UCD Professor Paddy Mallon

This afternoon.

In the Dail, Leinster House, Dublin 2.

During a Covid-19 Committee meeting.

Fianna Fáil TD Mary Butler questioned Professor Paddy Mallon, professor of microbial diseases in the school of medicine at University College Dublin concerning nursing home deaths.

Prof Mallon had earlier told the committee:

“Failure to learn, or delays in planning and resourcing for what is ahead, would not only be potentially negligent but would be a travesty to the memories of those who have died from Covid-19, some avoidably, during the first wave.”

Mary Butler: “Professor Mallon referred to “the memories of those who have died from Covid-19, some avoidably”. In this committee, I have constantly raised the question of what would have happened if patients were tested prior to entering residential care settings throughout March and April.

For example, we know that in March 1,300 patients were transferred from acute hospital settings to nursing and residential care homes.

We know this virus has borne down hardest on our older people, with 63% of all deaths occurring in residential and care homes. Professor Mallon speaks about avoidable deaths so does he believe that if these patients had been tested prior to entering nursing homes, some deaths could have been avoided?

Professor Paddy Mallon: “When I refer to avoidable deaths, my experience of this is when an individual attends a hospital without Covid-19 but with another illness and enters the hospital environment sick, that person does not expect to contract Covid-19 and die within that setting.

“We need to maintain safe environments for the public to be treated for their illnesses. From the point of view of a physician and on a societal level, that is critical. Whether it is in acute hospitals or in nursing homes, the same thing applies because the consequence of the sick, the vulnerable and the old acquiring this infection is death.

That is a fairly stark consequence that we simply cannot accept. We can talk about bed days and social distancing, but if we enter September, October and November knowing what is coming and we still end up with people dying within our healthcare facilities from nosocomial infection, then, in my view, we have failed.”

Deputy Mary Butler: “I understand that we were learning, everything was done in good faith and capacity was not available, but does Professor Mallon accept the following:I firmly believe that if the capacity had been available in March and April to test people who were being transferred to residential care from acute settings, and if patients had been tested prior to being returned to nursing homes, they could have been isolated for 14 days. It would have certainly made a difference.”

Professor Paddy Mallon: “There are probably a number of factors that contributed to what happened in the nursing homes. I had the experience of going out to visit nursing homes during the pandemic. There was huge variation in what was happening in nursing homes.

There could be a nursing home being decimated in one district, with all staff and patients infected with Covid-19 and a number of people dying, yet one could travel 200 m to 300m down the road and see a nursing home that was completely unaffected.

We can talk about hospital discharge and nursing homes, but it is not the only story. There is certainly something at a managerial level within nursing homes that some nursing homes were able to do excellently to maintain the safety of their residents and staff throughout the whole pandemic, but other nursing homes were unable to do.

That is the key. What were the nursing homes that avoided this doing right? We need to learn from what they did right…”

Deputy Mary Butler: “Absolutely.”

Professor Paddy Mallon: “And make sure all the nursing homes follow those sorts of practices because they worked.”

Meanwhile...

 HSE CCO Dr Colm Henry

Also at the Covid-19 committee meeting.

Sinn Fein’s Matt Carthy asked HSE CCO Dr Colm Henry if he accepted the claim made by Phil Ní Sheaghdha of the INMO who said, up to the end of May, 8,018 healthcare workers had been infected with Covid-19.

Ms Ní Sheaghdha said this rate of 32% of all Covid-19 cases is the highest among healthcare workers in the world.

They had this exchange:

Colm Henry: “I cannot accept that we can compare like with like country by country. That is what I am saying to the Deputy. I do not dispute the figure of 32%. However, because we have been measuring healthcare workers as a priority from the absolute go even when we had testing difficulties and because we had a very wide definition of healthcare workers – much wider than other healthcare systems in other countries, to me that is as likely a reason as…”

Matt Carthy: “…I have other questions. Does Dr. Henry accept that 32% is too high and that we really need to strive to improve that figure?”

Henry: “Any case is not just a disappointment, it is a huge risk for us and for healthcare workers. Every case is wrong, and we have to do whatever we can to protect our healthcare workers, be it with PPE, masks, infection and control measures, and education and training. Many of these cases took arose outside acute hospital settings in community settings.”

Asked later by Fine Gael TD Colm Burke if there is a full breakdown of the 8,180 cases and if there’s a breakdown of workers’ respective workplace, Dr Henry replied

“We have a breakdown based on the healthcare setting and based on professions in terms of those associated with outbreaks. We can provide figures to the deputy after this hearing.”

Yesterday: Left To Die: Nursing Home Timeline

Sasko Lazarov/Rollingnews