The State faces “very significant” costs in maintaining a supply of personal protective equipment for healthcare workers and setting up a “future model” of testing and contact tracing to manage the coronavirus pandemic, HSE chief executive Paul Reid has warned.
Speaking on Sunday at a weekly press briefing, Mr Reid said that personal protective equipment (PPE) would cost €1 billion per year for the Irish healthcare system and there would be a “similar very significant cost” to establish a testing and contract tracing model for the country.
“The cost of not investing in these are much higher in terms of the cost for society of not dropping our restrictions [imposed as a result of the pandemic],” he told reporters at the press briefing in the Mater hospital in Dublin.
Testing and tracing were “two key enablers” to unlock restrictions imposed on society during the Covid-19 outbreak, he said, warning that they would be “quite an expensive and costly service”.
The HSE would be commissioning a “scoping mechanism” next week to develop a future model of operation for testing and tracing to move beyond the “wartime model” created over the last eight or nine weeks in response to the Covid-19 pandemic in Ireland, he said.
Mr Reid said there were “a few clear uncertainties about what happens next” as the restrictions introduced to stem the outbreak are lifted on a phased basis over the coming months.
It was uncertain whether there would be a “bumpy experience” in terms of increases in infections or geographical outbreaks across the country as restrictions are lifted, he said, adding there were questions over whether there would be a “second wave or surge” in the disease across the State or continue to be outbreaks in “congregated settings”.
“It is all very uncertain for us from the HSE’s perspective in terms of planning ahead,” he said.
The HSE had to ensure that it did not “max out the capacity of the Irish healthcare system while trying to deal with the virus” and that there was a “relentless focus” on vulnerable groups and an “equity of care” for them, he said.
The cost of protecting healthcare staff by investing in PPE and in testing and tracing would be “very, very significant” and “at a scale that nobody could have foreseen a short few weeks or months ago”, Mr Reid said.
“The costs of these key enablers to unlock society are ones we have to face, because the relative cost of continuing relentless restrictions on society could be much more,” he added.
Face masks
The HSE chief said the change in definition on the use of face masks by all healthcare workers has meant the daily use of face masks across the health system has gone from 200,000 to 1.2 million, leaving the HSE with a requirement for 9 million face masks a week.
Mr Reid told reporters that the delivery of a further 120 million masks had just been finalised, with delivery over the coming weeks from South Korea through contacts made in the country and following a call last week by Taoiseach Leo Varadkar with South Korea’s president Moon Jae-in.
Explaining the significant scale of the order, Mr Reid said that 9 million face masks would, if stacked in pallets, would be 11 times higher than the Liberty Hall building in Dublin.
Mr Reid said that the HSE had completed the mass testing of 28,000 residents and 30,000 staff in the country’s 577 nursing homes which began last month.
He said that the State was still on schedule to make its target of 100,000 weekly tests by May 18th. The time it takes for a test from a swab being taken to a result was now 2.4 days, and contact tracing to find out who an infected person had been in contact with was done within 1.5 days of that, he said.
HSE chief operations officer Anne O’Connor disclosed that the executive had found “confirmed or suspected outbreaks” of the virus in 371 nursing homes, or 64 per cent of nursing homes in the country, after all of the nursing homes had been covered in the testing programme.
This is higher than the confirmed figure of 237 outbreaks in nursing homes contained in the latest Covid-19 daily update from the State’s Health Protection Surveillance Centre.
Ms O’Connor said the number of nursing homes and other residential care facilities that “would be of significant concern” in terms of coronavirus cases has fallen to 56, including 10 HSE-run facilities, from 90 a week ago.
“That gives us a level of assurance that things have actually improved in relation to residential care for older people,” she told the weekly briefing on Sunday.
The HSE was providing support amid the pandemic to 520 centres, including 335 for public, private and other types of facilities for older people, 107 for facilities for people with disabilities, 40 mental-health facilities and 38 other facilities, including direct provision centres .
Some 417 of these 520 facilities are regarded as “stable” after HSE intervention, she said. The HSE has itself redeployed 394 staff to help the residential centres, with another 100 staff coming from the hospital system.
Further testing
Ms O’Connor said the HSE was now testing the State’s 371 residential mental-health facilities and had already tested more than half of them, or 211. She said that by the end of today it would have tested all of these facilities where there are confirmed Covid-19 outbreaks.
In a further sign of stabilisation in the fight against Covid-19, Ms O’Connor said that the number of HSE staff seeking special accommodation in order to protect against the spread of the disease had fallen from more than 2,000 to 1,437, and only one-quarter of these were private nursing-home staff.
She said that the number of staff out on leave because of the disease had fallen to 3,010 from about 4,500 two weeks ago.
As focus shifts to testing and tracing, the HSE released figures showing key indicators watched to track the extent of Covid-19 in hospitals and nursing homes had declined further.
There were 72 intensive care unit (ICU) beds filled by critically ill coronavirus-infected patients on Saturday – down 55 per cent from a peak of 160. There was a total of 263 ICU beds occupied on Saturday night, with 161 ICU beds still available.
Ms O’Connor said that there were 543 people in hospital with confirmed Covid-19 cases and 196 in hospital with suspected cases, a total of 739 patients, on Saturday night, down from a total of 953 a week ago.
The level of non-Covid-19 treatment activity in hospitals had increased over the past week, she said. There were 1,242 general hospital beds still available, down from 1,680 last week.
Occupancy levels in the 17 private hospitals, which have been taken over by the Government to manage the pandemic, had increased to 48 per cent from 33 per cent a week ago.
There had been a 1.8 per cent increase in the number of emergency department admissions in the last week to 18,313, but this was still down 27 per cent on the same period last year.
“While we are seeing lower numbers of people who are confirmed Covid, we are seeing higher levels of activity in the hospitals using more beds and decreasing the available beds,” she said.
The HSE’s chief clinical officer Dr Colm Henry said that the health service would prioritise cancer services and “time-dependent” surgeries as the State’s hospitals reintroduce non-Covid services while retaining the ability to respond to surges in the disease as public restrictions are eased.
