Mr. Martin Rogan:

There has been collaboration with some international colleagues, including Dr. Joshua Morganstein and Dr. Brian Flynn in the United States of America who are experts in this field.

They described how, when there is a huge event that is traumatic, such as a terrorist event, school shooting or major weather event, it is timebound. They know that it is really difficult, time becomes elastic in the middle, but in three or four days the dust, sometimes literally, will have settled and people can get back to their lives again. It can be really difficult during that three or four day period but people know it has a terminus - it comes to an end. One of the challenges with Covid is that we do not know if we are midway through it or only, say, 10% of the way into it. We do not know where we are on the Covid time bar and that makes it particularly difficult. Healthcare staff have the added concern that they are working very intimately with people, using PPE and all the protocols and professional skill sets but they always have a concern that they will bring the virus home to their family and undermine their household health and that of vulnerable people they support. The HSE has introduced models whereby staff can stay in hotels and so on to avoid doing this.

Another phenomenon to which we need to be alert, which was also described on the recent tele-call with international colleagues, is one known as moral injury. This is when a person in a leadership role takes a decision based on the information he or she has at that moment, and that is absolutely correct based on that, but new information comes into the frame days later and the matter takes on a different complexion. For people who others look to for expertise, wisdom and experience in a given area, that can have a corrosive effect on their ability to lead and make decisions in the future. We need to be very mindful of that. People have been exposed to difficult and graphic circumstances and fast-moving and overwhelming situations. Working in closed spaces with PPE is very difficult over long shifts. The provision of employee assistance programmes-----