Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

There are a lot of questions. I will not be able to answer them all but I will answer as many as I can and then I will hand over to Dr. Holohan. The task force has met at ministerial level. We met about two weeks ago. At the time we decided not to issue a statement or hold a press conference as we did not want to unnecessarily heighten concern. The task force expects to meet again at ministerial level.

I was asked about having a suspect case, which we have. Members will be aware of a person who died in Donegal over the summer who had been to the region and had to be tested for Ebola post mortem. The person did not have Ebola. One or two people have presented in usual scenarios claiming they have Ebola but they have never been to the region or been in contact with anyone from the region. None the less, one cannot dismiss such cases and they must be taken seriously. There have been approximately a dozen cases, only one of which could possibly have been Ebola, in the sense that the person concerned was in the region or was in contact with someone from the region. My colleagues might provide more information on the case.

It is important to point out that there is a difference in what we can learn from West Africa to what we can learn from Texas and Spain. Speaking to people on the ground, including the Minister of State, Deputy Sherlock, it appears that health services are virtually non-existent in that part of Africa. We often hear people talk flippantly about the Irish health service being "Third World", but it certainly is not. Liberia has the same population as the island of Ireland and a total of 60 doctors. That is what people are dealing with. They do not have proper hospitals even in the capital city. Not too far away in Nigeria, which is a much more developed country, there was an outbreak of Ebola. There were 20 cases which resulted in eight deaths but no deaths have occurred in recent weeks. The situation has been contained there. In between those West African countries and Nigeria is Côte d’Ivoire, Ivory Coast, which has had no case at all. It is important to point out that what is happening in West Africa is first related to the fact that they are war-torn countries with effectively no health care infrastructure and they are countries in which the virus thrives because of the environmental conditions.

We can learn a lot from Texas and Spain. If Ebola does appear in Ireland it is much more likely to be along the lines of what happened in those places, namely, affecting somebody who has been repatriated or has come back independently and ends up in an isolation unit. We are still learning. What seems to have happened in Spain and Texas where health care workers got infected has been around the degowning procedures. They are now recommending that people should be observed as they degown and gown. We would not have known that a few weeks ago.

The situation is evolving and we need to learn from what is happening and adapt to it. I am satisfied that we are ready but the situation is escalating and we need to escalate our response to it from now on. We must also be ready to de-escalate it should the outbreak be contained in west Africa. If somebody who is being repatriated is taken to the national isolation unit, he or she will be taken in a sealed pod. Dr. Holohan will elaborate on that later.

I was asked to respond to some of the concerns that have been raised about staff. The concerns that have been raised by trade unions about their members and staff are entirely reasonable and legitimate. I should point out that any staff infected in the western world have been isolation unit staff, and not routine or emergency department hospital staff or GPs, but it is still a matter of concern. Concerns like that are best addressed through the regular meeting that we have. It is very important that we support the front-line health care professionals and that we use their networks to get the message out to health care professionals, some of whom might be a little sanguine about this and are only waking up to it in the past couple of days as it developed as a media story. By and large, I would prefer that when it comes to a public health emergency of any sort that we set aside normal politics and that applies to all of us around this table and our different political parties and it applies to everyone in the health sector as well. When it comes to a major public health emergency or the risk of a major public health emergency, we should set aside normal concerns about normal politics and normal debates and get behind the effort that must be taken.

I have not read the IMO statement but my understanding is that the advice is not to go to the GP's surgery but to call a GP. A GP or a well trained practice nurse would be able to triage a patient. One cannot expect patients to know about Ebola but GPs and practice nurses would be able to identify very quickly as to whether there is any possibility that the person could have Ebola. They would be able to triage a patient and then deal with it from that case. There will be people who have a high temperature and be concerned that they have Ebola, even though they have never been to the region or never been in contact with anyone who had Ebola.

When it comes to aid workers and people returning from that region, they are well briefed and well trained on what they should and should not do. They are asked to contact the public health department on the Health Protection Surveillance Centre, HPSC website, which is very good. It is worth looking at all the algorithms and protocols on it. There are telephone numbers as to whom a concerned GP can contact, as well as telephone number that a person coming home from the region can contact and get advice from a public health specialist so that the person is directed to the right place. One thing we may have to consider and which we are already considering, is putting together a team that can move in and go into a hospital if there is a suspected case and help the hospital to deal with it, if the staff of the hospital are not able to do it themselves. When it comes to practice runs, they have happened in some hospitals, but I know for a fact that they have not happened in other hospitals. We need to ensure that dry runs and practice runs happen in every hospital. That has to be led by the infection control and emergency staff on the ground, but we will be doing texts to ensure that has been done.

I cannot say for certain that every practice and out-of-hours service has got the equipment but I know that 5,000 packs have been issued and there are not 5,000 GPs and out-of-hours services in the country. If anyone does not have them, they need to let the HSE know and we will ensure they get them.

On the national isolation unit, NIU, I have all the details on the number of beds. I am not sure if members want me to go through the figures as it will take time to go through the details. I will leave that to my colleagues.

There is no vaccine for Ebola. The drug ZMapp is an experimental medicine and is only made as it is requested. We do not know if it works. The treatment for Ebola is supportive measures and also very tight infective control around it. I do not know off the top of my head the number of public health doctors in the country but I can get the figures for members.

I do not know the exact number of Irish aid workers specifically on the ground but there are 54 Irish citizens in those three countries and they are accounted for and registered with the Department of Foreign Affairs and Trade. To the best of my knowledge it is not correct to say that 10% of the deaths from Ebola are doctors and nurses, it is about 5%. When it comes to the repatriation of an Irish person overseas, that is something that will have to be considered at the time. Ireland does not have the capacity to repatriate somebody from west Africa, most small European countries do not, and what is happening at foreign affairs level is that efforts are being made to put together something on a European level, which is of particular interest to smaller European countries that do not have a big airforce and are not able to do what the British, French or the Italians could do.

If there is an Irish citizen overseas, consideration will have to be given to the scenario. One will have to consider if the patients is well enough to be transported, as sometimes they are not. Consideration has to be given as to whether they can be treated on the ground in theatre. If they can be treated well on the ground that would make more sense that taking the risk of repatriating them. We need to bear in mind that by its nature, evacuating somebody into Ireland does bring the disease into Ireland. It is a difficult to think about out but it is true, the only reason that the Spanish and American health care workers have been infected is because people were evacuated to America and Spain. From a very heartless epidemiological point of view one is helping to spread the virus through repatriation. At the same time I cannot possibly countenance the idea that we would leave an Irish citizen without care in the theatre. That is an issue we will have to consider on an individual case basis, should it arise. The NHS is trying to establish its own hospital in the region to help treat aid workers should they become infected.

Senator Burke asked a pertinent question about the different aid agencies certainly Médecins Sans Frontières, MSF and the International Medical Corps are well used to dealing with situations like this - I cannot say for certain about the others - aid agencies can help in different ways. They would not all be treating patients, some of them would be proving logistical support and other things that are often just as important, helping out the governments on the ground and the general government that barely exists in west Africa. People who criticise democracy and politics and everything else can see what the alternative to government and politics is. This is very evident now in west Africa.

I will ask Dr. Holohan to fill in some of the gaps.