BREAKING: HSE memo explicitly discouraged testing in Nursing Homes

In most other western countries, the release of this HSE memo by former Simon Harris appointee Dr. Marcus De Brun would be leading the news everywhere. Not in Ireland, though, where the top story everywhere is about schools re-opening in September, which is almost four months away.

And poor Dr. De Brun’s tweet of the memo has a measly 163 retweets, and hasn’t been picked up by a single journalist:

In plain English, it shows that on March 31st, the HSE restricted the availability of Coronavirus tests in Nursing Homes. This happened three weeks after Gript was the first (and at the time only) news outlet to report that the HSE was telling nursing homes to continue admitting visitors.

The memo makes several recommendations. In point two, it explicitly states that routine testing of so-called “low probability” covid cases should be discouraged. In other words, if a Doctor found a patient with symptoms that could be attributable to Coronavirus, but could also have been attributable to something else, then testing was discouraged.

In point four, which Dr. De Brun has highlighted, it states that if there was a single case in a Nursing Home, then everybody else in that home with symptoms was to be assumed positive, but not tested.

The memo contains no recommendation for the isolation, or special care, of Coronavirus patients.

Ireland has one of the worst records for nursing home deaths in the world. This memo goes a long way towards explaining why.

In the first instance, the advice to nursing home staff is desperately unclear. It leaves up to the discretion of staff what a “low probability” case is, and explicitly discourages testing.

This is despite the fact that it was known from very early on – and certainly well ahead of March 31st – that elderly people were very vulnerable, and that elderly people living together were at particular risk of the virus because of how contagious it is. Ireland had seen the experience in Italy and elsewhere.

A strategy designed to protect people in nursing homes would have taken the opposite approach. It would have encouraged testing as much as possible, as early as possible, for those with the slightest symptoms, and it would have advised their immediate isolation.

As it is, Nursing homes were effectively told not to test their first patient until it was blatantly obvious that that person had the virus, and then they were told to test nobody else after that. This meant that by the time the test results from the first patient came back (and at this stage, remember, test results were taking up to a week or longer) it was always going to be too late.

Further, it meant that it was impossible to confirm the spread of the virus inside nursing homes, because further testing was discouraged.

In turn, this makes treatment more difficult, because doctors cannot be certain what it is, exactly that they are treating.

You probably could not have sat down and designed a strategy less effective if you tried.

But despite the release of this memo, and all that it reveals about the deaths of more than a thousand of our elderly people, it has been greeted with, so far at least, a full media blackout.

Heads should roll for this. But this is Ireland, so they won’t.

Nursing Homes were left in an impossible position and given awful advice. There’ll probably be some sort of enquiry into this in a few months, but there’s not really any need for an enquiry when the evidence of failure is sitting in front of us. And in any case, given the record of enquiries in Ireland, it would probably just be cheaper to put the names of every lawyer in Ireland into a hat, pull out 20 names at random, and give them all a million euros.

We’ll leave you with Ivan Yates, suggesting that the nursing home farce will be “one of the biggest scandals in the history of the state”. That’s very optimistic: My own view is that it will be completely buried under a mountain of excuses about how “everyone was doing their best in a challenging time”.


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