Nphet raised serious concerns with the HSE over the lack of mass testing in hospitals when Covid-19 outbreaks were identified among staff.
he issue was raised directly with the HSE at a meeting of the expert public health group before Christmas.
Chief Medical Officer Tony Holohan also personally “voiced his concerns” over the speed at which outbreaks were being detected in hospitals.
Minutes of an Nphet meeting on December 10 report that the group “expressed concern and sought clarity” as to why mass testing was not being carried out in all hospitals where outbreaks had been detected.
Nphet noted the “criteria for mass testing had previously been identified and agreed”.
The HSE respond saying it seeks advice from “local public health departments” when there is an outbreak in a hospital and then decides whether or not to “engage in mass testing”.
It said outbreak management is carried out between local hospital management with “involvement by the central executive where necessary”.
On that date in December there were 52 open clusters associated with 21 acute hospitals. Approximately 1,000 cases were linked to these outbreaks with 48pc related to healthcare workers. There had been 63 deaths linked to these outbreaks.
In the first week of January, there were 158 outbreaks in hospitals. This brought the total to 1,819 confirmed Covid-19 cases in hospitals, of those 37 were admitted to ICU and 147died.
Nphet suggested that the HSE establish a national outbreak control team to “ensure consistency of approach nationally to addressing hospital outbreaks and engaging in mass testing”.
Nphet acknowledged the “significant contribution” of the Antimicrobial Resistance and Infection Control (AMRIC) Oversight Group in controlling hospital outbreaks and said it should work alongside the proposed national outbreak control team.
It was also requested that the new outbreak team report regularly to Nphet.
At meeting a week earlier, Mr Holohan is reported to have “voiced his concern about the speed of outbreak detection and response in acute settings”.
“The chair also posed the question whether a national outbreak control team has been established and if not, the reasons why?” the minutes of the meeting said.
The HSE responded saying one of the “core challenges” facing hospitals was how best to isolate the virus quickly when detected.
“The HSE pointed to some areas in need of improvement in hospital infrastructure and isolation capacity. While some facilities are well-equipped to deal with isolation requirements along with occupational health needs, there are other hospitals that are not. These deficiencies have been exacerbated by the pandemic,” the minutes said.
The HSE highlighted issues with the coordination of information as well as unfilled senior clinical vacancies within Departments of Public Health as factors influencing the speed of response.
It also noted there had been difficulties caused by “deficiencies in the current IT infrastructure”.
“The HSE explained that while Public Health staff are present to offer advice and help with decisions, they do not lead the response in facilities. The primary decision-making role rests with the hospitals themselves, who then choose the extent to which they follow Public Health direction,” the minutes said.
Separately, the HSE “voiced its concern” that many student nurses, who were on placement in acute hospitals, were working in nursing homes at weekends.
They said this movement of student nurses may be “exacerbating transmission in these environments”. It suggested that guidance should be developed to address the issue.
The Department of Health said it was difficult to ask student nurses not to work at the weekends as “it is often their only source of income”.
Nphet also discussed the “relatively high incidence rate” of Covid-19 amongst members of the Travelling Community. They said it is linked to several factors including the gathering of families ahead of Christmas, international travel, and the high number of weddings occurring.
Source: Irish News