Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I welcome this opportunity to update the House on the impact of Covid-19 on socially excluded groups and to outline the plans for administering the vaccine to those groups. Not everyone faces the same risk from Covid-19. From the outset of the pandemic, the Department of Health identified socially excluded groups living in congregated settings as having a heightened risk due to underlying health and social factors. The Health Protection Surveillance Centre, HPSC, provides weekly updates on outbreaks among socially excluded groups in congregated settings. Since the start of the third wave, there have been 355 such outbreaks, which represents less than 3% of all outbreaks in that period. There were 3,863 cases associated with the 355 outbreaks. The largest share of the outbreaks is among the Traveller community, members of which account for three quarters of all outbreaks, four fifths of all cases and nine out of ten hospitalisations. Regrettably, there have been eight deaths among Travellers associated with these outbreaks. This trend is reflected in the data for the past week, with 21 outbreaks and 112 associated cases among the Traveller population.

The incidence among other socially excluded groups is much less. In addiction services, there have been ten outbreaks involving 60 cases. In homeless services, there have been 24 outbreaks involving 163 cases. Among the Roma community, there have been 11 outbreaks and 72 cases. It is clear from the data that the impact of Covid-19 on homeless services and addiction services has been less than expected. This low incidence has been achieved by the actions of health and social care services in shielding the medically vulnerable homeless population. These services are saving lives, perhaps not in hospitals but by ensuring that people with underlying health conditions do not end up in intensive care in the first place.

The long-term strategy for protecting socially excluded groups, as well as other vulnerable people, is through vaccination. The Government has agreed a vaccination allocation strategy that provides the provisional sequencing for groups to be vaccinated based on clinical priorities and ethical values. Importantly, disadvantaged socio-demographic groups that are more likely to experience a higher burden of infection, and include individuals at highest risk of Covid-19 due to medical conditions, are prioritised in group 9. There are others within the socially excluded groups who will get a higher priority due to underlying health conditions and on the basis of living in long-term care facilities, such as long-term homeless accommodation. The numbers in these categories are small. For the homeless population, the total is approximately 700 individuals. It is critical that they are prioritised along with other high-risk groups.

There has been a lot of focus on age as a risk factor for Covid-19. We need to be cautious in how we apply this criterion to socially excluded groups, for the simple reason that they experience premature onset of illness - up to 20 years earlier - compared with the rest of the population. Furthermore, many of the people in these groups do not live to 60 or 65 years. We cannot be complacent about the on-paper prioritisation of socially excluded groups, because there may be unintended barriers to equal access to the vaccine. These barriers could include difficulties in attending designated vaccination centres, lack of contact with, and trust in, the health services, vaccine hesitancy due to a lack of information, and low levels of literacy or language barriers.

I am advocating a targeted campaign to reach vulnerable groups who otherwise may not have equal access to the Covid-19 vaccine. Advance preparation before vaccine roll-out is the key. Listening to, and engaging with, vulnerable groups is critical to building confidence in the vaccination programme. The HSE has already commenced its communications campaign with a series of webinars for service providers working with specific groups, namely, Travellers, members of the Roma community, migrants and residents in direct provision. The purpose of the webinars is threefold. They will provide information and guidance on the Covid-19 vaccination programme, including where to access trusted vaccine information, answer queries about the programme, and answer questions about the different vaccines that are available. While considering the vaccination allocation strategy for vulnerable groups, we must be aware that roll-out is contingent on the supply of vaccines into the country.

The Covid-19 crisis has brought into focus the health inequalities faced by socially excluded groups. It has demanded an intense and targeted public health response. Fortunately, there have been many secondary benefits from these measures in terms of easier access to services and the adoption of an inclusion health approach based on individual care plans, inter-agency working and an emphasis on long-term solutions, such as Housing First. I am determined that these benefits are captured within the health system and, to this end, the Department of Health has provided very significant additional resources to the HSE through its winter plan and service plan. I look forward to hearing the contributions of Deputies on these matters.

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