The Irish Times view on Covid-19 in nursing homes: protecting the most vulnerable
With infection rates rising, we need to learn the lessons of the spring
Kilminchy Lodge Nursing Home in Portlaoise has confirmed that three residents infected by Covid-19 have died. Photograph: Niall Carson/ PA
A public inquiry to investigate coronavirus deaths in nursing homes, as recommended by the Oireachtas Special Committee on Covid-19 in its final report last week, will serve two important purposes: finding out what went wrong and learning from it to prevent a recurrence.
The deaths of three residents of Kilminchy Lodge Nursing Home in Portlaoise, reported this week, should serve as a stark reminder of the dangers of this virus to our elderly. These latest fatalities underline the importance of looking back at how the virus got into nursing homes in March so that precautions can continue to be taken, especially ahead of the riskiest winter months, to prevent a repeat of mistakes made early in the pandemic.
The people most vulnerable to this coronavirus remain the elderly and particularly those in congregated settings. More than half of the fatalities from the disease in the State have been nursing home residents. Level 3 restrictions have closed nursing homes to visitors, reflecting the risks posed by rising infections.
This contrasts with the view of the National Public Health Emergency Team earlier this year when it said that private nursing homes closed prematurely to visitors on March 6th. This is one of the decisions that the Oireachtas committee wants investigated further at an inquiry.
Among the other areas the committee considers critical are the discharge of patients from hospitals to nursing homes in early March and the decision-making behind them, and how the virus spread in nursing homes due to difficulties finding staff and protective equipment.
Initial shortages of safety equipment and shortcomings in testing exacerbated the negative impact of nursing home outbreaks but, thankfully, for now, appear to have been largely overcome. Serial, fortnightly testing of staff has helped detect the virus before it becomes rampant among residents and this must continue, regardless of any pressure on testing capacity.
The greatest threat remains community transmission. If the virus is prevalent in the wider community, it will be impossible to keep it out of nursing homes. As chief medical officer Dr Tony Holohan said this week, widespread community transmission poses “an existential risk” to people in nursing homes and older age groups. As infections rise, it is essential that further defences be built around such institutions, regardless of whether they are public, private or voluntary. The recommendations of the Department of Health’s nursing home expert group, now almost two months old, must be implemented without delay – all 86 of them – and the health service regulator, Hiqa, should be bolstered with greater powers and resources. There can be no excuses this time.