Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank colleagues for their contributions and time. I always find debates in the Seanad really valuable, useful, thought-provoking, challenging and important, so I thank Senators as always for their time. I will try to address the various issues raised as best I can and I apologise if I miss some of them.

Senators asked about progress on the Delta wave. We are dealing with two different but related matters, namely, a Delta wave, which we have a plan in place to deal with, and the new variant, for which various actions are being taken. As has been pointed out, the latest information we have, which we received earlier this week from Professor Nolan's team, plotted what is happening versus the projections we were given a few weeks ago. As colleagues will be aware, we were given no-change future possibilities, with an optimistic and a pessimistic scenario. This was where we saw the issue that was most concerning to me, namely, that by Christmas week, we faced a range of just-Covid ICU patients of between 200 and 450. The implications of that for patients and the healthcare system are profound, so we acted and took various steps.

Probably the most important step was a message, which everyone in this House got behind, to say to people we had to reduce our social contacts, stick with the basic measures and use masks and the things we know work. Clearly, people have changed their behaviour, as they always do. I again acknowledge the incredible response from people. Individuals, families and communities throughout the country have adjusted their behaviour and it has had the desired effect of pushing back down the virus. Our case numbers now are significantly below what was likely to happen if there had been no policy change.

More encouraging than that again are the figures for hospitalisations and ICU admissions versus what was likely to happen if nothing changed. Here we can really see the impact of the booster programme, a subject I will return to given various colleagues have sought more detail on it. We are seeing a really important lower profile of hospitalisations and ICU admissions for Covid versus what it would be if nothing had happened. A combination of the booster programme, which is moving at pace, and, just as important, people acting in a safe manner to keep themselves and their communities and families safe has worked very well.

Many other measures are in place, as we are all aware. There is PCR testing and contact tracing; antigen testing, which I will return to shortly; the Covid pass, which we have extended; the winter plan; the flu vaccine; the nursing home measures; the working-from-home measure; the midnight closing in the hospitality sector; household close contacts staying at home for five days and being sent antigen tests; and antivirals, which were referenced and which, while they have not yet been deployed, we are ensuring will be deployed here as soon as they are ready. All these measures are working.

It is human instinct for us, including Members and the public, to focus on the bits that are not working. That is right and proper and, obviously, there must always be challenge. It is important, however, not to lose sight of the fact the overall approach, this national effort from people throughout our nation, the Oireachtas, the Government, the HSE and industry, is working. It is important people know their efforts are bearing fruit and, ultimately, will save many lives, in the context both of Covid and of not having to cancel non-Covid care at a level that otherwise would be required. In summary, when it comes to the Delta wave, the plan is working, and again, it is a national effort. I am not trying to claim credit for the Government here. As always, this is a national effort and it has, broadly, been a cross-party effort.

A really important message for us all to get out, and I thank all the Senators who raised it, is that everyone should get vaccinated or boosted. I put together some figures for the debate. Right now, more than half of hospitalisations and more than 60% of ICU admissions in respect of Covid are unvaccinated. If people, therefore, choose at this point to be unvaccinated, they are putting themselves and the people around them at risk. It is taking up an awful lot of capacity within the system that otherwise would be used for other patients to get them the surgery and the procedures they need. It is important we do not enter a blame game; that is not what this is about. We need to try to reach out to these people to say vaccination really matters to protect them, other people, healthcare workers and our healthcare resource.

Another figure I thought was quite interesting is that currently, about two thirds of Covid hospitalisations and ICU patients are under 45 years of age. It is important to bear that in mind, given there is an almost 100% vaccination rate among the higher age groups and that falls off among younger groups. In fairness to younger people, the figure is nonetheless between 80% and 89% among the late teens and 20-somethings, still very high by international standards, but it is interesting that two thirds of Covid patients in hospital, including in ICU, are now under 45 years of age. That is an important message.

The most important message the public health experts are always trying to get out to all of us is that if you are symptomatic, stay at home and get a PCR test. I acknowledge there are delays. We would like to get everyone booked in the next day but sometimes it is taking two days or, in some cases, three. A total of 80% of self-referrals are being seen the next day. We would love that figure to be 100% but the vast majority are being seen the next day. In the case of priority referrals, which are from a GP or as a close contact, 97% of them happen within 24 hours. We always want to make it better and better but the core message is that if you are symptomatic, stay at home and get a PCR test. If you are going out, layer up with protection, namely, masks, distancing, ventilation, hand hygiene and so forth. That makes a significant difference. I referred earlier to some new research that shows how effective these simple and basic measures are.

On the booster programme, I am delighted to be able to share that more than 800,000 doses have been administered, between the immuno-compromised, who received third doses, and the booster doses. A total of 210,000 of them were administered in the past seven days and we are moving at speed. The initial focus, as Senators will be aware and I think will be bought in to, has been on everyone over the age of 60, those with underlying conditions, those with weakened immune systems and our healthcare workers.Here is where we are at on that. Those aged 80 or above, those in long-term residential care and the immunocompromised are substantially done or have been offered a booster. Approximately two thirds of healthcare workers and those in their 70s have been boosted and more have been offered those vaccines. We are moving very quickly now through those in their 60s. As of two days ago, approximately 20% of that group had been done. More of them are now eligible by virtue of it having been five months since their vaccine. It is not the original six-month target that we are using; it is five months, which is the shortest gap we can use. Obviously, it is three months for those who received the Johnson & Johnson vaccine. This week, we have walk-in clinics for front-line healthcare workers and the over-60s. Critically, one of the groups in respect of which I engaged with the HSE to ensure it happens as quickly as possible is that of people with underlying conditions. The vast majority of people in hospital with Covid have an underlying condition, so it was very important to me that we got those people done as early as possible. That is now happening this week. They are being contacted by the HSE this week.

In terms of antigen testing, there has understandably been a significant amount of talk about subsidisation or stopping the subsidisation. Let me explain that. I believe antigen testing has a very important role to play. The priority for me is ensuring that antigen tests are widely available and affordable and that people are supported in using them and receive good advice on how to use them and how to interpret the results. In other words, it is the green light-red light idea. We must ensure antigen tests are not used instead of PCR testing in the situations where PCR testing is the right thing to do. There are very good materials now available online on the HSE website and public communications campaigns have been launched. The tests are widely available. We send many thousands of them to houses all over Ireland every day for household close contacts. They are now going out to schools. They are in colleges. They are used in nursing homes, as well as many workplaces and healthcare settings.

The latest information we have is that approximately one in five people in the country is using an antigen test every week. They are now being widely used. I wanted to go further and make sure they were available at a reasonable price because, for me, €7 or €8 a test is not affordable for far too many people. I wanted to see the price brought right down and, therefore, we looked at subsidising them. Subsidising them is not a cheap thing to do. We are talking about a lot of tests. As part of that process, there was a significant and healthy engagement with the retail sector and various others on antigen tests and the price came down. It came down from approximately €8 to between €2 and €4. That is not the case everywhere. I saw it reported that a person said this has not worked because he or she found a pharmacy where the tests are €8. If the tests are on sale for €8, people should not buy them there. They should go elsewhere and buy them for less than €8. I want to make sure the price goes down further. We are continuing to engage to that end. Essentially, the policy objective was to bring about a significant and quick reduction in the retail price, and that has been achieved without having to deploy public money. That is the situation there.

There has been much discussion this evening in respect of masks for nine, ten and 11 year olds. We need to be very balanced in how we speak about this. This is a public health recommendation from NPHET. It is one that NPHET considered in great detail and it is driven in part by the fact that there has been a very significant increase in cases for nine, ten and 11 year olds. There has been an increase in cases among younger age groups, but the rate among nine, ten and 11 year olds is the highest in the country. It drops right back down again for 12 year-olds. I am happy to share those data with colleagues after the debate. I can ask the Department to send them on. The belief is that the huge drop from 11 year olds to 12 year olds is down to a combination of factors. It is down to the fact that 12 year olds can get vaccinated, but also that most or many 12 year olds are in secondary school, where masks are being used. That is supported by international evidence that shows the really important protection masks provide. We got a sensible and fully thought-through recommendation from NPHET on mask wearing for nine, ten and 11 year olds. That translates broadly to third class and up in primary schools. A decision was taken to make it third class and up, rather than having mixed rules in respect of mask wearing in classes containing nine year olds and eight year olds. That is the public health rationale. It is in place for one reason, which is to keep children safe.

I ask Senator Gavan to reflect on his usage of language such as "punishing children". I do not know if it is a line his party is taking. It is really unhelpful language. This is a public health measure coming from the Chief Medical Officer and NPHET with one objective, which is to keep children safe. I have a child in that age group and this morning he picked up a mask and went into school. Would they all prefer not to be wearing masks? Of course they would. Do we take very seriously any public health advice that affects children? Of course we do. However, there is only one objective here, and that is to keep children safe. I ask all present to keep that in mind when debating this issue. Obviously, they may challenge and disagree with the measures but Oireachtas Members in particular need to be very careful with the language they use. I disagree with the kind of language used by the Senator. I do not think it is helpful.

That is probably a good segue to the issue of communications. There is, understandably and rightly, a significant amount of focus on communication. In a pandemic, communication is, obviously, essential. I will be the first to admit that we must always do better. There are definitely things we can do better. I take on board the challenge and criticism that has been levelled from all sides and that is fair. I was thinking this through during the debate. Of course, every day and week we should try to do more. Right now, between Government, the Department of Health and the HSE we have public communications campaigns on broad public health measures, as all present will be aware and support, in respect of distancing, masks and hand hygiene. Those are core messages.

There is a public communications campaign on vaccines and first doses for people. We have a public communications campaign on the boosters, not just their importance but where people can go, who we are doing, when each cohort will be up and how people can engage. We are communicating on the new international travel measures because, obviously, they have a big effect on people. People need to know about them. We have public communications on testing and tracing. We have public communications on PCR testing, contract tracing, enhanced contact tracing, antigen testing, flu vaccines and more. Those are just some of the issues I wrote down this evening. I make that point not by way of excuse - we have to do better - but because I want to share the significant complexity of the health communications during the pandemic. That is not to say we cannot do more and should not do better. We can do more and we must do better.

I wish to address this idea that if NPHET advises something but the Government decides to do something different, that is somehow mixed messaging. It is not. NPHET provides public health advice and the Government makes decisions. That is how it works. We have taken the decision, with which I think all present probably agree, to publish the NPHET advice. It is published online very quickly. I believe people have a right to know not just what governments decide, but what the public health advice is. If we publish public health advice that we get on a Thursday and then meet as a Government on the Tuesday and take a few days to consider that advice, which we do, and we may make decisions on a Tuesday that are different, then I suggest to colleagues that not only is that not mixed messaging but transparent communications. Most of us know that and get that. It is quite healthy. That is part of it. I hear and accept the challenges and criticisms in terms of the public communications. We have to always try to be as clear as possible and get it right.I will end on a positive note. The issue of antivirals was raised in this debate. A definitive position has not yet been reached. Engagement is still ongoing. As colleagues will be aware, a joint EU procurement programme, similar to that used to procure vaccines, is being considered. I have instructed the officials to engage directly with the pharmaceutical companies as well. The policy position is essentially to do whatever gets them here and in use the fastest. Good progress has been made on that. As the Senator will be aware, these antivirals have not yet been authorised by the European Medicines Agency but indications from the trials with regard to the role they may play, and that I believe they will play, is very encouraging. They will be another quite powerful tool for Ireland and other countries in helping people to avoid hospitalisation and really severe illness. Things look positive in that regard. When I have a more definitive position and when agreements are in place, I will update colleagues as quickly as I can.