John Crown (Independent)
Link to this: Individually | In context | Oireachtas source

Go raibh maith agat. I welcome the Minister. It is very likely that all the reassurance we are getting is entirely correct. It is most unlikely we are going to see any kind of apocalyptic scenario such as has been portrayed by Hollywood with respect to newly emerging viral illnesses. However, it is very plausible that we will get a few cases. It does not require any kind of conspiracy theory or apocalyptic bent to imagine that happening. I do think it makes sense because of the potential catastrophe that arises with respect to this infection that we prepare for a scenario somewhat worse than is likely. It may not necessarily be a question of preparing for the worst but we should prepare for something which is a little worse than is likely. Merely preparing for the likely is not enough.

We are hearing a lot of the word “evolution” but this has moved very quickly. There were no infections in western health care workers two weeks ago, and now there have been three and they have occurred in very sophisticated medical scenarios, not in places where people did not realise they were looking after somebody who potentially had Ebola, but in places where they did. We have already seen the most sophisticated and very successful international infection control organisation, the CDC, being somewhat flat-footed and finding itself behaving two days ago a little bit like a deer caught in headlights and suggesting there must have been a breach of protocols when somebody became infected and then understanding that it was quite possible that the protocols themselves were adhered to but were inadequate. We have not got clarity on the issue yet, but what we do know is that the CDC itself has ramped up the level of scrutiny and the level of intervention it is carrying out. Its “hit squads” will go around the country and are now advising a higher level of personal protection. We must understand without being alarmist that there is a possibility that the situation will be somewhat worse than it was.

I have a number of specific questions for the Minister, one which was mentioned by Deputy Ó Caoláin. We need clarity on the advice given to GPs because it looks like the original advice was to visit and that has now been downgraded to contact. If someone does contact his or her GP, what is the specific instruction the GP will be given if an issue arises? Could the Minister please tell me how many doctors we have employed in the specialty of public health in Ireland, a rough idea of how that compares to international standards, and how many of them are doing front-line public health jobs and how many are in administrative roles?

I could get emotional talking about the medical experts dealing with the crisis. To date, 10% of the deaths have been among doctors and nurses. That has never happened before. There has never been such a disease in modern times, where the people who get the sickest are the most infectious; that the people who need health care most pose the greatest threat to the nurses and doctors who treat them. They are great people. How many Irish nurses, doctors, missionary workers and aid workers are involved who are potentially going to get infected? Do we have a policy? Will the routine policy be that people will be repatriated? If they wish to be repatriated, will we have the facility to repatriate? Do we have the facilities in place for safe containment? I am fully supportive of any Irish person who gets the illness being repatriated.

Amplifying a little on the questions Deputy Ó Caoláin asked, what is the containment level and what is the personal protection level we are using in the Mater hospital unit at the moment? Is it level 4? From what is coming out of the CDC it looks like it is a moving target right now. The CDC is ramping up its own recommendations. Do we have pressure suits and, if so, how many?

With the current staffing and equipment level, how many simultaneous cases of Ebola can be handled in the Mater hospital unit? Do we have provision for staffing to recant from the buddy system everybody is recommending right now, which is effectively double staffing on an hour on and hour off basis? Can we cope with that? Do we have the ICU beds? What level of training has been given and what is the specific plan to increase the level of training? This is a very important undertaking. I hope it is an example of something we will never need to use but we might, and we need to be ready.

Another scary element is that a vastly larger number of people is infected with the virus right now than has ever occurred previously. The number of virus particles in humans right now is probably ten or 20 logs higher than it ever has been before. As the capacity for a mutation is possibly greater than it has been before we do need to keep ahead of this one.