Cianan Brennan: Covid-19 crisis in nursing homes worryingly familiar

The crisis that Ireland’s nursing homes, which accommodate in the region of 25,000 residents, are facing has played out in worryingly familiar circumstances.
Cianan Brennan: Covid-19 crisis in nursing homes worryingly familiar
The single worst day was April 4, when 19 new nursing home clusters were uncovered in the east and north-east of the country — two of the three worst-hit regions along with the west of Ireland.

The crisis that Ireland’s nursing homes, which accommodate in the region of 25,000 residents, are facing has played out in worryingly familiar circumstances.

Care homes across the globe have been disproportionately impacted by the coronavirus pandemic, particularly in Italy and Spain.

However, while the preparation and performance of the oft-criticised Irish acute health system in the face of the coronavirus storm has been reasonably accomplished, the same cannot be said for the measures put in place in institutions in which some of the country’s most vulnerable citizens reside.

While the Health Protection Surveillance Centre has been publishing daily statistical updates regarding the prevalence of the virus in an Irish context since last month, it is only since the beginning of April that data on nursing homes has been made available.

There are currently at least 236 clusters (a cluster being two or more cases in one place), more than half the number recorded nationwide, in nursing homes and other institutions here, a figure that has grown exponentially since the beginning of April.

In more stark terms, some 245 of the 444 deaths (the figure is 290 when other institutions are accounted for) recorded to date have been in nursing homes or as a referral from same.

That figure, recorded on Wednesday of this week, rose from 156 the previous Friday (the first occasion on which the Department of Health offered a figure for the toll in residential institutions) — a jump of 57% in just five days.

In terms of how the statistics have evolved, on March 30, three weeks after Nursing Homes Ireland advised its members to place a lockdown on all visitors, the number of clusters in Irish nursing homes was just 29, generally on par with the number noted in private homes.

Over the following fortnight, that figure ballooned five times in size to 155.

Over the same time period, the numbers in residential institutions and step-down facilities/community hospitals jumped more than six times from 13 to 81.

The single worst day was April 4, when 19 new nursing home clusters were uncovered in the east and north-east of the country — two of the three worst-hit regions along with the west of Ireland.

However, after a bruising period where never less than seven clusters were noted in care home settings on any one day, things have finally started to settle to an extent.

On April 12 just two new cases were noted. The following day the number was four.

Meanwhile, residential institutions held steady on 58 clusters on the same date — the first time that daily number has remained unchanged since the HPSC began producing the figures.

All of which would indicate that the isolation measures in place, coupled with a change in HSE testing protocols for care homes, are — belatedly — starting to have the desired effect.

    Useful information
  • The HSE have developed an information pack on how to protect yourself and others from coronavirus. Read it here
  • Anyone with symptoms of coronavirus who has been in close contact with a confirmed case in the last 14 days should isolate themselves from other people - this means going into a different, well-ventilated room alone, with a phone; phone their GP, or emergency department - if this is not possible, phone 112 or 999 and in a medical emergency (if you have severe symptoms) phone 112 or 999

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