Dáil debates

Wednesday, 24 November 2021

Covid-19: New Measures: Statements

 

7:27 pm

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)

I thank colleagues for the debate this evening, which has been very useful. I have taken a lot of notes and I have been checking in with the HSE and with the Department as we have gone through the various issues raised. I thank colleagues for the debate.

I would also like to thank our healthcare workers, who continue to do an extraordinary job. This year, there is a level of tiredness in the system that obviously surpasses this time last year because it never let up in healthcare, be it in community care, in our hospitals or right across the system. Our home carers, nursing homes and so forth have done, and continue to do, an extraordinary job. They really have represented the very best of us in this very difficult time.

We must also acknowledge the wider public, who, I believe, are responding yet again to the latest public health advice. In response to this surge, I, the Chief Medical Officer and many others have asked the public to reduce their social contacts, to work from home wherever possible and to take various other measures, and we can see it. Anecdotally, we can see evidence of people doing the right thing yet again, protecting themselves, their families and those around them. It is wonderful to see and would make anyone very proud to be a citizen of this nation to see our country working together again and again in the face of this awful virus. I just wanted to note my thanks and real admiration for the people of this country and everything they continue to do.

I had a closing speech, but what I will do instead with the time is to try to address the various issues that were raised. I will move through them at pace to try to get to as many as possible.

I hear colleagues loud and clear on PCR testing. I met with the HSE on it earlier today. The HSE deserves enormous credit for this system.

It is one of the most comprehensive systems of PCR testing around. Some 210,000 PCR tests have been carried out in the past seven days, which means that about one in every 25 men, women and children in this country has had a PCR test in the past seven days, which is incredible. We are all conscious that some people are not getting them as soon as they go to book them and this causes anxiety. People are symptomatic, they want tests and they are right to want tests. We are asking them to take tests and then they see messages telling them there are no tests available, and this understandably causes some anxiety. We are working to do everything we can to that end. Some four in every five people are getting a test within 24 hours, which is good. The one in five people who are not getting a test within 24 hours are those who are coming to Deputies and who we are representing. We want to see more done for them.

Prioritised referrals are for either close contacts or that come from GPs. Some 97% of the prioritised referrals are getting a PCR test within 24 hours, so that is still a high rate. The median end-to-end times for testing and tracing are still good. The end-to-end timeframe for a not detected test is 1.1 days and for a detected test the end-to-end from contact, through testing, getting the results and doing the close contact work is 2.1 days. The system is still moving very quickly and the people in that system are doing incredible work. Lines of people are coming in hour after hour and day after day to get their PCR tests and the people working in those centres are doing incredible work.

A lot of work has been done on antigen testing. It has a strong role to play, which is why I set up the various groups on it. Those groups have done an awful lot of work to make sure we could get to where we are now. We have clinical guidance on it, extensive training materials are in place and communications on it are ongoing. Antigen testing is being used widely. It is being used in hospitals, nursing homes and many other non-healthcare workplaces. It is being used in schools and colleges and for close contacts. The HSE has sent out more than 70,000 packs to people who are deemed to be close contacts. As well as that, the information we have suggests one in five people in the country are using an antigen test every week. Many of us wanted to achieve the widespread use of antigen testing. That has been achieved as they are being used widely in multiple sectors, commonly by individuals.

I want to go further and subsidise the price. The prices range from about €4 to €8 per test and I want them to be cheaper. That is a price that is affordable for some people but not for others. We also have public advice that says if you are regularly engaging in high-risk activities, which could be close contact sports, going to the pub, going to a concert or any other activity listed on the HSE website, you should use antigen tests twice per week. We have to make sure that they are affordable and that is one thing I want to see happen.

The other thing I want to see is even more communication. The information we have from Amárach Research is stark. For example, it says that of those with symptoms, nearly 70% of them took an antigen test when those people are meant to take a PCR test and only one in three of those people went on to take a PCR test. A serious concern is expressed to me by public health officials that if antigen tests are not used correctly, they reduce the number of people doing PCR tests who we want to do PCR tests. We need more communication in that regard and we are working on that.

On ICU capacity, we started the pandemic with 255 ICU beds, which was not remotely enough. It should have been an awful lot higher. We have done a lot and we are planning to do a lot more. Between this year and next year we will have invested about €52 million in increasing our ICU capacity. We have essentially asked the HSE how many ICU beds it can add, so there is no issue around funding. The HSE is working really hard on this to build the facilities, and the biggest constraint is recruiting and training the ICU staff, particularly the ICU nurses. We went from 255 ICU beds at the start of the pandemic to 297 today. We will add more beds in the coming weeks and months and the plan is to be at 340 ICU beds by the end of next year or early into the following year. That would be a 33% increase in our ICU capacity in a short time and that is as fast as the system believes it can go, but I want us to go further than that. The Department's 2018 capacity report stated that we should have 430 ICU beds by 2031. I stand to be corrected on that figure but that is what I recall. We want to go beyond that and I have secured Government agreement to go further than 430 and to go up to 446 ICU beds. A lot of work is being done and we would all love to have more capacity. I assure the House I am working closely with the HSE on this and it is scouring the healthcare and hospital system to find opportunities to put in more ICU beds.

Boosters are a huge weapon in our fight against Covid and I thank the vast majority of colleagues in the House for their ongoing support in getting the message out to encourage people to take the vaccine and the booster. Good progress has been made and about 630 doses have been administered between boosters and the third dose for the immunocompromised. The majority of those in the highest priority groups, which are those in long-term residential care, the over-80s and the immunocompromised, have either received their booster or been offered an appointment. That does not mean all of them have received their boosters but most have or have been offered an appointment. The next group is healthcare workers and those in their 70s. As of today about half of them have received their boosters and progress is quick on both counts. The next group is those in their 60s and those with underlying conditions. As I said at the start of the debate, it was important to me that those with underlying conditions would start to receive their boosters soon and they will start to receive them next week, which is positive news. About 33,000 of those in their 60s have received boosters to date and that will start increasing rapidly because the five-month period kicks in now. As that comes due, we are building capacity to have well in excess of 200,000 booster doses administered per week through all the various channels.

I want to reiterate the public health advice, which is so important. For any of us who are symptomatic the advice is to stay at home and get a PCR test. If you are deemed a household close contact, you should stay at home for five days and get three antigen tests, which will be sent out by the HSE. People should work from home wherever possible. We have all said we should get the booster and get the vaccine if we are still thinking about getting it for the first time. We should use the various layers of protection when going out, including hand hygiene,coughing and sneezing etiquette, ventilation, the booster, the masks and so forth. Between all of that, the work the Government must do, the work industry must do to play its part and the work we can all do as individuals, we will push this virus back again and protect public health and our healthcare system.

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