Nphet told extra protection for unvaccinated in hospitals not always possible

The HSE has told the State’s public health team that it has not always been possible to give extra protection to unvaccinated people in hospitals because of the way they are set up.

During a meeting of the National Public Health Emergency Team (Nphet) on August 25th, members discussed the “disproportionate impact that the current wave of cases is having on those who are unvaccinated or who are experiencing waning immunity” and this was “noted with concern”.

Newly released minutes of the meeting show members discussed hospitalisations and the need to be able to triage vaccinated and unvaccinated patients into “separate streams”.

The HSE confirmed during the meeting that while hospitals have been told to determine the vaccination status of patients on admission and to protect those who are unvaccinated where possible, “in some cases the infrastructure does not allow for this”.

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The need for “prompt identification of patients with high grade immunosuppression who are at high risk of breakthrough infections and ICU admission” was also stressed.

Amid concerns about the spread of Covid-19 in hospitals, the health service is carrying out extensive testing of asymptomatic fully-vaccinated staff and patients.

“When new asymptomatic infections of fully-vaccinated patients and staff are detected, they are managed as infectious cases.”

The Nphet members discussed a study of healthcare workers in the Netherlands which found that 68 per cent of vaccinated health care workers who suffered a breakthrough infection were found to be hosting “infectious virus cultures” in comparison to 85 per cent of unvaccinated healthcare workers.

“These findings indicate that there is still a significant risk that a vaccinated person can transmit the virus,” the meeting heard.

Low mortality

Modelling projections were also discussed at the meeting which heard that there continues to be relatively low mortality related to Covid-19.

The modelling group shared a range of updated potential scenarios which factored in the transmission of the Delta variant and the success of the vaccination programme as well as other factors.

In optimistic scenarios, case counts would peak at 2,500-3,000 cases per day in mid-September, with later peaks in healthcare demand seeing 500-700 people in hospital and 80-130 people in ICU.

Central scenarios showed the peak at between 3,000 to 5,000 cases per day, with between 750 and 1300 in hospital and 150-250 people requiring critical care. The group was said to be conducting “additional work to update these scenarios, to further examine the possible effects of school opening, and to provide additional detail on possible scenarios beyond October 2021”.

The actual coronavirus case numbers and hospitalisations have tracked well below these scenarios.

On Monday, there were 1,154 further confirmed cases of Covid-19 in Ireland.

The latest available figures also show there are 297 patients hospitalised with the virus, of which 63 are in ICU.

Influenza

The meeting in late August, which was held as the Government finalised its latest roadmap towards exiting Covid-19 restrictions, also heard that respiratory viruses including influenza may be more impactful than usual over the coming months.

This is because as a population we may be “more susceptible to these infections given our reduced exposure last winter, as well as differences in the public’s health behaviours”.

“In addition, non-communicable diseases including asthma, COPD and strokes are likely to be exacerbated during the winter and, coupled with the resurgence of respiratory infectious diseases, will put further pressure on our health system.”