Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Cathaoirleach for the opportunity to update the House on the Government's response to the ongoing Covid-19 pandemic and to the approach to reopening Ireland.

As Senators will be aware, this country has been developing and reframing our response to Covid-19 for almost a year. Our country moved swiftly to establish the mechanisms to respond to the disease and this was undertaken on a cross-Government basis. Senators will be aware that a National Public Health Emergency Team, NPHET, was established, as well as a number of subgroups and an expert advisory group. The recommendations of NPHET form a key part of the considerations of the Government in its response to the ongoing Covid challenge.

Since the first set of restrictions were announced by the then Taoiseach in March 2020, the aim has always been to return to a level of normality and to reopen the economy and society as safely as possible. I wish to acknowledge the work undertaken by the public sector and by employers across the economy in working with us to ensure that the measures were implemented safely. I also want to acknowledge the forbearance of the public in keeping with us on these public health measures. There is hardly as aspect of Irish life that has not been impacted in some way by coronavirus and it is acknowledged that this pandemic has affected us all very deeply.

The Resilience and Recovery Plan, announced by the Government on 15 September 2020, provides the overall framework by which we allow society and businesses to operate as normally as possible, while continuing to suppress the virus. It is designed to help individuals, organisations and sectors to better understand, anticipate and prepare for the measures that might be introduced to suppress the virus. Given the constantly evolving nature of this pandemic, it is critical that a certain amount of flexibility is built into the plan to allow for a nuanced response. This allows our public health doctors and the Government to take account of disease profile and trajectory at given points in time and to make decisions accordingly.

We are now at an important point in our response to Covid-19. As we face into the challenging season of winter, as well as a time when many families plan to come together for Christmas, it is important to ensure that we continue to observe public health advice, even as we seek to reopen. We have almost reached the end of the six weeks of the measures introduced on 21 October under level 5 of the resilience and recovery plan for living with Covid. It is fair to say that like many other countries, this Government has faced critical decisions on the measures that need to be applied to limit the spread of coronavirus and the impact of these restrictions on the economy and society. I assure this House, as well as all citizens, that none of these decisions have been taken lightly.

It is expected that the Government will this week announce the measures that will be in place once the current set of restrictions under level 5 expire at midnight on 1 December. These decisions will be taken following recommendations from NPHET, as well as consideration of the cross-sectoral impact of new measures. However, regardless of the measures that will be announced, it is important that we maintain our observance of the recommended public health measures, many of which have been in place since the beginning of this pandemic.

Encouragingly, as the House will be aware, we have now seen the emergence of positive results in relation to vaccine candidates that are in development. The reported positive trial results from AstraZeneca, BioNTech and Moderna provide reason for cautious optimism. However, it should be noted that all proposed Covid-19 vaccines will require approval from the European Medicines Agency prior to use. There remains a good deal of work to be done before we have a full understanding of the effectiveness of vaccines, including how long they may provide immunity for, and whether their effectiveness differs across particular age groups of the population, or between different ethnic groups.Most importantly, we need assurance as to the safety of any vaccine. Nonetheless, there are grounds for some optimism that we are beginning to see the breakthroughs that we need to move the world out of its current situation. The House is aware that Ireland is participating in the process being led by the European Union to procure vaccine supplies. However, given that it will be a number of months before any vaccine is here and accessible on a widespread basis, we must continue for the moment to rely on the tools that are immediately available to us. The use of face coverings, social distancing protocols and personal hygiene etiquette remain vital. We must remember that over 71,000 individuals in our country have now tested positive for coronavirus and, sadly, more than 2,000 people have died. Each of the 2,000 deaths represents a mother, father, son or daughter who has sadly passed away due to this disease. It is important, as we discuss the decisions taken by this Government, and its predecessor, that we continue to remember and reflect on these facts. I urge all members of the House to continue to promote the public health messaging on Covid-19 in order that the most vulnerable in our society are protected.

Victor Boyhan (Independent)
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I thank the Minister of State for coming in. I thank the House and the Leader for facilitating two sessions on this matter and it is timely, appropriate and right to have statements in this House on reopening Ireland.

I am conscious in particular of the 2,000 people who have died. As the Minister of State has rightly said, they represent husbands, wives, partners, family, brothers and sisters who connect into a bigger family and, ultimately, a community family and the nation. It is clear to us all, particularly those in politics be it at local or national levels, that none of us is immune to the facts and reality experienced by the many people who have been deeply hurt by the Covid pandemic. It has hurt and broken many people, destroyed many businesses and livelihoods and people are suffering. I am particularly conscious of the number of people who have suffered and are suffering with their personal and mental health. Recently I listened to an RTÉ radio programme where a mother rang in to talk about her 12- or 13-year-old son and how he had lost his confidence and nerve. He had lost his ability to leave his home, to travel to school and to engage. Within ten minutes the radio station received as many as 20 or 30 calls talking about other teenagers. Most people have lost nine months of their lives but let us realise that it will be a year or maybe more and, hopefully, there will be a vaccine in the future.

Many of our businesses, people, parts of society and what holds us together are broken. One of the saddest calls that I received in the last nine months came from a man who lives close to me. He did not know me personally but rang to say that he could no longer visit his wife of 55 years. He told me that they married on his wife's 18th birthday when he was 19 years of age. I received his first call in Leinster House when he asked if I could give him a few minutes and of course I said I could. He talked for 15 minutes about his experience of going to a glass door located on the side of a nursing home to visit his wife who was in the early stages of dementia and being unable to hold her, kiss her, hug her, embrace her and tell her that he loved her. That is the effect that this terrible pandemic has had on people, which is happening all over the country. That is about everyone and our own families. Let us think about being close to somebody yet having that person pass away after being sick for a few months. One would have been unable to visit or see the person or to say goodbye. Moreover, in many cases, people have been unable to attend the funerals and say farewell. That is something for which we have to prepare because when all of this, hopefully, goes away in a few months, we will have to pick up the pieces, support people and listen to people.

One thing that I would like to see is a bigger campaign about mental health as too many people are suffering in silence. It is not always easy to say that one has issues with one's health, particularly now, and issues that may never have come to the fore before. When society is locked down and shut down and when one experiences a lot of quietness and stillness not by choice then that bubbles up within one, so one must confront issues that may have been parked for a long time. I refer to issues that one chose to forget and decided to avoid. If anything, in this pandemic, many of those issues have surfaced for many people. I say to the Minister of State at the Department of Health that it is important that we address and consider these issues.

I wish to use my remaining time to thank the public sector. I am delighted that the Minister of State has acknowledged the public sector because its workers get a lot of stick from time to time but they have excelled. I thank the gardaí, nurses and front-line workers, be they delivery persons, essential farm workers and whoever they may be. It is important that we acknowledge that front-line workers have stood tall and did their jobs well. I hope that when all of this dusts down, we will remember front-line workers and be strong advocates for them when it comes to their pay and conditions. I thank the teachers and all the people who are involved in all other aspects of life. Finally, I thank the people involved in local government who responded, as well as the volunteers who got involved in the Community Call, which is a wonderful initiative that spans across the 31 local authorities. It was great to have such consensus and support. Finally, I thank the Minister of State, the Government and the previous Government. If I am honest, there are difficulties with this Administration in terms of transition. I have seen a difference in style and communications from the last Administration to this one and there are lessons to be learned. The previous Government demonstrated exceptionally good communication. I know we are in a transitional period and I do not want to use my time to be negative but I urge that messages are crisp, clear and encouraging.

Malcolm Byrne (Fianna Fail)
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I thank the Minister of State for coming to the Chamber. I agree with many of the comments Senator Doherty made about how we live with Covid-19. The issues around well-being and loneliness need to be addressed, and not only for older people. There is a challenge for younger people as well in terms of how we ensure their well-being is protected.

I want to talk about when the vaccine is finally released. We have two clear communications messages and challenges. We need to stand up for science. We need to talk about the importance of how vaccines work. We need to explain how they work and the verification process that they have gone through to give people confidence. We need to explain that independent regulators will have assessed and ensured that these vaccines are in place. We need to take on the anti-vaxxers in society. I have no problem with freedom of expression that is based on medical evidence but when people make spurious social media claims and spread disinformation, that needs to be taken on. As a society, we need to stand up for science and research. Part of the information campaign has to be about that.

I have a second request. We are clear on the process of the roll-out of the vaccine, who gets it and in what order. We are talking about our front-line workers and those who are most vulnerable. That needs to be explained and communicated in language that is as clear and comprehensible as possible. It should not necessarily be all medical language and it should be done in multiple languages. English and Irish are not the first languages of many people in the State. In communicating the roll-out of the vaccine, that is especially important.

My next point follows from what Senator Doherty said. We have to look at having a real debate on the social impact of Covid-19. In that regard, I echo what the Leader said. We need to look at investment in sociological research in this area. We need to be able to provide funding through our higher education institutions to research institutes and other agencies to examine the impact this period has had on a variety of areas of Irish life. This could be done through the Health Research Board or other agencies. There will be knock-on consequences from this period we have gone through that we have not even thought about. In that regard, it is essential that we are prepared for this, that we learn from it and that we are able to help those who have suffered during this period, whether through loneliness, loss or whatever. Our higher education institutions have adapted well to cope with all these changes. They have invested in research in this area. Specific funding and support will be important to research the impact of Covid-19.

This period has been challenging and difficult for all of us. It is most important that we give people hope that we will come out of this. I put it to the Minster of State that in communicating the messages - I mentioned the message relating to vaccines and so on - we talk about the fact that, as a people, we have shown incredible resilience. We have shown that we can achieve a great deal together when we co-operate. It will be important that we use the meitheal or co-operation we have seen during this difficult period to address our other problems.

I wish the Minister of State well in the next period. I echo the comments made around communications being important. We need to address the importance of vaccines and investment in research in this area. More important, this is about building on the resilience that our people have shown in this period.

Annie Hoey (Labour)
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The issues I will raise are not those I thought I would be talking about.This morning we had the first meeting of the Sub-Committee on Mental Health of the Joint Committee on Health. Senator Black is not here at present, but I commend her on getting that committee set up. We had a fruitful discussion about mental health during Covid and the knock-on effects that we will see for society and our mental services beyond Covid. I will mostly talk about some of the issues we discussed this morning. We have had reference to mental health already.

An interesting point that came up was around accessing mental health services at present. The group talking to the sub-committee was Mental Health Reform. It feels that those with mental health difficulties are less likely currently during Covid to reach out to seek help with pre-existing mental health conditions. I was taken aback by that. This is a very difficult period for people. Everyone is struggling through this, and when the group said that, it was the first time I had heard that it feels that people who have pre-existing mental health difficulties have been reticent to come forward.

We went on to discuss accessing mental health services post Covid or towards the end of it. We have not had in living memory perhaps such a far-reaching collective experience as a nation of struggle and difficulty, and everyone being in the same boat, while simultaneously having the most individual and isolating experience. I certainly do not recall us having such a collective experience and I hope I never have to again. We discussed how we are putting out messages about how to keep oneself well that will possibly have an impact on people feeling that they can come forward and say that this has been hard and it is affecting their mental health. We are all listing to the podcasts, baking the banana bread, going on our walks and doing all of our things, but that will not be enough for many people. While we are all saying that we should pull ourselves together, we are all in this together and everyone should put their best foot forward, we discussed earlier how that will impact people feeling a stigma around coming forward. There is a lot of stigma around mental health as it is. We are constantly trying to encourage people to talk about it, but it was a very interesting discussion around how we have all gone through this and put our best forward.

I am interested to know if there are any plans, not that the Minister of State has to answer me right now on this issue. In that context, however, I wish to flag to him that we may need to think about mental health and how we are accessing people in a different way. While we are putting out the message of collectivism and we are all in this together, that may result in people feeling that they do not have a right or a reason to put themselves forward to say that they are struggling with this. I just thought I would flag that with the Minister of State.

We talked about expenditure on mental health as an investment. I would say it is an investment when we invest in mental health services, not a cost. It becomes a cost when people cannot access services. It becomes a cost to them personally and to the people around them - their friends or their family. Then it becomes, I would say, a cost to the State because it becomes more costly to treat people with mental health difficulties the longer it takes for them to access them. I thought I would flag that we need to have a strong plan of focus on mental health going forward.

Reflecting on the Keep Well campaign that launched a month ago, that involves real steps that we all can take. I can look on that website and recognise a suggestion for me to do, but we need to make sure that there are a series of things that are beyond the things that I can do within my own daily realm of well-being and life. This investment is important.

Someone said at the subcommittee earlier that the fourth wave of Covid, which they think will be the largest and longest wave of Covid, will be the mental health wave that comes afterwards. While we prepare for exiting out of Covid, that is what I want to emphasise because it was the first meeting of the Sub-committee on Mental Health today and it was such a brilliant discussion. I would recommend it, if anyone wanted to listen in on it. Mental Health Reform was brilliant in talking us through a litany of issues. It was a brilliant subcommittee meeting this morning. We really need to prepare, and we have to move quite quickly in making plans for what will come at the other side of Covid.

I will quickly hop on to the almost weekly waltz I have with the Minister of State concerning our front-line workers and the respect and pay we give to them. We cannot come out of the global pandemic where we have all been lauding our front-line workers, where we have all stood at our front doors clapping, where we have put candles in the windows and where we have done all of the things that we can do and not have a fundamental shift in how we treat, appreciate and value our front-line workers in terms of their pay and working conditions. I cannot, and I would certainly think that no one else here would, stand over us continuing to treat them they way we do. Of course, I will put in my pitch, as I do every week with the Minister of State, for our student nurses. They are on the front line, they are not being paid, and they are on the Covid wards. I would hope, as we look at our plan for exiting out of Covid, that we really think about how we value and treat the front-line workers who got us through it.

Fintan Warfield (Sinn Fein)
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I add my voice to many of the comments, particularly from Senator Hoey, in terms of front-line workers and, as the Minister of State stated, to remember that more than 71,000 people in the State have tested positive and to remember the 2,000 people who have died.

I welcome the progress on developing a vaccine. We have now several viable contenders which hope to be able to distribute a vaccine in the first quarter of next year. Vaccine availability, while a few months off, will come quickly and we need to be as ready as possible to hit the ground running in that regard.

I wanted to include in my contribution a particular ask of the Minister of State, Deputy Feighan. I know he has done good work in terms of keeping addiction and outreach services open. The Minister of State at the Department of Health has always had a particular interest in sexual health and from mental health to sexual health, to give it some hearing in these Houses, I would like him, having written to the HSE a couple of weeks ago, to ensure that the HSE reopens the gay men's health service in the Meath hospital as a matter of urgency. I am hugely concerned about its continued closure. It is the only statutory public health service for gay and bisexual men who have sex with men and the trans community. Since its establishment 28 years ago, it has provided a range of services that now include a full sexual health service, a pre-exposure prophylaxis, PrEP, service, a hepatitis A and B and HPV vaccine programme, and counselling as well. We all know that STI tests and HIV tests cost a considerable amount of money privately. The staff in the gay men's health service, GMHS, are world class, and I have first-hand experience of that.

The service was closed in March to enable the redeployment of staff to Covid-19 test centres. Most other public sexual health services, as I understand it, are also closed as staff have been redeployed to the Covid-19 response, but some of them have since reopened with reduced capacity. The services at GMHS were availed of by 12,000 last year. It is extremely important work. The fight against HIV in Ireland depends on it. Various language services in the health sector were mentioned by Senator Byrne. I am especially concerned about vulnerable groups in the community - young men, sex workers, migrants - as members of these groups generally face more difficulties in accessing services and treatment. I would ask the Minister of State to talk to the HSE to ensure that the GMHS is reopened as a matter of urgency.

Jerry Buttimer (Fine Gael)
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I thank the Leader for having this debate, which I requested. I am glad it is broken up into two parts.

Conscious of the 2,033 people who have died and the thousands of people who have tested positive, I am mindful of the gargantuan work being undertaken in our hospitals and in community care settings by our public servants.This debate is important. Earlier this week, I was walking in the gates of Leinster House and I met a man who had Covid-19 last April, and he told me that he still to this day is affected by it. That is the backdrop to this debate.

Senators Hoey and Boyhan very eloquently spoke about mental health. If we were to undertake an analysis of the world, the collective mental health of people has been severely impacted by this pandemic. Therefore, there is a real need to have a conversation about mental health. I am conscious that we are in a dilemma and that we are at a crossroads in our society about the competing demands of public health and of business. There is a balance that we need to achieve. I am mindful that we have had the good news of vaccines being announced but I am also conscious that, today, AstraZenaca acknowledged there are manufacturing errors in its vaccine. Let us look at that.

I know I am semi-detached from Government, although not really. I want to make this appeal as an ordinary citizen on behalf of many who are petrified, who are afraid who turn on the six o'clock news or the 5.30 p.m. news to get the numbers of the day, and to hear the public press conference. I appeal to Ministers and the representatives of NPHET to stop flying kites in the media. The selective releasing of information is not good enough. We are feeding a beast, and we should not. Let us make our decisions and announce them, and do so on behalf of the citizens and the public servants of our country. There is a need for Government and NPHET to work together and to have differences, absolutely, but we must have a roadmap whereby we can coexist with Covid-19.

Senator Doherty is right when she speaks about the whole issue of contact tracing. I made this point here two weeks ago. There are people to this day who have not had a phone call from contact tracers. There are people to this day who have not had a scintilla of information from the HSE. There is confusion around messaging, which there should not be.

I am extremely conscious that everyone is trying to do their best. However, as the Minister of State has testified, we are focused on Healthy Ireland, the well-being of people and the holistic approach to looking after each other. One of the positives of Covid-19, and I do not mean this to sound controversial, has been the re-emergence of community. The "meitheal" without being a meitheal has been reformed, if Members understand me. People are now looking in on one another. The act of neighbourliness has become part of our daily routine and whereas it was gone before, now it is back. Cork City Council won an award today from Chambers Ireland on the whole issue of community - the gathering of people without gathering, if Members knows what I mean.

There needs to be confidence around contact tracing. I very much welcome the appointment of Professor Brian MacCraith and the whole issue around vaccine supply. I wish him well. I appeal to the Minister of State, as somebody who understands people, that the vaccine supply group that Professor MacCraith chairs has to succeed. We cannot go back to the old days of, dare I say it, Joe Jacob and the iodine tablets. We must move on from that and we must be prepared to plan. Look at what is happening in America, with Joe Biden, the incoming President, and his corona task force planning. Planning is critical.

There are people today in nursing homes who cannot have a visit from a loved one and people who are working tirelessly for all of us. It is our job to work to support them. It is the Government's job to govern. Please let us not do so by the selective giving of information.

Mary Fitzpatrick (Fianna Fail)
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I thank the Minister of State for coming to the House for this important debate. We appreciate his time as there are enormous demands on him and his Department. His Department is to be commended, along with NPHET and all of government, for the continuing efforts and outstanding commitment to helping our country tackle and survive this pandemic.

Before I say anything else, it is important to not lose sight of the thousands of people who have lost their lives, and the many thousands of their friends and families who have been bereaved, the many thousands who have been infected with this terrible virus, and all those who work on the front line - our nurses and doctors, but also our bus drivers, binmen, postal workers and gardaí. It has been tremendous the courage that all of those people have demonstrated, and their courage has encouraged all of us to do our best. I point to the Community Call response, co-ordinated by our local authorities and the GAA. In my own constituency of Dublin Central, Oliver Plunkett’s, Na Fianna and St. Finbar’s GAA clubs have all worked with Dublin City Council and volunteers. That has given people hope and confidence as well.

We have talked a lot today about mental health. I was talking to a GP recently in Glasnevin who, completely spontaneously, commented to me how he had never witnessed in his long career such elevated levels of anxiety among his patients. He specifically said it involved patients of all ages. He talked about how elderly people experienced the isolation of doing the right thing, of keeping their distance and of confining their movements to the home, the bare essentials and the absolutely necessary journeys. He spoke of the very young people and the parents of toddlers, pre-school and early school going children, and the fact that three-year-olds and four-year-olds know what the virus is. When there was a lifting of restrictions and they could potentially see their grandparents again, they were saying, "The virus must be gone. The flu must be gone." There are also the young adults.

Everybody is doing their best and we are all pulling together, and there is no doubt the Government and NPHET have been a huge support to us all. We have to recognise that the achievement of getting Ireland to having the second lowest level of infection is a tremendous achievement for us all - it is a huge achievement against such an insidious virus. As we look to the opening in the next month coming up to Christmas, the Government has big decisions to make to help guide us over this Christmas period. That is all the Government can do: it can really just guide us. We all have to wash our hands, keep our distance and wear our masks. The Government cannot come and police that, and I think it largely recognises that.

The Minister of State will be involved in the debates among the Cabinet. Who would want to be in their shoes, having to make these choices and issue the guidelines? We all want a Christmas and I am sure the members of Cabinet want a Christmas as much as anybody else.The main thing that people are saying is that they have all got into the habit of taking responsibility, so can the Oireachtas look at managed settings and places that people can go to and behave in a responsible manner? That includes churches, gyms and playing pitches. People have been allowed to train for juvenile sports but they should be allowed to recommence competitive matches.

One knows the good, real pubs in Dublin from seeing that they are professionally-run, with a professional barman and no bouncer or security at the door, because the barman knows his job and can smell trouble from outside the door and will not allow it in. He cannot see or smell the virus. These are mostly family-run pubs. They have been closed since March. I am thinking of families such as the O'Gara, Hughes, Hedigan, Kavanagh and Walsh families. These are Dublin families who have been left without anything. The people who are living in their communities want to have some access to socialising but do not want to resort to ordering kegs and taps to their home, as some irresponsible people are, and having pints, drinking along the canals and streets. That unregulated, unmanaged socialising has to be recognised and maybe we should trust the professionals.

I would appreciate if the Minister of State could refer in his response to how the health service is using all of the funds that have been provided and how that will look as we exit the lockdown. On tracking and tracing, on two occasions, I have had to be tested, not because I was infected, since I tested negative, but because of people I spent time with. I commend that service. It is a well-functioning, efficient service, between the scheduling of the appointment, texting and follow-up. I commend those involved in its provision.

Micheál Carrigy (Fine Gael)
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I welcome the Minister of State. I echo the comments of a number of Senators paying tribute to staff in front-line services, in hospitals, care homes, An Post, the gardaí and carers, who we sometimes forget. They are the people who work with the HSE and go into the homes of elderly people seven days a week. It is important to pay tribute to them for the work that they have done and the care that they have given to so many elderly people. I echo Senator Hoey's comments and mentioned a couple of weeks ago that we have many student nurses who are working in hospitals but are not being paid. I do not think that is fair. Student gardaí are paid when they are doing probationary work, etc., whereas the nurses who have gone into hospitals are not getting paid and are not allowed to work in other settings where they would have been earning money to put themselves through college. That needs to be looked at.

I will address two areas in the health sector that have been affected by Covid, and I think there will be consequences long afterwards. I spoke about it this morning and they are the lack of speech and language therapy and occupational therapy, and services for younger people. I refer to a figure from September, that more than 21,000 people under the age of 17 are waiting for a first occupational therapy assessment. While we understand that Covid has put many services on hold, we were told by the Minister that much work has been done to recruit people into services, to track and trace and to swab, so that those front-line people can get back and assess young children who need assessment. However, we cannot see this on the ground. Occupational therapists and speech and language therapists who are supposed to be dealing with those children have spent the past seven months doing contact tracing in the HSE. How many of them have returned to their positions? I do not think any have. As far as I can see, until this is done, this already serious situation will get worse.

I was at a meeting for the CHO 8 area which I live in, in Longford, Westmeath and Meath. Twelve people were employed when the call went out last September to employ new people so that we could bring the specialists back into the services. Only 12 people were employed but all of them had to be kept tracking and tracing, including the speech and language therapists and occupational therapists. Nobody came back on to the front line to assess those kids that needed it. We will have a serious problem after that. I spoke with numerous parents in my own county, Longford. These are real families and real people. Each number on the waiting list is a child and a family desperately seeking evaluation. I ask that this be addressed immediately.

On the issue of alcohol, I always firmly believed that the pubs should have been open. We have driven alcohol consumption nearly underground. We have not brought in the legislation for minimum pricing for alcohol, and we have cheap drink on sale in off-licences, which have not closed. We have closed our pubs, which are regulated, and now we have underground drinking and parties in houses, which many cases are coming from. If we were in a regulated setting, this would not have happened. That legislation for minimum pricing for alcohol will have to be brought in quickly because I think we will see a serious problem with drink come out of this. We have seen an increase in domestic violence and much of this is attributed to a high use of alcohol available at a cheap price.

An issue that is quite personal to me is visitation to care homes over the past eight months. I have personal knowledge of it. My late mother was in hospital throughout this period and we as a family found it extremely difficult when we could not visit a loved one at any stage. We went for a number of months where we had only one or two visits where we physically saw her. The same thing happened in the nursing home. I compliment its staff on the care that they gave, not just to her but to all the patients. It is extremely difficult for families. Many families have suffered greatly because of that. We are extremely grateful to the home where my mother was that we got in in the past couple of weeks before she passed away, with a concession from the HSE, but many families were not able to get that. The effect that it has on the person who is sick and also on their family needs to be looked at.

Many issues will have to be dealt with post Covid and I look forward to working with the Minister of State. I ask that when this is all over in 12 months or whenever it is, that we look back, develop a plan, learn from the mistakes that we have made and make sure that we have a plan in place in case something like this ever happens again.

Fiona O'Loughlin (Fianna Fail)
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There is no doubt that the past few months have been the most difficult that we have ever seen, with difficult political decisions that had to be made regarding Covid. They had to be made quickly while not knowing what was coming down the line but we had a sense of what had happened before and what we had seen in China and Italy. There was an effort to save our citizens and give everybody the best opportunity to be healthy. It was all difficult, particularly with regard to the Department of Health. We have to thank those who led us through the crisis and once again give our thanks to all those in medical professions on the front line, and of course those in our food shops and teaching in schools. We are anticipating announcements over the next 24 hours about where we will be in the next few weeks.It is a very difficult place to be for those in Cabinet making that decision and for those who are providing advice, particularly NPHET. I said it before and I say it again, while NPHET is giving great service to the country, it is risk averse. Its job is to give the worst possible scenario. Now more than ever, political decisions need to be made, absolutely based on NPHET's advice, but that must not be the sole voice in deciding where we go over the next few weeks. Now is when businesses should be at their busiest and they are still closed. All going well, they will hopefully be open next week and will remain open. Next week, we also hope to see the reopening of cinemas, hotels, gyms, etc., and, from what we hear, pubs and restaurants will open the following week.

Obviously, the speculation is that only gastropubs, with their own kitchens and chefs, will be allowed open. I think that is completely wrong. Many of our villages and small towns have no pubs with such facilities. There will be places where none of the hospitality industry will be open. People need to have the opportunity to socialise, albeit in a very limited way with family and friends in their community because they have really suffered over recent months. The suggestion of pubs possibly closing at 10 p.m. and restricting the number of occupants is fine. No house party could ever be as safe as being in a properly regulated environment. Previously, some pubs opened by bringing in pizzas, fish, burgers and chips. It is completely wrong that they would not be allowed to open because they do not have kitchen.s All pubs and restaurants should open with regulations and of course with restrictions. If young people cannot go to pubs, they will continue to go to house parties, which is to the detriment of us all. We need to bear in mind that a significant number of jobs are at risk.

It is really important that places of worship should open. By their nature, our churches and other places of worship are very large buildings and are ideally suited to maintaining social distancing. For many older people, going to Mass is part of the social structure of their lives. It is where they get to see friends and acquaintances and get to check in on one another, and particularly on vulnerable members of the community. The closure of these churches has left a gaping hole in their lives. At an online meeting involving the Taoiseach and Irish Church Together, all religious leaders committed to taking the necessary precautions.

In Ireland, our sense of family and community is one of the things that defines us. We must put our trust in people to behave responsibly. We need to allow them to live positive and meaningful lives as we continue to battle this virus. We know there is good news on the horizon in terms of the vaccines. It was wonderful to see Teresa Lambe from Kildare, a professor at Oxford, being interviewed about her input into one of these vaccines.

As we head towards Christmas, we owe an enormous debt of gratitude to many people who have put in so much work over recent months. We also want to allow those people who have worked so hard to have some respite and the opportunity to spend a small amount of time to catch up with others.

Aisling Dolan (Fine Gael)
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Our first priority is to save lives. We are in a battle against Covid and every measure we take, every response and every part of our national armour is to protect Irish people and families. It is the worst crisis we have faced in generations. I think of the more than 2,000 families who have lost loved ones, of people who have gone to funerals with limited numbers and of people who cannot hug during a period of grief. We stand together with them. Ireland stands united in this battle. I pay tribute to everyone who has adhered to the rules relating to this lockdown. I know the challenges and difficulties of loneliness and isolation. I know the impact on businesses and the stress that loss of income puts on families. I know the anxiety that everyone feels every day and the fear of spreading Covid. I know sometimes the load feels too much to bear, but the end is in sight.

Thanks to the response of our public health advisers, through NPHET, and that of the Government, Ireland is one of the leaders in Europe. Only Finland and Iceland have lower numbers. In the next day or so we will hear positive news for people in Ireland to move out of level 5, as we all hope and wish for, and to have more normality as Christmas approaches. However, our guard needs to stay up. Our job is to keep people out of hospital.

The Minister of State, Deputy Feighan, is here today. What is the advertising campaign for the winter flu vaccine, which is a major part of keeping older people out of hospital? There has only been a 20% uptake rate in respect of a free vaccine. Nursing homes have also been mentioned. I think of one close to my home. What further measures has the HSE put in place to ensure an immediate response to any new outbreaks? It should not take Twitter to ensure that we get a response.

This morning, I was very proud to speak at the very first meeting of the Oireachtas Sub-Committee on Mental Health, chaired by Senator Black. We heard from representatives from the Mental Health Reform group. I am very happy that the Government has allocated €1 billion in respect of mental health, an increase of more than €50 million on last year's budget. It comprises €38 million for new measures, including a continuation of the Covid-19 supports. However, Jigsaw notes a 50% increase in referrals. The HSE's child and adolescent mental health service has also noted an increase in referrals. In what way can we help with an online, print and television campaign regarding how people of all ages can reach out? There is a very dark aspect to mental health at the moment. I remind people to text "hello" to 50808 or log on to mentalhealth.ie for help.

How are we working with eHealth to access technologies to support reducing the numbers on our waiting lists for acute interventions? I know Healthy Ireland falls within the brief of the Minister of State. What policies does Healthy Ireland have to keep people in good mental health?

Scientists and researchers in our colleges and universities are working together to find a solution. Research will save lives across pharma, medtech and healthcare. Safety and efficacy are crucial for the vaccines they are working on. The way we roll out the vaccine is crucial. We need to work with the community on the uptake of these vaccines. The European Medicines Agency needs to be given the time and space to approve the right vaccine for us to go forward with. What plans does the Government have to inform and build awareness and hope for the vaccine? What area of the HSE will be involved in managing the communications on the vaccine to ensure good uptake?

I offer my thanks to the Leader, Senator Doherty, in her previous role as a Minister, and to all of those who stepped up at a time of crisis. I thank all the heroes and volunteers in our communities who help others in challenging situations. I thank our healthcare and front-line staff who have been going non-stop since March and have done Trojan work. The best of us are working to keep people safe and to keep our country running.It is to know that the measures taken by the Government are to put people first. There will be a better year in 2021. We will get through this, and we will have an approved and safe vaccine. Until then, I thank all those who are working to do their best for us.

Garret Ahearn (Fine Gael)
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I thank the Minister of State for attending. When the Minister of State, Deputy Damien English, was in the Chamber, I touched on one topic in my contribution and I thought it would be important to bring it up with the Minister of State, Deputy Feighan. My colleague, Senator Carrigy, spoke extremely well about his experience of nursing homes and caring for people. It has been an extraordinarily difficult time in many sectors of society and for many groups but it is very important to highlight the situation of individuals in nursing homes in the past couple of months. Since we went into the level 5 restrictions, they have not been able to have any visitors. The Government will make announcements tomorrow and there will be a lot of talk of hotels and pubs, and I am as guilty as anyone else in focusing on those, but behind it all, one of the most serious issues is people who are very lonely in an environment where they are well looked after by people who do fantastic work and where they enjoy being most of the time but who miss their families. It is vitally important at Christmas time that they get a visit from either a close family member or, if they do not have one, a neighbour or a guardian who is very close to them. It is something we need to consider that will make a very big difference because people in that situation have had a very difficult time. They are very lonely. They know they are in a vulnerable position. They know of nursing homes that have had outbreaks. They know it can happen to them at any time and they have not been able to confide in their family, friends or community. I urge the Minister of State to use his influence, if he can, to make it possible in some way for families to meet, even if it is one or two family members, in a nursing home during the Christmas period. We have a next door neighbour who has been in a nursing home for a long number of months and he has not been able to meet his brother. They are both in their late 80s and they are lost without each other's company. Everyone will focus on the economy, and rightly so, but there is also a human aspect to this.

I thank the Minister of State for his presence and the Acting Chairman for the time.

John McGahon (Fine Gael)
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I want to focus on three issues in my remarks. The first is what I would describe as a public relations strategy that will combat vaccine scepticism. We have seen reports in the past week alone that one third of Irish people are wary about the vaccine. A total of 12% of people believe they will not take it. If a vaccine were to be introduced into Ireland that had, say, a 90% effective rate we will need 85% of the population to take that vaccine for it to have any sort of effect. It is very important that we make it clear-cut and obvious that this vaccine is safe to take, that it has to be taken for the greater good, and that there will not be any problem with it. That will be a difficult task because we have seen the issue trending on social media. Conspiracy theories, downright lies and whatever can take hold of the pubic imagination and, for want of a better description, spread like wildfire. As Senator Malcolm Byrne said earlier, we need a clear, pro-science approach based on logic and data that will show that we have to take the vaccine and that it has to be done as soon as possible.

The second issue I want to focus on is what I spoke about earlier in the week in the Seanad, which is the roll-out strategy for getting out the vaccine across the entire population. That can be done in a couple of ways. In the first instance, when the Taoiseach brings this to Government on 11 December, as he said he wants to do, that should be published for the public at large. That would be very welcome coming out of this lockdown because it would show people that there is real light at the end of the tunnel, that this is the vaccine roll-out strategy, this is what we intend to do to get it through our population, and that these are the timeframes and targets for when we want to do it. That would give solace to people going into December and the Christmas period and into early January. The roll-out strategy should involve a list of tiers of people we will vaccinate first, namely, the most vulnerable, the elderly, healthcare workers and people working in front-line jobs. We would work down the list in that way. We want to have those people vaccinated by certain dates to ensure there is a clear trajectory and timeline whereby people can say that X number of the population will be vaccinated by the end of January, X number will be vaccinated by the end of February and so on. That would be a good idea in terms of reassuring people on 11 December.

My final point relates to the concept of lockdown strategies. I am torn about that. On one level it is easy to listen to people who say we need to open this or that or do this or that. It is clear that this virus thrives in crowded places. That is the one aspect we know about it. It will be another two years before countries across the world can sit down and say that Ireland, New Zealand or Sweden did it right when clear, clinical data will be available to people. That is the only time when the world will be able to say that this or that country got it right or this or that country could have done better. Like every other country in the world, we are dealing with something that is unprecedented; we have never seen it before. That has to be acknowledged.s

Lockdowns are a blunt strategy but at this point in time they are the most effective strategy available to us. I would much rather be at level 3 and the concept of a third lockdown, possibly next year, has to be forgotten. I do not believe that is feasible because the virus has changed so much since March of this year. We know much more about it. We should not be necessitating lockdowns based on the metrics of case numbers given by RTÉ and so on every night. Lockdowns should not be decided upon case numbers. If the point is to live alongside Covid-19, as a society we should be happy with restrictions and case numbers bubbling around at a certain level. I do not believe that necessitates putting the entire country into a stricter lockdown. We did it this time. I backed that, but I believe we would find it extremely difficult to get public buy-in for that a third time around. However, if we have a clear vaccine roll-out strategy that would allow us tell people that this is the final extra time, as such, in this Covid nightmare that started nearly ten months ago, it would give people much more confidence to buy into anything else that is coming down the road.

Aisling Dolan (Fine Gael)
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I thank Senator McGahon, and all other Senators, for their contributions on reopening Ireland and the Government's response. I want to acknowledge the comments of Senator Carrigy on the loss of his mother. Our thoughts are with him. I ask the Minister of State, Deputy Frankie Feighan, to respond.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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How much time do I have?

Aisling Dolan (Fine Gael)
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The Minister of State has 45 minutes, if he wishes to use it all.

Fintan Warfield (Sinn Fein)
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He has to answer our questions.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Senator Warfield. I also thank all the Senators for their contributions to this debate on Covid-19. It is clear that we have a common goal of reopening Ireland safely. While we would like to open Ireland completely at this time, unfortunately, that is not possible. The virus is still circulating in our community and while at large, it poses a very real threat to all of us, particularly those who are most vulnerable.As referenced earlier, 71,000 cases of Covid-19 have been detected in Ireland, with 2,000 deaths, sadly. Worldwide, there have been more than 59 million cases of the disease reported to the World Health Organization, with the number of deaths standing at almost 1.4 million. Many countries have seen significant challenges in their response to this disease, with some facing impacts on their healthcare systems as capacity is stretched with cases requiring hospitalisation. Thankfully, we are not yet at that level in Ireland, but it is precisely the type of scenario that we are trying to avoid. As such, any new measures will require careful consideration of what can be safely opened in society without increasing the risk that case numbers will increase dramatically.

We know that this disease has had a significant international impact, and as of 23 November 2020, in a group which includes the EU, EEA and the UK, Ireland ranks 29th in respect of the 14-day case notification rate. In Europe, only Finland has a lower 14-day incidence rate, and our 14-day incidence rate has fallen from 309.9 just over four weeks ago to 108.7. While we have made significant progress in Ireland over recent weeks, we know that it is possible to reduce case numbers from our experience earlier in the year.

As we approach the Christmas and holiday season, we need everyone to follow the public health advice so as to limit the transmission of Covid-19 in Ireland and protect those who are most vulnerable in our families and communities. We are urging the public to combat the disease by limiting their number of daily contacts. People should work from home and stay at home as much as possible. A small additional effort to reduce our contacts will make a big difference to reducing the incidence of the disease before 1 December. We are also asking that those who have been deemed to be close contacts take up the offer of testing when advised to do so. This will improve our ability to reduce the risk of onward transmission of the disease.

The HSE has put in place a robust testing and tracing strategy, and our testing programme has expanded enormously since the onset of the crisis. We now have the capacity to undertake up to 140,000 tests per week, and in excess of 1.8 million tests have been done since the pandemic began. We are continuing to undertake serial testing of all staff in nursing homes and in the food production sector while also performing mass testing where it is required. If we do those things, it will give us the best chance to continue to suppress the virus until vaccines are widely available.

When the virus is transmitting, there is a direct link between the numbers getting infected, the numbers being hospitalised and then subsequently admitted to intensive care units, and the number of people who, sadly, pass away. This is why the Government has taken extensive measures throughout the pandemic to limit the transmission of the virus when required to ensure that we have not had a situation where our hospitals and intensive care units have been overrun. Such a situation would not only impact on those needing treatment for Covid-19, it would also impact upon those needing to access hospital for the treatment of other diseases and in emergencies.

I acknowledge again the work undertaken by the public sector and by employers across the economy in working with us to ensure that measures have been implemented safely over the past year. I thank the Senators for the contributions they have made today. Senator Boyhan raised the issues of physical and mental health, businesses, and nursing homes in the context of the pandemic. He also raised the issue of the Keeping Well campaign that we launched on 29 October, with a focus on the physical and mental health, the five tenets of which are keeping active, staying connected, switching off, eating well and minding one's mood. Effectively, what we are trying to do with this programme is to get those at home or in different situations to reflect on their mental health. The campaign works with others in the area doing things such as community calls, and they have been very helpful. However, it has been a difficult time for everyone and their mental health.

There are a range of funded efforts in place in the area of mental health, including the provision of online and telephone counselling through NGOs. The national psychosocial response framework focuses on the impact of Covid-19, and the Minister of State, Deputy Butler, in collaboration with the Department of Education, recently launched the winter health support leaflet for young people.

Senator Doherty raised the issue of nursing homes and also testing and tracing, which was mentioned by others. As I said previously, we have the capacity to complete a total of 140,000 tests per week. I thank the German lab which has supported us in this effort. As a member state of the EU, we can enjoy such support, and we are not competing with bigger countries in respect of accessing a vaccine, because there is an exchange of knowledge and information through the EU and the WHO. In the context of a pandemic, the importance of being part of an international group becomes clear. As regards contact tracing, there are now more than 700 people undertaking this work and in excess of 1,000 working in swabbing.

Senator Byrne rightly talked about vaccines and made the point that information on any vaccine should be issued in multiple languages, which is very reasonable. He also mentioned the Health Research Board, an organisation with which I have had contact. It is very active, does great work, and provides advice and information on where this country is going in relation to health issues. It is good to have accredited information at our disposal. Within the EU we are involved in the procurement exercise for vaccines and the EU is seeking to develop a portfolio of different vaccines. The preparation for the Covid-19 vaccine programme has been completed and the programme will be rolled out as soon as vaccines become available, and across Government a task force has been established to oversee and support the immunisation programme.

Senators Hoey and Warfield spoke about front-line workers and highlighted the importance of treating them well, particularly student nurses. The Irish Nurses and Midwives Organisation and student nurses have raised the issue of student nurses' pay, and the Minister for Health, Deputy Donnelly, is considering proposals to support student nurses further to continue clinical learning, and we hope we can work on that. Senator Warfield also raised the issue of gay men's health services in the old Meath hospital. I have emailed the hospital for a response on the issue and I will get back to the Senator as quickly as possible. I thank him for raising that important issue.

Senator Buttimer raised the issues of contact tracing and supplies of the Covid-19 vaccine. Again, I think I have already addressed that to a certain extent.

Senator Fitzpatrick talked about Christmas, young people and the virus, following the guidelines and practising good hygiene etiquette. I would say that the Government cannot wash people's hands for them, so there has to be buy-in from the public. I thank the 99% of people who have worked with the Government and together with their families and communities, because they have saved lives. However, there are people out there who have their own information and it seems that everyone becomes a virologist overnight after going on the Internet. It was the same when we experienced the downturn in the economy and the country was in peril, and everybody was an economist. I like to get my information and take my advice from health professionals and people who know their stuff, and that is what the Government is doing. It is taking that advice and then we have to make those important decisions.However, it will be a Christmas like no other. With regard to pubs, churches, gyms and pitches, it is a difficult time for everybody.

Senator Carrigy talked about the really difficult times in nursing homes, the student nurses and about alcohol and minimum unit pricing, which is an issue under my Department. Many of the staff dealing with alcohol and tobacco were dealing with the Covid crisis. They are back now. I would love to bring in the minimum unit alcohol pricing. We want to bring it in and we feel it is necessary. There is an issue, which is that we are waiting on the jurisdiction in the North of Ireland to come with us. They are working on that and I hope that, early in the new year, we will be in a position to work with our colleagues in Northern Ireland. It is the wrong time in the Covid-19 crisis to bring that in but I would not like to bring it in unless we are working with our colleagues. It might send out the wrong signal as we want to work this on an all-island basis. It is on the top of our agenda to get it in. I pay tribute to the staff in my Department who are working extremely hard so we are all on the same page. It was introduced in Scotland, and in Glasgow it reduced alcohol purchases by 8%. Furthermore, it reduced deaths directly related to alcohol by 20%. The Senator is right regarding cheap alcohol that targets vulnerable people. Minimum pricing will increase the price but we are trying to affect vulnerable people who will abuse alcohol. We want to bring it in and there is a huge push to get that sorted.

On care homes, the Senator rightly said the passing away of his mother in that nursing home was a huge strain on his family. I cannot imagine the strain and hurt that it caused. The Senator addressed it and said that families are going through huge issues. It is something we need to work on but I thank the Senator for articulating that as sensitively as he could.

Senator O'Loughlin talked about pubs and places of worship. I congratulate and thank the Taoiseach for meeting with church leaders and faith leaders. They genuinely want to open up the places of worship. I have seen first hand that they have put the necessary restrictions in place to protect the public. I would like to think that in the coming weeks that work will be acknowledged and the churches will be allowed to open. However, we have to rely on NPHET and it will be a decision for the Cabinet sub-committee.

Senator Dolan talked about grief, funerals and the winter flu vaccine. I got the winter flu vaccine. I had to wait two or three weeks for it. I have always said it is something that, at a certain age, we all should get. Especially now with Covid, there are huge implications if the winter flu takes hold. It is important.

Aisling Dolan (Fine Gael)
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Does that include the children's flu vaccine?

Frank Feighan (Sligo-Leitrim, Fine Gael)
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My child got it about a month ago and it seems to be going well but I was not sure about the 20% take-up. We can follow that up. The Acting Chair is on the mental health committee and I praise Senator Black for heading up that committee. It is hugely important and she has done great work on many of those important issues and I wish her well in that committee.

The Acting Chair also praised Senator Doherty. Think of the work the Senator did in her Department when this Covid crisis arose and she was not elected to the Dáil. I pay tribute to her. She was a great leader, along with all the health professionals, front-line staff and all the people in the Department of Health. I am in that Department, having come from a business background, and I am hugely impressed by the talent, commitment and the fact that these are people at the top of their game. I came from a private background, having employed 30 people at one stage. Most of these people in the Department of Health could be put in as CEO of any multinational, not just in Ireland. That goes for most Departments I have seen. We are so thankful for the public servants and front-line staff we have. It is wonderful and I say that without fear or favour.

Visiting guidelines have been introduced to improve the safety of residents and patients. The Government is conscious of these difficulties. The Health Protection Surveillance Centre is reviewing visiting guidelines in tandem with stakeholders, including Nursing Homes Ireland. We are talking about resumption of services and building capacity for winter 2020 and 2021. This is a priority and is under way. The HSE financial allocations for 2021 includes: funding for ongoing Covid response, including personal protective equipment, PPE, and test-tracing; additional capacity for acute and community settings, an increase of 2,600 beds in such settings; increased community care, including home care hours, and enhanced community services; and improved access to care, including alternative pathways.

I come back to Senator Warfield, who spoke about addiction services reopening.

Fintan Warfield (Sinn Fein)
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I commended the Minister of State's work.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I pay tribute to my staff and all the drug and alcohol task forces. There was a collaboration between all the services for people who are homeless, use drugs and so on. It showed the work that was done and I thank the Senator for acknowledging that. I pay tribute to the people in the Department for the work they have done.

The Government will review current level 5 measures and consider the next phase of the response to Covid under the living with Covid plan. This will include consideration of any recommendations from NPHET in this regard, as well as monitoring of the international situation. I urge Members of the House to continue to promote the public health messaging on Covid-19 so the most vulnerable in our society are protected.

I thank all Senators for their vital and valuable contributions. I hope that we continue working together as we have done across parties, across the House and across communities. To all the people out there and their families, I hope they have a peaceful and safe Christmas. Next year is 2021 and we are all looking forward to a different year from the one we are having this year. I hope there is light at the end of the tunnel. Deep down, we are better because there are many opportunities arising out of Covid. We learned how to relax more and enjoy our families more. We have also learned that the simple things in life, such as a walk or fresh air, have been good. There are challenges ahead and we can only face them by working together. I thank Senators.

Aisling Dolan (Fine Gael)
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Hear, hear. I thank the Minister of State, especially for those heartening words at the end. It is true that the end is in sight and 2021 will be a better year for the world, for Ireland and for the families living here. In accordance with the order of the Seanad today, the House stands adjourned until 2 p.m. next Monday.