mortality.

If (where possible) Covid-negative residents were permitted to return home to temporarily isolate/cocoon with their Covid-negative families, the risk of transmission and subsequent mortality would be substantially reduced.

It is understood that many Residents would not be medically fit for transfer, and many families would not be capable of providing care in the home setting.

There are however many many empty public and private beds in Irish hospitals at present. It is not unreasonable to suggest that many Covid-negative residents could be cared for in Covid free environments. All that is needed is a degree of political will.

It might be argued that confining Covid-negative residents within Covid-positive Nursing Homes, is tantamount to state sanctioned Euthanasia.

I would urge the Minister to act now upon the behalf of this most vulnerable cohort of people, and their families, before it is too
late.

Dr Marcus de Brun

Previously: Prominent doctor, appointed by Simon Harris to medical board, resigns over coronavirus crisis in nursing homes

Rollingnews/Medical Times