Dr. Tony Holohan:

We have some specific data on nursing homes. We are keeping a close eye. In recent times, we have experienced a number of outbreaks in nursing homes. The first explanation for this is what we call the force of infection; there is just so much infection out there in the population, although it has reduced somewhat in recent weeks. We do not have 100% vaccination, although we do have very high levels of vaccination, and we do not have a vaccine that is 100% effective. We will always have some people who will be vulnerable if they encounter another individual and pick up the infection. This is exactly what has happened in our nursing homes. It is also what has happened in these age groups in the community. We have seen a rise in the incidence in the corresponding age groups in the community. This leads to several things. Perhaps Professor Butler will wish to speak on one of these, which is the decision to accept the advice of NIAC on boosting vaccination for people who are residents in nursing home facilities and who are over the age of 65. There is also the continual importance of maintaining high levels of compliance with infection prevention and control. This continues to be every bit as important now as it was at the beginning of the pandemic. We do everything we can in our nursing home communities for the patients and staff to maintain high levels of infection prevention and control.

The Senator partly answered his own question in his remarks on staff. We have high levels of vaccination among staff. We believe there has been a challenge in some nursing homes in maintaining high levels, particularly perhaps among those who work in nursing homes but who come from agencies. Maintaining a focus on ensuring we do not deploy staff who are not adequately vaccinated, if it can be avoided, is at the core of what the HSE is trying to do in terms of its management of nursing homes.

There are several points we would make in general terms and I will ask Dr. Glynn to share some of the specific data. We have much less of this than we had for corresponding level of infection at previous times in the epidemic. This is good news in terms of the level of protection.

For those people who pick up this infection in the nursing home communities, in terms of the impact of that infection, we did not always have very high levels of hospitalisation as compared with, perhaps, other parts of the population, but the effect in terms of mortality was a very different experience. Although we have had some mortality in these communities, it is at a much lower level than we would have experienced at previous points in the pandemic when we did not have the benefit of vaccination protecting the people who reside in them.