One of the most remarkable achievements of the Irish government in the Covid-19 crisis has been its ability to avoid almost any hard questions for any of its actions, even when they’ve made clearly terrible decisions that would end up costing lives.

Most media outlets have simply fallen into line and become mouthpieces for the regime, parroting the talking points of the Minister or the Department, or excitedly reporting the Taoiseach’s emergence as a major player evidenced by his ability to quote Churchill and post sycophantic tweets about thanking the ruthless and autocratic Chinese government.   

Last Sunday, Hugh O’Connell, interviewing Simon Harris for the Independent, raised the bar. At a time when older people are dying in their hundreds in nursing homes because of the fatal errors the government has made, this was O’Connell’s opening: “Two months ago, Simon Harris was one of the most unpopular health ministers in living memory. Now children write to him telling him they miss school, while his growing Instagram following swoons over his every word in daily video updates on the Government’s response to an unprecedented pandemic.”

Harris went on to claim the government had made no mistakes in its handling of the crisis. That’s the level of braggadocio and arrogance to be expected when most of the media is failing so miserably in its basic duty to challenge authority and ask hard questions – or any questions at all.

This pandemic is, of course, an unprecedented event in most of our lives, and its easy to be wise in hindsight. However, this caretaker government, and it’s army of well-paid advisers, made the following fatal errors when in full possession of the evidence that should have urged them to do precisely the opposite.

 

1. They refused to stop travel from affected areas in Italy, or to test those who came back.

By 31 January, the Italian government had declared a state of emergency in relation to the coronavirus. Flights to and from China were banned but the virus had already entered the country. The northern region of Italy, popular with Irish people for skiing on the mid-term break, was especially badly affected.

However, several weeks later Simon Harris refused to stop flights from Italy landing in Ireland, saying that the free movement of people was “at the core” of the European Union.

In an absolutely pointless gesture, on February 25th, the Health Minister moved to cancel an Italy-Ireland rugby matched scheduled for March 7th, but allowed Italian rugby fans to fly to Ireland anyway. In fairness to those fans, flights to and from affected areas in Italy were arriving and taking off at Dublin airport on a daily basis.

Even more astonishing was Harris’s advice at the time that there was no need to self-isolate if one had returned from an area affected by the coronavirus but was showing no symptoms.

The Minister told RTÉ on February 26th that “if someone has returned from an at-risk area and is displaying no symptoms, they should consult the HSE website”. He said there was no recommendation to self-isolate under EU guidelines.

As we now know, four people who travelled to Italy during that period were amongst the first Covid-19 cases in Ireland. One was an asymptomatic carrier of the virus who was also a healthcare professional, and who came into contact with patients after returning to Ireland from Italy.

In fairness to this family, they were just following the advice of our government.

 

2. They also told those coming home from Cheltenham NOT to self-isolate. and didn’t test them

It’s now widely acknowledged that it was a significant mistake to allow the racing festival at Cheltenham, attended by more than 200,000 people to go ahead, with reports indicating that the Gloucestershire area has a higher rate of infection and death from Covid-19 than surrounding counties.

That decision lay with the British authorities, but the Irish government compounded the harm by refusing to test those coming home from Cheltenham at the airport – and again telling them not to self-isolate if they didn’t show symptoms.

Simon Harris said his “public health emergency team did specifically consider Cheltenham again .. and it has decided that they do not need to self-isolate on return.”Instead, the thousands who headed home from the packed festival, even as Ireland was now in lockdown, faced nothing more than a ‘health conversation’ at the airport.

It’s also worth remembering that the government’s decision to close down public gatherings such as the St Patrick’s Festival was only finally made on March 9th largely in response to public anger on social media, and persistent warnings from leading medical professionals that the government was doing ‘nothing’.

 

 

3. They didn’t plan for likely shortages of protective clothing and equipment

In his interview with the Independent last Sunday, Simon Harris claimed that by February 8th, neither he nor the government, nor anyone else was much aware of anything about the coronavirus. As journalist Ken Foxe pointed out, memos had been prepared for the Minister as far back as January 21st about a “cluster of pneumonia cases caused by a novel coronavirus in Wuhan”.

In fact, on February 7th, the Chief Medical Officer at the Department of Health, Dr Tony Holohan, was telling RTÉ News that he was “confident that the arrangements in place here will be successful in containing the coronavirus” and that the country had “a reserve of supply and protective equipment in Ireland”.

At the time, the World Health Organisation, on whom the Irish government unfailingly rely, were warning that countries were stock-piling protective clothing and equipment (PPE) and that a “global shortage” might occur.

It soon emerged, however, that Ireland had nothing like the PPE required to deal with the crisis. Nurses and doctors were reduced to making videos asking for PPE donations since they were fighting an extremely dangerous and infectious virus without the necessary equipment to protect themselves. Healthcare workers were posting online that they were worried sick about the situation.

The HSE’s first reaction was to deny the problem, saying on March 20th that there was an adequate stock of critical supplies. Then when it became obvious that this wasn’t the case, they rushed to order €30 million of PPE from China, and Leo Varadkar made a major PR exercise of phoning the Chinese government to thank them for selling us equipment. It turned out that a lot of what arrived was faulty or sub-standard, with the Sunday Business Post reporting that a shocking four of the ten items assessed were described as “unsuitable” or “not suitable for use” in clinical or other healthcare settings by the Antimicrobial Resistance and Infection Control (Amric) Oversight Group.

In one large Dublin hospital, RTÉ reported, that “nursing staff working on a ward which is exclusively for Covid-19 patients [had] expressed concern about the density of the material of the protective gowns they have been supplied with”.

The day after the controversy erupted about the faulty Chinese PPE, Leo Varadkar announced that he was going to work as a doctor for half a day a week during the pandemic, ensuring copious amounts of favourable national and international headlines. While not doubting the validity of his intentions, the timing of the announcement was rather convenient.

As of April 20th, more than 4000 Irish health care professionals have been infected with Covid-19 – amounting to almost a quarter of all confirmed cases in the country. The government failed to plan for a shortage of PPE which would keep our frontline healthcare workers safe. Now some of those medics are paying the price for this mistake.

So, tragically, are the staff and residents of nursing homes.

 

 

4. They re-opened nursing homes – and told staff NOT to wear PPE

These errors are utterly inexplicable and have had the most dreadful and far-reaching consequences.

Nursing homes across the country initially moved quickly to restrict visitors when it became obvious the coronavirus was a global emergency. By March 6th, Nursing Homes Ireland had issued a general restriction banning all non-essential visiting for care homes nationwide.

On March 10th, the Department of Health ordered that those visiting restrictions be lifted even though other countries such as South Korea had already been reporting clusters of Covid-19 in care homes by February 24th. Gript Editor, John McGuirk described the move as ‘madness’. “You don’t have to be an expert to know that that’s about the most stupid thing you’ve ever heard. Old and sick people matter. Ignore our idiot Government and stay away from them,” he wrote.

Most of the media, however, kept shtum on what was obviously a terrible decision. Very few red flags were raised. The nursing homes remained open at a time when parades and schools were being shut down.

Having made such a devastatingly bad call, the Department of Health then compounded the error by advised healthcare workers in care homes that they didn’t need to wear PPE. They were working with the most vulnerable people in the country in relation to an infectious disease that had locked down the world, and they were told they didn’t need to wear protective clothing. This amounts to criminal negligence, in my view.

The care homes weren’t being supplied with any PPE in any event. In a survey published by Nursing Homes Ireland in the first week in April, just one-quarter of care homes reported having a sufficient supply of PPE.

Now, more than half of all coronavirus deaths in Ireland are occurring in nursing homes, and one study suggests that Irish care homes appear to be hit worse by Covid-19 than some other European countries.

A member of the Medical Council who resigned yesterday in protest at the government’s handling of the crisis in relation to nursing homes said the actions of the authorities  ‘beggared belief”. Dr Marcus de Brun wrote: “it remains an evolving tragedy that these vulnerable people were not considered as the first priority for the state, rather than being the last to be considered.”

 

5. They didn’t meet with nursing homes to address their concerns

The nursing homes sector says it repeatedly sought a meeting with the Minister for Health as the crisis escalated, but that no such meeting was forthcoming.

“We view it as a failure by the Minister that we have to keep endlessly pursuing him as this crisis escalates hour-by-hour, day-by-day. Unprecedented challenges present in ensuring we are positioned to meet the care needs of nursing home residents. Yet we are chasing the Minister for Health for weeks,” Tadhg Daly of Nursing Homes Ireland said on March 25th.

Chasing the Minister for weeks? The sector caring for those most at risk from the coronavirus couldn’t get to talk to Simon Harris. That was an enormous blunder on behalf of the government.

“It’s astonishing we are now well into a health crisis of a magnitude never presented before and the Minister for Health and his Government have not engaged with a sector providing care to thousands of the most vulnerable people,” Daly continued.

“We’re told by An Taoiseach and Government we are in this together but the ignoring of our sector defies such pronouncements.”

Indeed.

Writing for this platform, Dualta Roughneen observed that on April 4th the Department of Health finally announced a Financial Support Scheme for Nursing Homes “in the coming days”. On April 16th Deputy Dr Cathal Berry told the Health Minister that “not a single red cent” had been paid out, and that a mechanism had not even been put in place.

 

6.  They didn’t test enough people

Most of the countries with the lowest mortality rates in this pandemic, such as Taiwan and South Korea, seem to have one thing in common: they tested widely and early, they included asymptomatic people in the testing, and they followed through with contact tracing.

That didn’t happen in Ireland.

There have been huge delays, even where people have had symptoms, in carrying out tests and delivering test results. At one point shortages in swabbing kits meant that sampling centres actually closed, while insufficient supplies for laboratories slowed down the output of test results.

This led to many people – including those working as healthcare providers – waiting three weeks or more for test results to be returned. Then, as the backlog grew, the government changed the criteria for testing. As Peadar Tóibín TD observed: “they did this not for any clinical reason but purely because of capacity. This reduced the numbers seeking tests down from 15,000 a day to 2,500. This meant that many people who were actively ill with Covid-19 could not get a test. Many medics stated that this slowed treatment resulting in significantly worse outcomes in certain cases.”

He also noted that when he asked the government “to test asymptomatic people who have been on contact with confirmed cases,” he was told by the Taoiseach said that “this does not work”, even though the experience of other countries had already shown that it does.

Perhaps the most shocking evidence of all regarding the shambles the government presided over in relation to testing was the experience of those working in nursing homes. It is almost beyond belief that staff and residents in care homes were not a priority for testing. Instead, the opposite seems to have happened.

Dr Marcus de Brún wrote that: “Up until 9/4/2020, nursing home residents were refused testing in nursing homes where Covid-19 had already been detected.”
Nursing home staff were advised, he said, to presume everybody has it. “Residents who had been booked  for testing by their GP’s were summarily removed from the queue for testing, without the requesting GP even being informed.”

“Only on the 9/4/2020, after an outcry from some GP’s and Nursing  Home Managers, was this rule/guideline changed.  On 9/4/2020 GP’s around Ireland were contacted and requested to ‘reapply’ for testing, for those residents who’s test requests had simply been erased,” Dr de Brun revealed.

The Irish Mail on Sunday reported (April 19th) that two nursing homes where twenty residents had died after contracting coronavirus had blamed the refusal to blanket test in care homes for aggravating the spread of the disease.  “Our pleas to test all residents were denied”, they told the paper.

Last week, the HSE confirmed that eleven people had died from Covid-19 in St Mary’s Hospital in Dublin, while another eight patients died of the virus in a residential centre in Portlaoise. The same day, Simon Harris finally announced that testing was to begin “on people living in nursing homes and residential settings who are not showing symptoms of coronavirus”.

 

In Summary

These are extraordinarily difficult times and everyone wants the country to pull together and remain positive. That doesn’t mean the fatal errors being made by the government should not come under scrutiny. We owe that to everyone who has lost family and loved ones and who has suffered in this crisis.