From top: a Dublin Nursing home; The Citywest emergency ICU facility; Taoiseach Leo Varadkar (centre) with HSE CEO Paul Reid (left) and Minister For Health at the Citywest opening; DrTony Holohan, Chief Medical Officer for the Department of Health and chairman of The National Public Health Emergency Team (NPHET); from left: Mr Reid with Dr Colm Henry (right) Chief Clinical Office, HSE arriving for a Covid 19 Committee meeting in Leinster House on June 6

There are approximately 440 private nursing homes and 120 HSE-run nursing homes in Ireland with around 30,000 residents.

More than 1,680 patients were approved for transfer from acute hospitals to private nursing homes in March (1,363) and April (324), the height of the pandemic.

This was as emergency ICU facilities and private wards secured by the government lay empty.

According to the most recent data, 943 people have died in nursing homes from Covid-19 with a further 5,371 who are Covid-19 positive.

This policy was replicated in seven European countries and five states in America, most notably New York, where before a u-turn, 4,300 recovering Covid-19 patients were sent to nursing homes in the state.

Below is a timeline of events as they pertain to residents of nursing homes in Ireland from the  the beginning of the virus until this week. Any additions or corrections will be made (just leave a comment).

February 19, 2020: The CEO of the HSE Paul Reid meets with representatives of nursing homes to discuss Covid-19 preparedness. On April 16, Minister for Health Simon Harris informs the Dáil that this meeting occurred and said:

“I am told by local HSE staff that there was an unprecedented level of engagement by individual HSE officials with nursing homes.

That is not to say in any manner or means that enough has been done. We need to do more.

This is a pandemic in which we take actions every single day. We then take another set of actions and then another set. That is what we are doing.”

In respect of the same February 19 meeting, CEO of the HSE Paul Reid told the Oirecachtas Covid-19 committee on May 19:

“Specifically, on the meeting with Nursing Homes Ireland, I would meet and discuss with Tadhg Daly on a reasonable basis throughout this whole process – in the pandemic over the last few weeks. There have been very good relationships between Nursing Homes Ireland and the HSE throughout this period.

“On the Deputy’s question of 19 February specifically, I can remember the meeting clearly. I have met a wide range of stakeholders since I took over the HSE. That was my first meeting with Nursing Homes Ireland. It was my first meeting with Tadhg Daly and its chairperson, Maurice Pratt. It was really geared towards an informal welcome and discussion…

“We had a brief discussion about how this may impact on Ireland. There was a very brief discussion between both of us. I would be doing it an injustice and indeed the HSE an injustice to say it was an in-depth discussion because we were just learning at the start of this – 19 February was very early stages.”

February 28: Chief Medical Officer Dr Tony Holohan confirms the first case of Covid-19 has been detected on the island of Ireland, involving a woman who travelled through Dublin Airport on her way home to Northern Ireland from northern Italy. She subsequently tested positive for the illness on returning home to Belfast.

February 29: The Health Protection Surveillance Centre confirms the first case of Covid-19 in the Republic of Ireland. The patient is a male in the east of the country.

It’s also reported that the first death of a Covid-19 patient had taken place in the US.

March 1: Scoil Chaitriona secondary school in Glasnevin, Dublin 9, closes for two weeks. Health officials do not publicly name the school but its identified on social media. It follows confirmation that a male student had Covid-19. He had been at an at-risk area in northern Italy.

March 2: Paul Cullen reports in The Irish Times that Covid-19 is especially worrying for elderly people with underlying health conditions.

He writes::

 “In the US, a serious outbreak near Seattle has occurred in a nursing home. Obviously, the risk of something similar happening in Ireland is a huge worry.”

He later added:

 “Nursing Homes Ireland, representing the owners of private nursing homes, has sought to reassure the public that its members have the experience to know what to do if the virus arrives, given their experience in dealing with seasonal flu and the vomiting bug. Some restrictions on visiting may be needed if the threat from the virus rises.”

March 6: It’s reported that visiting restrictions are being introduced in more than 400 private and voluntary nursing homes across Ireland. Nursing Homes Ireland says no non-essential visits by children or groups would be allowed.

March 9: The Government cancels all St Patrick’s Day parades.

March 10: The Department of Health’s Chief Medical Officer Dr Tony Holohan said blanket restrictions on visitors at nursing homes and some hospitals should be lifted as they were premature.

He said visitor restrictions at private nursing homes had a major impact on residents, for whom social interaction was a key part of wellbeing.

While restrictions might be necessary in a particular nursing home depending on circumstances, he said there was no case for across-the-board restrictions, saying: “We want to avoid introducing measures before they are really necessary.”

The National Public Health Emergency Team (NEPHT) announced in a statement that “socially restrictive actions” around hospitals and nursing homes were “not necessary at this moment in time”.

It’s reported that the annual St Patrick’s Day reception in Washington DC has been cancelled but that a meeting between the US President Donald Trump and Taoiseach Leo Varadkar will still take place.

On the same day, Nursing Homes Ireland writes to the Minister for Health Simon Harris and the letter is also sent to the chief executive of the HSE Paul Reid, and the Department of Business, Enterprise and Innovation.

In the letter, the NHI called on the Government to lift curbs on the recruitment of healthcare assistants from outside the EU and warned that older people’s health could be placed in danger if HSE poached nursing home staff following the lifting of public service recruitment restrictions.

March 11: A woman in the east of the country dies of Covid-19, the  first death to take place in Ireland.

The World Health Organisation says Covid-19 is a pandemic.

March 12: Speaking from Washington in the US, Taoiseach Leo Varadkar announces the closure of schools and significant public restrictions in Ireland until March 29 because of Covid-19.

Rose Hegarty, an 84-year-old resident of St Mary’s Hospital nursing home in the Phoenix Park, Dublin listens to Mr Varadkar’s speech from her bedroom.

March 16: Dr Tony Holohan says that restrictions will be imposed on visitors to nursing homes, hospitals and prisons.

March 17: During a St Patrick’s Day speech broadcast on RTÉ and Virgin Media One, under Section 122 of the Broadcast Act 2009, Taoiseach Leo Varadkar tells those listening and watching that the restrictions will likely go beyond March 29. He adds:

“We’re in the middle of a global and national emergency. A pandemic. The likes of which none of us have seen before. So far, the number of cases in Ireland has been relatively small. However we believe the number will rise to 15,000 cases or more by the end of the month and rise further in the weeks thereafter.”

He also says:

“At a certain point we will advise the elderly and people who have a long-term illness to stay at home for several weeks. We’re putting in place the systems to ensure that if you are one of them, you will have food, supplies and are checked on. We call it cocooning and it will save many lives, particularly the lives of the most vulnerable, the most precious in our society.”

It’s also reported that Nursing Homes Ireland is appealing for people within hospitality and retail to look for opportunities to care for older people. CEO of NHI Tadhg Daly is reported as saying:

“One considerable concern is to ensure a staffing complement is consistently available to meet the day-to-day social care needs of nursing home residents, especially at a time of emergency and with visitor restrictions.”

“Irish people have a tremendous ability to support one another during difficult times and this has never been more required.”

March 21: In a HSE memo from David Walsh, National Director of Community Operations, to the chief officers of community healthcare organisations, about revised guidance in relation to testing.

Mr Walsh tells his colleagues:

“Following confirmation of a Covid positive diagnosis within the unit/centre then it is assumed that all residents presenting with symptoms are Covid positive. Multiple re-referrals to NAS for potential Covid cases should be avoided.”

March 22: It’s reported that  40,000 people are waiting up to five days for Covid-19 tests. It’s also reported that “when asked about reports of a cluster of positive cases at a nursing home, the HSE said outbreaks of infectious diseases in nursing homes were not uncommon and staff were used to dealing with this issue. However, the scale and numbers would be extremely challenging.”

A cluster is defined as two laboratory-positive cases in an institution.

The report added: “The HSE has asked the media not to identify any nursing homes concerned.”

March 24: Taoiseach Leo Varadkar announces further restrictions until April 19.

March 25: The HSE’s Health Protection Surveillance Centre reports that there have been six outbreak clusters of Covid-19 in hospitals and four in nursing homes.

It’s also reported that 21 male residents of a nursing home in the Vosges in France, all aged in their 90s, are believed to have died of Covid-19. It’s feared as many as 100,000 nursing home residents could die of Covid-19.

March 26: Chief Medical Officer Dr Tony Holohan expresses concern about clusters of cases in healthcare settings such as hospitals and long-stay settings such as nursing homes.

March 27: In a report about the statistic that about 25 per cent of confirmed cases are health workers, at least four Covid-19 outbreaks have occurred in nursing homes and that nursing home operators, and others, are concerned about a lack of guidance and the availability of PPE.

Later, new figures show there have been nine Covid-19 clusters in nursing homes. Dr Holohan says the clusters are a significant concern for public health experts.

Taoiseach Leo Varadkar announces further restrictions for two weeks, until Easter Sunday on April 12, specifically that people must remain at home, with limited exceptions, and must remain within 2km of their homes when shopping for food or exercising. During his speech he mentions the increase of clusters in nursing home and residential care centres.

He also quotes from the movie The Terminator 2: Judgement Day when he says, “There is no fate but what we make for ourselves.”

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