Mr. Jim Breslin:

I thank the Chairman. I am outside my usual habitat.

I thank the Chairman and committee members for their invitation to meet with the committee today. I extend my best wishes to the committee, and, indeed, the new Dáil, in its important work.

Just under 17 weeks ago, on 22 January, the World Health Organization, WHO, announced that there was evidence of human-to-human transmission of the novel coronavirus, Covid-19, in Wuhan, China. Since then, the Department of Health, the HSE, the wider health sector and colleagues across the civil and public service and community and voluntary sectors have put in place an unprecedented response to an unprecedented emergency. I am deeply proud of the way in which people in my own organisation have risen to the challenge, at great personal cost. We must particularly express our deepest gratitude to the staff of our front-line health service who have met this challenge head-on with what has been the most supreme determination.

In the period since we first learned of Covid-19, there have been more than 4.7 million cases confirmed worldwide and at least 315,000 people have died. In Ireland we have had more than 24,200 confirmed cases - that is the figure as of last night - and unfortunately, 1,547 deaths have been notified, each of them deeply mourned.

All crises come in phases. This public health crisis has a particularly prolonged acute phase. We have made definite progress in getting virus levels back down through stringent public health restrictions but the social and economic costs of Covid-19 have been huge and will be with us for some time. Yesterday saw the first easing of these measures under the roadmap. The bedrock of this progress has been the tremendous commitment on the part of citizens and communities to the behaviours necessary to reduce transmission. The progress is such that we can now collectively take some calculated risks in extending the range of activities it is permitted to undertake but we need to be aware that we will continue to be in the acute emergency phase of this crisis for some time, with further waves an ever-present danger. This is not a one, two or even three-day storm, after which we move to the recovery phase. The acute phase of this crisis will definitely be measured in months and, most probably, years rather than days.

Our health service has been tested to the limits but not overwhelmed, as the European Centre for Disease Prevention and Control, ECDC, and many of us feared. None of us has seen anything like this before – the scale of the challenge is unprecedented but so, too, has been the response. There has been a focus on moving quickly to utilise all available resources, recognising that our healthcare capacity is challenged even in normal times. For example, we have introduced payments to GPs for telehealth so as to avoid unnecessary visits to surgeries. The HSE has developed 29 community assessment hubs to avoid unnecessary hospitalisations. Private hospital facilities have been secured in preparation for the surge and they are now helping with the non-Covid care that has been displaced from our major public hospitals. The HSE, voluntary hospitals and other health agencies have worked with private nursing homes to support them in preventing or managing infection and continuing to care for our older people.

The health service has also been engaged in a massive effort to scale up our Covid-19 testing capacity. Covid-19 is a new virus. Four months ago there was no test for the virus, much less commercial supply of such tests and the infrastructure necessary to undertake testing at scale. The HSE has striven each week to increase testing capacity with the opening of 47 testing centres, commissioning 40 additional labs for the testing of Covid-19, and procuring supplies against a backdrop of global shortages, and also implementing IT systems to manage referrals and automating processes.

The plane has been in flight while all this necessary work to improve its efficiency and range has been undertaken. The issues that have been encountered along the way are well documented but, despite these, Ireland is positioned towards the top of the international testing league table. Ireland is fourth highest in the EU in terms of tests completed in population terms. To date, more than 280,000 tests have been conducted. There is much more work to do, in particular, in improving test turnaround times, but this week the HSE is on target to have a testing capacity of 15,000 tests per day with an average turnaround time from swab to result of between one and three days.

The scale up of contact tracing by the HSE has also taken place.

The median turnaround time for giving someone a positive result and commencing contact tracing is just over one day. There are outliers, and further improvements are planned and will be necessary to continue to improve turnaround and support any increase in contact tracing requirements associated with the greater circulation of people.

Congregated settings, by virtue of their physical nature and the susceptibility of those living there, are recognised by the World Health Organization, WHO, and the European Centre for Disease Prevention and Control, ECDC, as involving higher risk of infection. The deaths we have experienced in our long-term care facilities are the most difficult aspect of our experience with Covid-19 so far. The testimony of those who lost loved ones and cannot say goodbye in the normal way is truly heartbreaking. The international experience involving similar or in some cases worse problems than our own has been highlighted by WHO and ECDC, which made specific recommendations for this sector in the latter half of March. Our commitment to testing and recording of all deaths, wherever they occur, means our figures are much more representative and accurate than in many countries. We have also undertaken a comprehensive survey of deaths in long-term residential care to ensure that we are fully and transparently capturing the actual position. Since the outset of this emergency there has been a high level of alertness to the vulnerability of older people in general and those in long term-care in particular.

Important new and international information has emerged-----