Dáil debates

Wednesday, 21 October 2020

Ceisteanna ó Cheannairí - Leaders' Questions

 

12:00 pm

Photo of Mary Lou McDonaldMary Lou McDonald (Leader of the Opposition; Dublin Central, Sinn Fein)
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At midnight we will enter our second lockdown of this pandemic. Workers, families and communities are being asked to make enormous sacrifices once again. People will lose their jobs and businesses are being told to close. Families are being told to stay apart and lives are being disrupted and put on hold. Understandably, there is a great deal of anxiety. There is also anger and frustration, but I have no doubt people will play their part.

In asking people to make these sacrifices the Government must also play its part. The lockdown suppresses the virus and buys us time. That is all. The most important thing we have in our fight against Covid is an efficient and effective testing and tracing system. It is hard to believe that we are nearly eight months into this pandemic and the Government has failed to get this right. This matter has been raised endlessly with the Government during those eight months. The contact tracing system became so swamped at the weekend that it completely broke down and collapsed. Now, between 2,000 and 2,500 people who tested positive for Covid-19 will today receive a text message from the HSE and they will be asked to tell their own close contacts of their positive test and, in turn, to ask those contacts to immediately contact their GP to seek a test. We are asking people who have tested positive to do the job of a contact tracer and to give their contacts health advice. This is a sure recipe for infections being missed and further outbreaks not being caught in time.

I accept that the growth in demand will have put the system under enormous pressure at the weekend. What I do not accept is the Government's failure to provide the necessary level of staff and resources. The warning signs were there. Dr. Anne Dee, a specialist in public health in the mid-west, rang the alarm bell loudly and clearly two weeks ago. She made it clear that regional health departments do not have enough staff to do contact tracing. She said:

We can’t cope with the volume of work, there are not enough of us. Outbreaks will be missed, and the situation will get worse. The regional public health system is as close to collapse as it has been at any time before.

I commend our public health teams that are doing Trojan work in extraordinarily difficult circumstances. They understand that contact tracing is absolutely essential to getting in front of the virus, controlling its spread and protecting our people. We also know that failure to get this right will mean a cycle of damaging lockdowns, with all the hardship and suffering that entails. The reality is that we have to lock down when the virus is out of control and we lose control of the virus when testing and tracing do not work.

Will the Taoiseach indicate what is going wrong that we still do not have the number of contact tracers that we need? Promises were made by the Government in July and again in September that recruitment would take place. Why is that is taking so long? We need to get to a point where we have a 24-hour turnaround for testing and a 24-hour turnaround for contact tracing. Does the Taoiseach accept that that is where we need to be by the end of this six-week lockdown? If he does accept this, which I hope he does, can we get weekly progress reports on how many staff are being hired and how we are progressing towards meeting these goals?

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I thank Deputy McDonald for her remarks and for raising this issue. Since the new Government was formed and came into office at the end of June, we have been determined to build up our testing and tracing capacity. That is what has happened. Without question, the contact tracing dimension has come under extreme pressure in recent days, in particular over the weekend. I recall the Deputy asking some weeks ago about the target of 100,000 tests per week. We have now reached a testing capacity of 120,000 in our laboratories. We processed more than 115,000 tests in the past seven days. We continue to test in the community and in hospitals and we conduct serial testing in nursing homes, meat plants and direct provision centres.

The HSE informed me that we are meeting all the demand for testing from the community and hospitals. Yesterday was the highest day, with more than 12,500 appointments in community swabbing centres and that is in addition to acute swabbing and serial testing. Our laboratories have processed up to 19,000 swabs on a given day, the highest ever, and they have done this within their committed turnaround time of 24 hours or less. Our testing capacity at the moment is more than 120,000 weekly. That capacity will increase again in November and December. Capacity is increasing every week. We will continue to have offshore testing capacity during the winter.

The HSE informs me that on metrics, tests are completed end to end in less than three days, more than 95% of GP referrals get a same-day or next-day appointment, more than 90% of people get their result in less than 48 hours from swabbing appointment, and the overall end-to-end median is less than 2.2 days. Of course, there are always improvements to be made on that and to further consistency at the end of the testing process.

I do not have to go through all the serial testing, but 35,000 tests have been undertaken in 82 meat plants since 21 August, with 151 positive cases emerging. Some 3,300 tests have been carried out in direct provision centres, with 18 positive cases since 12 September. A total of 234,000 tests have been carried out on healthcare workers in 574 nursing homes since early July, with 631 positive cases. There are concerns about schools. The HSE says it has tested approximately 13,289 students and teachers, with 355 positives, which is a positivity rate of about 2.6%.

Recruitment has been ongoing. Currently, 400 staff are employed in contact tracing.

There will be 220 added before the end of next week and there will be ongoing additions. As the Deputy knows, we did not have a testing system at the beginning of the pandemic. Many front-line staff came from within the health service, for example occupational therapists and physiotherapists, and from other Departments, and they went back into services. At the moment substantial recruitment for contact tracing is going on. The first 700 people are through the interview process. Some 220 new staff have started already. There will be 74 next week and 128 will start on 2 November. They want to bring in about 60 to 70 new staff every week to work on contact tracing, ultimately to get to somewhere close to 800 contact tracers. It could be close to 1,000-----

12:10 pm

Photo of Mary Lou McDonaldMary Lou McDonald (Leader of the Opposition; Dublin Central, Sinn Fein)
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I thank the Taoiseach for again rehearsing the figures for testing. I am aware that the target of 100,000 set in the springtime has now been met and surpassed. However, in the words of the WHO, "You will never test too much", and that capacity will need to be built on.

I asked about contact tracing. The facts are that this system collapsed over the weekend, which is extremely alarming, happening as it does on the eve of us moving into another lockdown. I made the point to the Taoiseach that unless we get the testing capacity right and keep developing it, and unless we have a tracing system that is efficient enough to turn around in a 24-hour period, we are storing up big trouble for ourselves. We are heading into another lockdown and all of us, including the Taoiseach, know what that entails. We need to come out of this six-week experience with a state-of-the-art gold-standard testing-and-tracing system. That means a 24-hour turnaround universally for testing and a 24-hour turnaround universally for tracing. That must be our objective and we are far short of that now.

I want to hear from the Taoiseach today that he accepts that we need to get to that gold standard, that the Government will produce a plan to get us there over the next six weeks and that he will report to the House every week on the progress made to meet that objective.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I outlined the very significant increase in capacity in testing to put it on the record of the House and it needs to be acknowledged. Things need to be viewed with balance and perspective. I am not happy and I am disappointed that because of the extraordinary demand over the weekend given the level of community transmission we currently have, there is not a test-and-tracing system in the world that will not come under pressure, and they are. I have just listened to colleagues of Deputy McDonald's. A similar situation applies in Northern Ireland, the United Kingdom and other EU member states. I think we are about 11th highest in testing capacity in the world. I do not want to go into league tables or anything like that, but our testing capacity is high. The contact tracing is under pressure. We are recruiting very fast. There are procedures to be followed in recruiting. We have been recruiting contacting tracers since August. I want to ensure, as we outlined in our plan, that we get to our target. Overall, we had a figure of about 3,000 people from the labs right through in our own test-and-tracing permanent workforce. That is the target we set ourselves when the new Government was established and we are on track to do that.

I have no difficulty in weekly reporting, nor does the HSE. It already outlines the number of tests and so on that it conducts.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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This is about tracing and not about testing. I always have a degree of sympathy and sorrow for the Taoiseach and particularly for the Minister, Deputy Donnelly, because it is obvious that they were not aware of this until very recently. They have been out in the public and they have been talking in here expressing confidence in testing and tracing.

On a point of order, I ask the Ceann Comhairle to tell the Deputy at the back to get off the phone. It happens in here almost every day. It is ridiculous at this stage. I could hear his conversation and I am here trying to ask the Taoiseach a question.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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I am sorry. I cannot see the Deputy at the back.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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I would say you have a fair idea now.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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I say to whatever Deputy it is, please do not interrupt.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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At what time yesterday, or whenever, was the Taoiseach made aware of the issue? When was the Minister made aware of it? I compliment The Irish Timesbecause I do not think we would have known about this if it were not for the work of Simon Carswell, Jack Horgan Jones and their colleagues.

The Taoiseach mentioned that it is taking 2.2 days from end to end. The real figure we need to know is how long it is taking in the community. It took considerable journalistic action to find out it is actually 4.1. Every day and every week we need to get the figure for how long it is taking to trace people in the community. How is it in any way sane or sensible to send people text messages? Some people may have Covid or may be in hospital, including in intensive care, for all we know. How can we ask them to contact people? I accept there are pressures, but this is bonkers. It is absolutely ridiculous. We cannot allow this to happen. We had time to deal with this.

For instance, when there were issues previously, the previous Minister called in the Army. Why was this not done? We had an opportunity. From last Friday until today, that is four and a half days, people have been circulating and not contacting people. Covid has spread in multiples that we do not know. As regards contact tracing, it is in the thousands or tens of thousands; we do not know. This happened before but never on this scale.

What is the status of the famous app? How effective is it? I think its effectiveness now is seriously questioned. The HSE has a huge amount to do. I am not saying that Paul Reid and his team are not under pressure, because they are. It is not always about jumping up and down about them. However, could the tracing aspect not be separated from the HSE and done as a different component under another regulatory body? It is not right to have it in charge of regulating itself as regard the accuracy and efficiency of this tracing. We need to know that in a spike such as this we have enough resources and enough people. The public do not mind if the people working on tracing do not have much to do because they will be there in case there is a spike. Will the Government consider a process by which the regulation of tracing will be done separately from the HSE to ensure that we know the figures are accurate, allowing the HSE to do its proper job?

I ask the Taoiseach to reveal when he knew and when the Minister knew. Will he commit that publicly we will get the community end-to-end testing and tracing rates every week from now on?

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I got a text last evening which included The Irish Timesarticle. That was when I first knew. I was not informed of the operational measure the HSE undertook in response to the extraordinary demands it was under over the weekend with community tracing. The HSE has reconfigured the call structure to deal with 1,500 positive cases per day this week. All the cases yesterday were dealt with. It has essentially reset the process so that it is managing all the contact tracing as and from yesterday again as per normal. They reconfigured the call structure to deal with 1,500 positive cases per day this week. It believes it should be able to get to everyone within 24 hours. Next week it will introduce the ability for a close contact to arrange their own test online and this will be a significant development. The Deputy will be aware of that development in enhanced technology which will speed up the process of contact tracing. That is important. It will have additional staff again next week.

The Deputy is correct in identifying that the pressure is on contact tracing and that is where the issue is. I have been pushing for a week-to-week acceleration of the recruitment process. There are many issues. Some people need to leave jobs to take up new jobs. There is the Garda vetting process of the new staff coming on board, which is going fast to be fair to it. My understanding is that Army personnel are still involved. They would have been more involved earlier in the year, but Army personnel are still involved in assisting with contact tracing.

I understand they have been very effective in the application and professionalism they bring to bear to the job. There would have been far more of them involved early in the first phase. The idea is to create a permanent workforce in contact tracing. Ultimately, that is the only way to deal with a pandemic of this sort, and that is provided for. There is no shortage of resources to enable this to happen, either financially or in any other way.

I accept that testing and tracing is very important to deal with the pandemic but it is not the primary shield. We are moving into level 5. We must reiterate the importance of our individual behaviours and collective behaviour in reducing our social contacts and physical distancing to stop the spread of the virus. That is extremely important. This is not to understate the centrality of test and trace as a key weapon in dealing with the pandemic into the future.

On the Deputy's point about regulation, is he suggesting that we set up a new agency to regulate the-----

12:20 pm

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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Yes.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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We have a lot of agencies and we are recruiting a lot of people.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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I am not into quangos. It is just a situation where the whole thing is being inspected, run and-----

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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We cannot have a conversation.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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It is a very fast-moving situation with a pandemic. For example, Deputy Kelly made a valid point on antigen testing.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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The time is up now.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I will just make this one point. I asked the Chief Medical Officer and his team, through the oversight committee this morning, if we can get a quicker response on this. It is currently being clinically validated on the ground. That could be a very important supplemental resource to our testing regime by the time the lockdown is over.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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I asked a few questions that the Taoiseach did not answer. I respect his point that he got this information by text, which is extraordinary. I do not believe the public would know about this were it not forThe Irish Times. Were it not for Simon Carswell and Jack Horgan-Jones, we would not be talking about this issue this morning. That needs to be looked into. Will the Taoiseach inform the House when the Minister found out about this?

The running of the test and trace system needs to be in some way separated from the HSE because it has enough to do. We have to be honest about this. When I say it needs to be separated, the real issue is that end-to-end testing and tracing in the community takes 4.1 days, not 2.2 days as the Taoiseach keeps saying. While there are quick turnaround times in the hospital and GP settings, turnaround times in the community are way out by comparison. This is why we need it separated.

Members of the public are watching proceedings. The Garda vetting unit in my constituency is very efficient and, in fairness, it is prioritised when it is needed by Government. There are hundreds of thousands of competent people out there, including retired public servants, people who have worked in various organisations and jobs and those who have been made unemployed, who could have been recruited in recent months.

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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The Deputy's time is up.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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For the public, it is not conceivable or understandable that contact tracing was not resourced until now. We need bandwidth and elasticity to ensure the public is protected. That did not happen and it is bloody well not acceptable.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I believe that measures like this should be announced publicly and in advance by agencies. I have always been of that view. People are working under pressure and they advised of this measure. There was nothing secretive about it. When people get a message from the HSE it will be quite transparent.

It is interesting that Deputy Kelly has suggested that we separate out the process from the HSE. I do not know where that idea is coming from. It is a bit late in the day in this pandemic to consider that.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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It is failing.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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We are where we are in terms of the recruitment processes. There will be close to 800 people recruited for contact tracing. Testing and contact tracing are connected. We are testing more than we ever tested.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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I know that.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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We missed a lot of cases in the first phase of the pandemic when people were not tested because we did not have a testing system to the same degree we have now. People were positive and were walking around not having been tested, and they were infecting others. We know that this happened.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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It is happening now.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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When there are higher volumes of testing and much higher community transmission-----

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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It is not transparent.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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-----by definition, there will be huge pressure on the contact tracing system. That said, I do not think we can now start separating out processes and so on.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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Perhaps the Taoiseach will answer the other question I asked.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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People are being recruited. We are creating a permanent workforce as opposed to what happened in the first phase when staff were taken out of physical therapy and occupational therapy.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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That was done through an agency, CPL, not directly by the HSE.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I do not believe that was a good utilisation of personnel. It had to be done, however, in the emergency we had at the time.

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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When did the Minster know?

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Ceann Comhairle; Kildare South, Ceann Comhairle)
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Gentlemen, perhaps you will have a chat outside.

Photo of Catherine MurphyCatherine Murphy (Kildare North, Social Democrats)
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It is not unfair to say that we are heading into the second lockdown because we have lost control of the virus. Last night, as has been said, we heard through The Irish Times what happens when the system of contact tracing is underresourced and cannot cope. More than 2,000 people who tested positive at the weekend are being asked to carry out do-it-yourself contact tracing. If each of those people had just five contacts, which is a modest number, that adds up to more than 10,000 people who are possibly circulating in the community completely unaware that they are at risk.

NPHET held an unscheduled meeting on 4 October, so concerned was it with the escalation of the virus. It recommended moving from level 2 to level 5 for a period of four weeks. A day or two later, as has already been noted, a leading public health specialist took to the airways to warn of the regional departments of public health no longer being able to cope. I raised this matter with the Tánaiste in the same week. The specialist warned that the regional health system was as close to collapse as it had been at any time previously. We were told about the urgency of getting staff in place, and her fear that it would be the new year before this would happen. I am absolutely shocked that the Taoiseach found out about this issue by text. This is not a minor deal.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I did not get the text from the HSE.

Photo of Catherine MurphyCatherine Murphy (Kildare North, Social Democrats)
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I know that. The Taoiseach should have been aware of the issue and how much pressure the system was under. The Taoiseach should have been briefed continuously by the Minister for Health, who should have been completely on top of exactly where we were with this process. We know that recruitment has been outsourced. I am hearing that some applicants cannot even speak to the company they are waiting to be employed by. I am also hearing that the eligibility bar is very high with regard to the matching terms and that, as of last week, qualified people were told that the company had the numbers it needed. However, I heard the Minister for Finance state this morning and the Taoiseach state this afternoon that this recruitment is ongoing. This does not add up. We need to get a grip on exactly what is happening, what will be put in place and how confident we can be that the system will be robust enough to cope after this lockdown is over.

It is very difficult to figure out exactly what we can expect in the future. The Taoiseach talks about hope. We all want to have some hope in a very uncertain time. It is very difficult to figure out what the strategy is. We know we are moving into level 5 lockdown for six weeks, after which we are likely to move to level 3 and then level 2. We know there could be more changes in the new year. We need to know systems will put in place that will prevent lockdowns and not that lockdowns are being used as the only mechanism. That is central to this and we need to hear that strategy.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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The only guaranteed way of preventing lockdowns in the future is human behaviour. The virus spreads when people congregate. That is, unfortunately, the truth of this virus. It is very challenging for people generally because we all have to do things we would not normally do. It has upended our lives when it comes to the normal practices of daily life. That is the unfortunate reality of the virus and that has to feed into any strategic approach towards it. I have been honest and candid about this. I do not believe a zero-Covid approach is the correct approach. I do not think we can do that given our geographic location. I do not think we can seal the Border and we have very close relations with the United Kingdom. That is a view I have and NPHET shares that view. NPHET has said to us that it does not believe a zero-Covid elimination strategy is a doable proposition.

Likewise, herd immunity is something no one wants to contemplate for obvious reasons in terms of its impact. Therefore, we are in a suppression strategy, and that is dependent on a number of factors. Testing and tracing is very important, and I do not want to understate that. Human behaviour is also important, as is learning from the earlier phases of the pandemic, and constantly evaluating what is happening within our treatment situation, hospitals and acute settings more generally. For example, we started the serial testing of nursing homes as far back as August 2020. We have done 234,000 tests, with very low positivity rates. We did that to keep on top of the virus in an area of acute vulnerability, as we had learned from the first phase of the pandemic. We then extended the testing to meat plants because there was an outbreak in those plants during the summer. We learned from that serial testing the likelihood is that the actual origin of the virus was outside of the meat plants, but that when it came in, it spread. The positivity rate from the serial testing is low. This is also the case in respect of testing in direct provision centres. Such serial testing statistics are important as they enable us to keep on top of the pandemic. That is the overall strategy.

On the recruitment side, there is a hell of a lot of recruitment going on for community swabbing and contact tracing. As regards recruitment for community swabbing, more than 1,000 people have gone through the interview process and are now at the compliance checking stage. That started before this month. As regards recruitment for contact tracing, 700 people have been through the interview process. Deputy Catherine Murphy attended the briefing held last week by the HSE. It stated that it is recruiting and is hoping to take on 70 to 90 people per week. The ultimate objective is to recruit close to 800 people on the community tracing side, and 1,000 on the swabbing side, and those numbers may grow. We should have a briefing from the HSE on this particular situation.

I have been in touch with the people directly responsible for, and overseeing, testing and community tracing within the HSE. What I am imparting is the information I have been given by the HSE on this matter. There is no issue with resources or funding on the Government side, because it has to happen.

12:30 pm

Photo of Catherine MurphyCatherine Murphy (Kildare North, Social Democrats)
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We know that the public will play its part, but the State also needs to play its part. We need absolute assurance that there will be a system in place after this lockdown about which we can feel confident. Does the Taoiseach have confidence in this recruitment company? I certainly have my doubts. Does he have the confidence that he is being briefed in the way that he needs to be when a failure occurs? Two weeks ago, a senior public health person had to take to the airwaves to say how under pressure they were. It was no surprise that what happened at the weekend happened. It was predicted by virtue of the fact that staff were saying they were nearing collapse. The Taoiseach found out from someone texting him about an article in The Irish Times. I would have thought that he would be fully informed by those who need to inform him of something that is a big problem, for example, where 2,000 people are being asked to do their own contact tracing. That is not good enough. Surely the Taoiseach agrees it is not good enough.

From the point of view of what the State is doing, what will be in place by the end of this lockdown to stop us from having to go into further lockdowns? I accept the testing has been scaled up, so it is the contact tracing on which I want the Taoiseach to concentrate.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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The testing has been dramatically scaled up recently. Contact tracing is coming under tremendous pressure because of the high level of community transmission of the virus and the number of positive cases that have emerged. The HSE is saying it has reconfigured the call structure to enable it to deal with 1,500 positive cases per day this week. That is what the HSE is saying as of now. Members referred to what other countries are doing and I believe other testing technologies should be considered. HIQA conducted a major study on this, which has been clinically validated in terms of antigen testing and rapid testing by public health. I hope we can get early reports on it so that by the end of this lockdown, we can supplement the existing testing technology with additional testing technology. That is important in terms of dealing with the situation.

There have been policy differences on the efficacy of such tests for quite some time. I have made it clear that we are willing to implement this, but we need the clinical evaluation of these technologies. France, Portugal, Greece and other countries are doing this and it could be useful. It will never replace polymerase chain reation, PCR, testing on its own, but it could complement and support our endeavours, particularly in certain settings where we want activities to continue.

Cathal Berry (Kildare South, Independent)
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I wish to put on the record that I am generally supportive of and in agreement with the Government's decision to increase the Covid-19 restrictions to level 5 nationwide, as of midnight tonight. It is a prudent and sensible thing to do under the circumstances. As an individual who comes from a constituency that covers the Laois, Offaly and Kildare region, I am familiar with the additional burden that lockdown will put on the local population. However, I also recognise that it is a viable strategy as a last resort to keep a lid on this virus and prevent it from gaining a foothold in our vulnerable populations, although I appreciate that this is not a universally held view. Even members of the medical profession differ in their opinions on this, however that is not unusual. We are dealing with something that is at the very frontiers of knowledge, and we are learning more about it every single day.

However, I wish to focus on something which is more hopeful. It concerns the potential discovery of a vaccine. The discovery of a vaccine is not going to fit into a very rigid political timescale, but it is something on which we should definitely focus. While we cannot influence the process directly, we could be looking at improving the environment or conditions to expedite that process.

I have three questions for the Taoiseach. First, where are we from a vaccination perspective? Most Members in the Chamber recognise that a vaccine would be a game changer. We are familiar with what is available from an open source perspective, but is there any information at a national level or European level to which the Taoiseach might be privy, that he can share with the House? Where are we from a vaccination discovery perspective?

Second, we have an extensive pharmaceutical industry in this country. Is it playing its part in this global effort? Are we leveraging the expertise we have in Cork or in Newbridge where the Pfizer plant is located?

Third, is there anything else we can do from a State or governmental perspective? Are we leveraging organisations such as Enterprise Ireland and the new Department with responsibility for further and higher education, research, innovation and science? Are our public universities involved with commercial industry, taking a collaborative approach, so that we can expedite this process from a vaccination perspective? Those are my three questions and if the Taoiseach could shed some light on them, I would very much appreciate it.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I thank the Deputy for his comments. I recall that in the summer when we introduced restrictions that were equivalent to level 3 in counties Laois, Offaly and Kildare, which people may forget as things are moving so quickly, there was anger at the time, and understandably so. Those level 3 restrictions had an impact on that occasion, in terms of reducing the spread of the virus in those locations. Interestingly, I just saw comments from the chief medical officer in Northern Ireland that the measures taken in the Derry and Strabane areas, which were equivalent to level 3, appear to have had an impact in terms of reducing the number of cases, although it is early days. That is something that we need to follow in terms of how it might inform us.

On the vaccine question, the Government is part of an EU advanced purchase procurement agreement so we are part of an EU approach. Under that, the EU has already entered into agreements with Oxford University and AstraZeneca, for example. We are part of that and we make a financial contribution, having signed off on it. Yesterday the Cabinet took decisions to participate in agreements with Sanofi Pasteur, GlaxoSmithKline Biologicals and Janssen.

The EU is currently exploring other options with additional vaccine manufacturers, including with CureVac for the initial purchase of 225 million doses on behalf of the all the EU member states. Exploratory talks between Moderna and the European Commission are under way for the purchase of 800 million doses on behalf all EU member states as are talks with BioNTech-Pfizer for the initial purchase of 200 million doses on behalf of all EU member states. Three are more or less signed off on and there are three more on which talks are currently under way between the European Union and the pharmaceutical companies.

As part of the European Union's vaccination strategy, it is helping countries to prepare their vaccination campaigns so we asked at the European Council meeting two weeks ago to co-ordinate priority distribution of the vaccine. When one vaccinates, who does one vaccinate first? Will it be similar to the flu vaccination programme where it is the elderly and those who are compromised who need it initially? That is ongoing. In other words, it is about a fair distribution and that the most vulnerable get priority. It is about safe, affordable and effective vaccines. A vaccine on its own is not a panacea. There will be challenges when it arrives. The effectiveness of the vaccine is important.

In terms of our situation domestically, early in September I visited APC. All these companies, including Pfizer, have locations in Ireland but the manufacturing is not occurring here. I met with Pfizer recently in Cork, more generally about its operations in Ireland. Pfizer was reasonable confident about the prospect of it having a vaccine by the end of the year. That has been widely reported, so that is not news.

APC is an award wining Irish pharmaceutical research and development company supported by Enterprise Ireland. I met with it in early September. It has developed the manufacturing technology. It is working with an Australian biotechnology firm, Vaxine Pty, which is working on a vaccine as well. That is interesting and I take the Deputy's point in this regard. Enterprise Ireland is supporting that company with a view that it can increase its capacity so that should a vaccine or vaccines arrive, it would be able to assist the global manufacturing effort because it will take an enormous manufacturing effort globally to get enough vaccines to vaccinate everyone in the world. That is an interesting company with an interesting technology that could be of great value to these companies which are currently researching and producing vaccines because it could add manufacturing capacity to them.

12:40 pm

Cathal Berry (Kildare South, Independent)
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That is great. I thank the Taoiseach for that very useful information of which I was not aware. We are all conscious of cost in this Chamber. We are all familiar with the past history of pharmaceutical companies which may profiteer on pandemics like this one. In light of the global emergency crisis at the moment, has there been any discussion on perhaps the waiving of patents by pharmaceutical companies? Does the Taoiseach have any idea of what the unit cost of a single vaccine dose will be? He may not have that information to hand so maybe he could follow up with a written reply.

Photo of Micheál MartinMicheál Martin (Taoiseach, Department of An Taoiseach; Cork South Central, Fianna Fail)
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I do not have the specific unit cost of each of the deals. It is not as high as one might have thought or as might conventionally be the case. One has to be cúramach about what one says publicly about it, but there is a genuine effort being made here. That said, the difference here has been the advanced purchase process. In the US, the government there has been doing it. There has been a big debate there in the context of the presidential election etc. and that is why the companies came out strongly and said they will not have a vaccine before the election. They wanted to separate themselves out from any potential perception of politics playing a role in it. The advance purchase enabled it to go for it.

These processes in terms of the research, development and production of a vaccine are, in historical context, taking place at breakneck speed. They are really moving at pace. The US has the FDA approval and authorisation process and in the EU it will be the EVI process.

I can get a breakdown for the Deputy in terms of the contribution we are making. I want to be specific for the record. We are reasonably satisfied in terms of the contribution and the potential output in terms of the supply of a vaccine. It is hopefully an area where Europe can leave its mark in terms of co-ordination across member states and that it is not every member state for itself when the rush comes if and when a vaccine is produced. I have asked that considerable work continues on this so that when vaccines arrive we are in a position to distribute to the most needy and most vulnerable first and to those who will benefit best from an effective and safe vaccine. That will involve an entirely different debate here in terms of public reaction and perspectives.

Sitting suspended at 12.45 p.m. and resumed at 1.05 p.m.