Clarity sought on vaccine rollout in nursing home outbreaks

Calls for rapid vaccine rollout for non-Covid cases as more care homes battle outbreaks

 The HSE said on Thursday   there were 142 nursing home Covid-19 outbreaks and it was monitoring 103 closely as many residents await the  rollout of vaccines. Photograph: Dominic Lipinski/PA Wire/Bloomberg

The HSE said on Thursday there were 142 nursing home Covid-19 outbreaks and it was monitoring 103 closely as many residents await the rollout of vaccines. Photograph: Dominic Lipinski/PA Wire/Bloomberg

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Clarity is being urgently sought from State health officials on whether nursing home residents not infected by Covid-19 in significant outbreaks can be vaccinated outside the care facility.

The increase in nursing home outbreaks in the third wave of the pandemic has alarmed relatives of nursing home residents who fear delays in the vaccinations due to an increasing number of outbreaks in residential care facilities as the virus remains at very high levels in the wider community.

Minister of State for Older People Mary Butler told the Dáil on Wednesday that the vaccines will be administered in nursing homes as planned where there is “a small outbreak.”

“However, if there is an outbreak among 50 residents and more than 80 per cent have Covid, a decision may then be taken with regard to health and safety,” Ms Butler told Fine Gael TD Fergus O’Dowd in an exchange in the Dáil.

The HSE said on Thursday that there were 142 nursing home outbreaks and it was monitoring 103 closely. Including all long-term care facilities, there are 279 open outbreaks. The number of new nursing home outbreaks more than doubled to 52 in the week to January 9th.

An outbreak is defined as two or more cases of the disease and it is not declared closed until 28 days have passed from the last positive test.

HSE national director of social care Dr Siobhan Kennelly said that there were 1,200 nursing home staff out sick with Covid-19 or self-isolating because they are a close contact of a case.

“That is causing a significant strain in some nursing homes,” she said.

The number of residential care facilities categorised as “red” in the HSE’s alert system has almost doubled to 29 in seven days, reflecting growing infections in settings for older people.

The Government has accelerated the vaccine rollout to 75,000 nursing home residents and staff by a week to have the first of the two-dose Pfizer-BioNTech vaccine delivered by January 24th.

A person cannot be vaccinated if they have Covid-19 and must wait at least four weeks from when symptoms were first noticed or when they tested positive.

The first dose provides protection between five and 12 days afterwards and a much higher level of protection from the virus after the second dose 21 days later.

Sarah Lennon, executive director of Sage Advocacy, a group that represents older people, has questioned whether the 20 per cent of residents not infected in a significant outbreak could still be vaccinated safely either within the nursing home or by travelling to a location in the community.

“How do we get those people who don’t have the virus vaccinated in those environments. Is there a way?” asked Ms Lennon.

She said there had been considerable anxiety among relatives of nursing home residents awaiting vaccines and the place of certain care facilities in the queue for the vaccines.

Some nursing homes have suffered outbreaks and multiple Covid-related deaths, including Simpson’s Hospital in south Dublin and Droimnín Nursing Home in Stradbally, Co Laois, just weeks out from their residents being vaccinated under the HSE’s programme.

A further four residents with Covid-19 at Droimnín have died, bringing to 10 the number of fatalities related to the virus in an outbreak that struck just over two weeks ago.

Gearoid Brennan, chief executive of Brookhaven Group, owner of the nursing home, said he was trying to rearrange the postponed vaccine rollout at the Co Laois home with the HSE.

“We are just trying to get our own staff and our own residents who are clear of Covid vaccinated in the next couple of days,” he said.

The HSE said on Thursday that “necessary supports” had been put in place to manage another Covid-19 outbreak at Lusk Community Unit, a HSE-run nursing home in north Co Dublin, and that the rollout of the vaccine had begun in the nursing home and that “all residents who wanted the vaccine were facilitated to receive it.”

Mr O’Dowd said that it is “not acceptable” that some nursing home residents not yet infected by Covid-19 would not receive the vaccine because others are infected in a care home outbreak.

“Why should they not get it? It is the only thing that will protect them. They are in a vulnerable category. You cannot ‘percentage’ that away. It is going to kill so many people,” he said.

Tadhg Daly, chief executive of Nursing Home Ireland, which represents private and voluntary nursing homes that make up 80 per cent of the country’s 582 nursing homes, said the only people who should not receive a vaccine were people who have had Covid in the previous four weeks.

“Our view is: bring it on,” he said.

Mr Daly pointed to the importance of proceeding with the vaccination of nursing home staff working in severe Covid-19 outbreaks who had not been infected by the disease.

“The staff have to be protected as well,” he said.

Co Louth man Paul Nugent whose mother is a resident in Blackrock Abbey near Dundalk, another nursing home battling a Covid-19 outbreak with infected residents and staff, called on the Government to fast-track vaccines to care homes with outbreaks. Residents at the Dundalk home are due to receive vaccines on Tuesday.

“Louth is a hotspot for Covid at the minute. They should have had a rapid action force that can come in and inoculate people in homes in Co Louth that haven’t got Covid as soon as possible and give them a chance of surviving and living through this,” said Mr Nugent.

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