Dr. Vida Hamilton:

We are very conscious of the vulnerability of those individuals. As the Deputy said, they cannot cocoon in their homes and have to leave to access dialysis. We work closely with the dialysis programme. We increased our dialysis delivery in satellite centres, away from the main hospital, by 20% in March 2020 in order to move people away from hospital settings for haemodialysis. We also increased the number of individuals who could avail of home dialysis and provide their own care in the home.

We put in robust guidelines on the management of patients while receiving dialysis, including instigating the use of masking during haemodialysis. With their agreement, our patients stopped eating and drinking during the dialysis period so that they could maintain masking and robust infection prevention and control practices.

We have audited our outcomes in terms of the acquisition of Covid-19 and outcomes from Covid, and they benchmark very favourably internationally. There have been low acquisition and mortality rates compared with international comparators in that vulnerable group of patients.

We are very conscious of their vulnerability and we continue to work actively with the relevant doctors to increase the number of home dialysis solutions and other solutions.

An additional challenge has been the difficulty in delivering transplant services for patients with renal failure due to the increased risk among transplant recipients if Covid-19 is acquired in the post-transplant period. That has put additional pressure on our renal services, but we are managing this extremely carefully.