Protecting the vulnerable from Covid-19

To date, Ireland has avoided the feared Covid-19 surge. This is, of course, to be welcomed and credit should go to healthcare professionals and other experts, the Government, Department of Health, and the HSE for their part in this national effort.

However, our response to the pandemic has not been perfect, with the high number of deaths that have occurred in nursing homes a particular black spot. The argument that other countries have also struggled to prevent the virus spreading in the nursing home sector should not absolve our own leaders from failing to act quickly and decisively enough to protect some of our most vulnerable citizens from the pandemic. 

A meeting of the national public health emergency team (NPHET) on 14 May heard that available testing capacity should be mobilised towards increased testing of vulnerable groups. This was in response to Health Protection Surveillance Centre (HPSC) data, which showed three Covid-19 outbreaks among the Roma community with 21 cases; five outbreaks among Irish Travellers with 36 cases; and 12 outbreaks in direct provision centres with 159 cases highlighted at the meeting.

The data also showed five outbreaks in prisons had occurred, with 18 notified cases. A further eight outbreaks in “homeless settings” had been notified to the HPSC. However, it was noted that “there are gaps in data for this group”.

Noting the improvements in the general population, the need for protecting these vulnerable groups through more focused testing was highlighted.

It should also be mentioned that another group has been particularly affected by Covid-19 in Ireland – healthcare workers.

As of midnight 25 May (24,735 overall cases), the number of confirmed Covid-19 cases associated with healthcare workers had hit 7,852, almost 32 per cent of all cases.

Our Clinical Editor Priscilla Lynch pointed out in a piece for the Medical Independent website that a recent report (April) from the European Centre for Disease Prevention and Control (ECDC) stated that 3.8 per cent (1,716/44,672) confirmed cases of Covid-19 in China were among healthcare workers and 10 per cent of cases in Italy, with the Lombardy region reporting up to 20 per cent of cases in the group. In Spain, 20 per cent of Covid-19 cases were in healthcare workers. In the US, overall, only 3 per cent (9,282/315,531) of reported cases were among healthcare workers. However, among states with more complete reporting, healthcare workers accounted for 11 per cent of reported cases.

These figures show Ireland now has one of the highest reported infection rates of Covid-19 among healthcare workers in the world. The question now is what can be done to better protect frontline staff from infection? Obviously procuring sufficient high-quality personal protective equipment is a vital component of this. More widespread testing may also be required.

The testing challenges for Covid-19, in terms of capacity and turnarounds, have been much commented upon. Critics say that the current HSE aim to have 90 per cent of tests reported within three days is still not ambitious enough.

But with the surge avoided for now, at least, there should be no delay in rolling out and increasing the amount of testing for vulnerable groups and healthcare staff in the firing line.