Coronavirus: Republic reports 22 further deaths, 424 new cases

Some items in weekend personal protection equipment (PPE) consignment ‘not suitable’, HSE confirms

Fianna Fáil spokesperson for health Stephen Donnelly TD highlights how a lack of PPE has lead to positive coronavirus cases in nursing homes and the homecare industry. Video: Oireachtas TV

 

Another 22 patients diagnosed with Covid-19 have died, the highest daily total recorded so far, the National Public Health Emergency Team (NPHET) reported on Friday evening.

The patients included 11 women and 11 men.

Eighteen of the deaths occurred in the east of the country, three in the south and one in the west.

The median age of the deaths reported on Friday is 80, and 16 of the patients were reported as having underlying health conditions.

There have now been a total of 120 coronavirus-related deaths in the Republic; 96 involved patients with underlying conditions and 93 occurred in a “hospital environment”. Fifteen deaths were associated with admission to intensive care.

So far, 156 patients have been admitted to ICU since the outbreak began. Of these, 115 were male and 41 were female. The median age of admission was 63 and 110 remain in ICU. Some 31 patients were discharged and 15 died.

There have now been 4,273 confirmed cases of Covid-19 in Ireland.

Of the 3,655 cases reported up to Wednesday, half were in males and half in females. The median age was 48 years, 28 per cent were hospitalised and just 4 per cent required admission to ICU.

Cases among healthcare workers accounted for 26 per cent of the total and Dublin accounted for 57 per cent of cases.

The NPHET met on Friday to review Ireland’s response to Covid-19 but did not elaborate on any decisions taken at its daily briefing later.

Dr Tony Holohan, chief medical officer said: “We are concerned with the number of clusters identified in nursing homes. We have identified a range of measures, working with the HSE. We need to see continuous actions being taken to reduce the risk of transmission in nursing home and long-term residential facilities.”

Dr Holohan said a range of measures were being implemented to strengthen controls and infection prevention in nursing homes, and to support training. Specific risks had also been identified in some homes and were being followed up.

Dr Ronan Glynn, deputy chief medical officer said: “We are now facing into the end of week one of new measures. It has been a tough adjustment but these efforts save lives. We will continue to protect vulnerable groups against this virus, by staying home and following public health advice. These efforts result in lives saved.

“Anyone over 70 years of age should remain cocooned as per public health advice, and for essential food and prescription shopping, call on family, friends or services to help you. Over 70s should not be leaving home.”

Main points in Covid-19 pandemic on Friday

Dr Colm Henry, HSE chief clinical officer said there was now “a clear picture of more severe illness in older people” and this underlined the importance of advice on cocooning.

Dr Henry said most sampling centre were now “back up and running” after secure supplies were procured.

He said demand for testing had fallen considerably since the case definition for the disease was changed to focus on a “tighter group of people”.

The number of people tested has increased significantly on the 30,000 figure at the start of the week, though Dr Holohan said the new figure would not be disclosed until next Tuesday.

Asked how close to the surge of cases the health system was, Dr Holohan said he did not know.

“We don’t know how successful we will be in controlling the rate of growth of this epidemic. If we continue to grow at 10 per cent we will end up with a significant challenge for the healthcare system.”

The daily growth in cases numbers has dropped from 33 per cent to 10 per cent, he said, but the slower the growth the lower the peak in cases would be and the more “into the future” it will be.

“We think the next seven to 10 days will be crucial in terms of understanding that,” he added. The NPHET should be able to make “more certain estimates” towards the end of next week when the impact of the restrictive measures ordered by the Government become apparent.

“It really will be the better we do, the lower the peak will be [and] the further into the future it will be.”

No clusters of the virus related to the Cheltenham racing festival have been identified, Dr Holohan said.

Meanwhile, some of the new supplies of personal protection equipment (PPE) secured last weekend by the HSE for the fight against the coronavirus outbreak is not suitable for use, the health service has confirmed.

Prof Martin Cormican, consultant microbiologist and HSE national clinical lead for healthcare associated infection and antimicrobial resistance, said at lunchtime that items of personal protective equipment received from a new supplier at the weekend had been looked at by health authorities.

“Some of it is suitable for use, some of it has limited use and some of it is not suitable for use,” he told RTÉ’s News at One.

“It is useful for us to have this new supply line. A good deal of the material will be useful for us. That is really important as it is quite hard internationally to secure this.

“The evaluation that we did indicates that some of the items that we received are not suitable and we will have to work with the supplier to make sure that what we are getting . . . that those items that do not meet our standards, we don’t want to receive any more of those items.

“But that the items that are useful to us, that we need to keep that supply line open.”

Meanwhile, nurses have urged the HSE to introduce a requirement for facemasks to be worn by all staff in healthcare settings.

In a letter to the HSE on Friday, general secretary of the Irish Nurses and Midwives Organisation Phil Ní Sheaghdha said the universal use of surgical masks should be adopted with a view to preventing transmission of infection.

Ms Ní Sheaghdha said: “In the nature of nursing and midwifery care, it is not possible to maintain 2m distances in the course of care provision.”

Alternative PPE

Also on Friday, Minister for Finance Paschal Donohoe said the Government will continue to source alternative PPE for health workers following criticisms of the quality of the items available.

The first Aer Lingus flight to China to collect a batch of PPE for the Irish health service arrived in Dublin on Sunday afternoon. On Friday, Prof Cormican did not specify his comments were in relation to the equipment that arrived on this flight.

On Saturday, Minister for Health Simon Harris said the flight would be the first of upwards of 10 flights carrying PPE, including surgical masks, gowns and eye shields for health service workers.

The HSE had previously admitted that some elements of the first batch of PPE imported from China this week “are not ideal” and suppliers are being notified of this – with the view to issues being resolved with subsequent orders.

On Friday, the National Association of Principals and Deputy Principals called on members to donate their school’s surplus science laboratory personal protective equipment to frontline services.

Nursing home clusters

Meanwhile, the number of outbreaks of coronavirus in nursing homes in the State has jumped to 38, according to the latest figures from the HSE.

The vast majority of clusters detected in nursing homes (29) are in the east; three each are in the midwest and northeast, two are in the west and one in the midlands, according to the epidemiological report from the executive.

A Covid-19 cluster is defined by the HSE as two laboratory-positive cases in an institution.

Concern is growing about the impact of the virus on nursing homes, with Fianna Fáil’s spokesman for health Stephen Donnelly stating that almost 100 staff members and residents in one nursing home have tested positive.

The situation in nursing homes was “very, very serious”, Mr Donnelly said.

“The nursing homes can’t get the staff that they need. They can’t get their hands on personal protective equipment either. They are getting very, very small amounts and it is not enough,” he added.

A surge in coronavirus cases is expected to hit hospitals in the next week or two, the president of the association of emergency medicine has said.

Speaking on RTÉ’s Morning Ireland, Dr Emily O’Conor said she expects the surge will arrive in hospitals in the next week or two and that the surge is being experienced “in nursing homes now”.

At the Government’s Friday morning briefing, Liz Cavanan of the Department of an Taoiseach said some home help hours have been stood down for those who are relatively well and have adequate family support.

These supports are being moved towards more urgent needs, such as long-term residential care.

Friday’s epidemiological report states there are also 31 clusters that originated in private houses and 29 in hospitals. Another 21 are travel-related and 11 are in residential institutions.

The report shows two people aged 25-34 years who were diagnosed with Covid-19 have died, along with one each in the 35-44 and 45-54 age groups.

There have been six fatalities in the 55-64 age group and 81 among people aged 65 and over.

Of the 3,282 laboratory-confirmed cases of Covid-19 up until that point, 91 had died up to Tuesday evening, giving a case fatality rate of 2.77 per cent.

While women slightly outnumber men among confirmed cases, the number of male deaths greatly exceeds deaths among women.

Lockdown

Meanwhile, infectious disease specialist Prof Sam McConkey has said nobody knows how long the lockdown will last, but so far he thinks the country is doing a good job of stopping the spread of Covid-19.

Prof McConkey pointed out that in China restrictions were lifted after 64 days, but he questioned if the level of physical distancing in Ireland was as good as that in China.

“They did a lot of things [in China] that we cannot,” he told Newstalk Breakfast.

The rate of spread of the virus in Ireland has slowed down, he said. He had been alarmed three weeks ago, but now the country was managing the numbers. If the numbers are not maintained at this level then more measures will have to be taken to slow interaction.

“So far we are doing a good job I think.”

At a briefing on Thursday evening, the National Public Health Emergency Team (NPHET) said there had been 13 new fatalities, bringing the total to 98.

There were a further 402 new confirmed cases of Covid-19 in the State as of lunchtime on Thursday, bringing the total number of cases to 3,849.

On Friday, Northern Ireland’s Public Health Agency reported 12 more deaths there, along with an additional 130 confirmed cases of the virus.

Globally, total cases of Covid-19 reached in excess of 1 million, and more than 51,000 people have died so far. The US has the highest number of cases, at 236,339, while Italy remains the worst affected by the outbreak, with 13,915 deaths.

Flattening the curve

In Ireland, cases of Covid-19 are growing at a rate of 10 per cent a day – a sharp reduction from earlier growth rates, which were about 33 per cent. “We have flattened the curve,” chief medical officer Dr Tony Holohan said on Thursday. “But we need to flatten it further.”

While there is some optimism in Government that the shutdown of commercial and social life is succeeding in slowing the spread of the virus, Dr Holohan said there needed to be further progress to avoid a situation in which the number of people requiring intensive care outstrips available beds.

On Thursday, the head of the World Health Organisation’s emergencies programme Mike Ryan said Ireland is doing a good job in setting out the kind of strategy required to “break the chains” of coronavirus.

Economic outlook

The Central Bank has warned that the crisis is likely to blow a €22 billion hole in the State’s finances and could see half a million people losing their jobs.

In its latest quarterly bulletin, published on Friday, it says lost tax revenue and increased spending on various support schemes will see the exchequer move from a €2.2 billion surplus to a €19.6 billion deficit this year.

It predicts the crisis will lead to the loss of up to 500,000 jobs as the economy shrinks by 8.3 per cent.

Exchequer returns, published by the Department of Finance on Thursday, showed that tax receipts for the first quarter of 2020 were €800 million lower than expected, primarily due to a collapse in VAT returns.

Speaking on Friday morning, Minister for Finance Paschal Donohoe said that “many different scenarios” are being examined to accelerate the recovery of the economy when the Covid-19 crisis has passed.

Mr Donohoe told Newstalk Breakfast it would be important to reboot and create a new economy after the crisis.

“It is very clear that we can create a new economy and the country can recover from this,” he said.