Living with Covid-19 Restrictions: Statements (Resumed)

We will resume statements on living with Covid-19 and have an update on level 5 restrictions. I welcome the Minister of State at the Department of Health to the House.

The following people have been noted as speaking and I am advised that they cannot speak again. Senators Clifford-Lee, Byrne, Keogan, Conway, Hoey, Gavan, Higgins, Dooley and O'Loughlin. Senator Currie had possession so she can resume and she has four minutes.

Last week I spoke about directors of nursing in nursing homes. These directors have years of experience doing assessments for tests for all of the other viral infections except Covid-19 but must go through GPs who do not necessarily visit homes every day. While I might call my GP and organise a test quite quickly, directors of nursing cannot do so. I can also call my out-of-hours service which can organise a test without delay. However, a nursing home might have to wait for a GP to visit and officially say that a test is needed, and then the nursing home does the test. This is an unnecessary delay that I hope can be fixed.

I understand from a general data protection regulation, GDPR, point of view that when it comes to blanket testing the results go to the employee rather than the employer. If an employee consents can the results also be shared with his or her employer so that the employer and the home can make sure they can co-ordinate and manage staffing and safety protocols more safely? The Minister of State will know the strain on staffing levels.

I have a question on the turnaround time for tests. Are tests for private nursing homes prioritised in the same way as hospitals? Why do people who are diagnosed with Covid-19 only receive their code to input into the Covid app, which kicks off the automatic phone-based contact tracing, after the HSE's contact tracing has reached out personally? One gets a text to say whether one has Covid-19. Should the code that one can put into one's phone not be given at that stage if the result is positive rather than wait for the contact tracing team to make contact and then send a text with the code? That, too, might speed up the process.

The news about vaccine development is very encouraging. Where are we with the vaccine uptake strategy? I recommend that somebody meets the Psychological Society of Ireland as it has compiled a report on influencing vaccine behaviour. The society is in a really strong position due to its experience in behavioural change and health to inform a communications strategy that will be essential. As many as 1.5 million people die each year from not getting vaccines, according to the PSI. In the Ipsos MRBI RTÉ survey, one third of the respondents said they would be unsure about a vaccine and 12% said they would not take it. They recommend an approach that is about altruism and good citizenship rather than fear-based messaging, and to tease out how to avoid choice anxiety, taking into consideration where we are at the moment in terms of behavioural challenges.

I wish to refer to maternity hospitals once again. These women need more compassion and transparency. Their partners are willing to do anything such as paperwork, texts or whatever. Can we come up with a commonsense approach as we exit level 5? One in five women suffer a mental health problem in pregnancy or after birth, which can be mild or severe, but if left untreated this can have a significant impact on family relationships. Has the Department of Health liaised with the specialist perinatal mental health services to establish if there has been an increase in women seeking treatment since March? What measures are being taken to address the issue?

I have heard that water births have been ceased. I am a bit confused by that as they can happen at home, which might be a way to reduce the spread of infection.

Will the number of people allowed to attend weddings and funerals be increased as we consider levels? Can the Minister of State advise if children's swimming lessons could be included as a controlled sport under level 3 because swimming is a life skill and is not just a sport?

I welcome this debate and the Minister of State. I congratulate him on his appointment and elevation to the Department of Health.

I do believe that we need to have a rolling debate on the reopening of our country. The former Minister, Deputy Eoghan Murphy, made a suggestion at the Fine Gael parliamentary party meeting last week on the need to have this debate. It is important that the Houses of the Oireachtas have a debate on the reopening of our country, not just living with Covid-19, because, as Senator Currie has eloquently articulated, there are a myriad of issues that need to be addressed.

Part of our difficulty still remains the body charged with overseeing the HSE contract tracing, now more than ever. I welcome the Government's commitment to hiring more contact tracing personnel. There was a deficit as we headed into the second spike that should never have been allowed to happen. The Government and the HSE knew there was a second spike coming yet we did not recruit enough people for contact tracing.

I know people who have never been contacted by the contact tracing team or the HSE. In saying that, I pay tribute to the men and women working on the front line in Covid wards and ICUs for the way in which they look after and care for patients. Equally, I pay tribute to the people who work in nursing homes for the care they give to older citizens.

There is a real debate needed, whether regarding retail, sport, hospitality or education but the list goes on. This morning, the Teachers Union of Ireland made a very positive and worthwhile suggestion that 18 December would be a cut-off point for schools, which is a very tangible measure that can be taken.

With the permission of the Cathaoirleach I wish to read into the record of the House an email I received from a person who works in the hospitality sector. It reads:

We are all delighted that the numbers and coming down and look forward to reopening. However, in order to reopen we need to know next week will we be reopening on Level 3 or Level 2. There is a huge difference between both levels from a staffing, stocking and organizational point of view. We need to know how many staff to rehire, how much stock to bring in etc. In order to open again on 1st December, if we will open at all, and we need to bring staff back the week before ( 24th November) to clean and organize the reopening of the hotel again. It is not possible to reopen the business with 24 hours notice of which level we will be reopening under. We are also getting a lot of enquiries for Room Bookings for December and we are unable to take any bookings until we have outline indications.

While I appreciate that the government may not want to make an announcement on reopening levels and that public health and safety are of paramount importance and then have to backtrack, consideration needs to be given to business so that we can reopen in a timely and safe manner.

We have all received emails about public health and how people are treated. There is a need for a debate. In its contributions this week, IBEC has been very moderate in asking for clear indications. We welcome the announcement by different pharmaceutical companies with regard to vaccines, but vaccines in themselves will not be a panacea or spell the end of Covid-19. We must all redouble our efforts.

I am glad the Government did not pander to commentary on a number of small but well-documented incidents in Dublin and Cork at the weekend. To be fair, 99.1% of our population is being very compliant. As an aside, what is it costing the HSE to sponsor content, I believe the weather forecast, on RTÉ? Why is the HSE doing this when that money - if any money is being spent, I am open to correction on that - would be better used in fighting Covid-19?

I again thank the men and women in our health service for the sterling work they are doing every day. I sympathise with the people who have lost loved ones or family members to Covid-19. We all have a duty of care to ensure that the battle against Covid-19 is won and the virus is eliminated. I commend the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Feighan, on the work they are doing.

I too welcome the Minister of State back to the House. I also pay tribute once again to all of those who continue to put themselves forward to help others, both workers and the many volunteers who have come to the fore during this pandemic. I am aware of people with disabilities living independently who are only seeing their carers for 30 minutes in the morning and another 30 minutes in the evening. Outside of that, they are in total isolation and have no human contact for the rest of the day. Most have severe underlying health conditions and cannot have visitors or go anywhere within the area allowed under the restrictions. Some of these individuals receive phone calls from social inclusion groups within their area such as Older Voices Kildare, a terrific group which does great support work. I ask the Minister of State to consider providing further supports for those isolated in this way and groups such as Older Voices Kildare which are filling gaps in the lives of many at this difficult time.

We will discuss the area of domestic violence separately in the Seanad next week, but I would also like to raise it today. It is always important to let people know that help is available. Women's Aid Ireland recently reported a worrying increase of 1,000 in the number of calls to its helpline each month since Covid began. Its telephone number is 1800 341900. Unfortunately, like many others, I have dealt with more distressing calls as a public representative in recent months than I have ever had to deal with previously. Covid has unfortunately created many new domestic monsters and organisations such as Women's Aid and Teach Tearmainn in my county of Kildare need as much Government support as can be given at this time.

I also raise the issue of pay for our student nurses. I support the call made on this and ask the Department to urgently consider it. Student nurses have rightly received applause and warm words from members of the Government but these young people need payment. I have been contacted by many student nurses who have had to give up their chance to work for care providers or nursing homes because of the demands on their time during this Covid crisis. Student nurses should be paid for the essential work they have carried out. I am sure the Minister of State would agree that, without them, the health system would be under much more pressure than it currently is.

Like many colleagues, I continue to receive queries regarding waiting times for hospital appointments and procedures. I am informed that the number of patients on the outpatient waiting list is now over 600,000. I would appreciate it if the Minister of State could let us know what he and the Department are doing to address these non-Covid medical needs. What plan is in place, or what plan will be put in place, for non-Covid conditions? To tease out the issue a little further, how will those who have missed out on appointments be treated within the system? Nothing really stands out in that regard apart from the fact that the number on the waiting list is well over 600,000. Perhaps the Minister of State could address that in his reply.

Moving away from the area of health, I will mention an issue regarding education. I refer to the pressure on the leaving certificate class of 2021 due to the lack of clarity as to whether they will sit a final examination. There is constant pressure on them to perform to their maximum in each class test as each result may be taken into account if we have to go down the road of predicted grades once again. Having spoken to a number of students, I know this additional pressure is having a detrimental impact on their mental health. They feel that they are in constant examination mode and they are not getting the downtime they need. I ask the Minister of State to address that issue with the Minister for Education.

I am sure the Minister of State is aware of all of the local efforts to run "shop local" campaigns to support local businesses, as has been mentioned, but also to support the local communities that depend on those businesses. In my home town of Athy, there is a very active campaign to shop local. Like other Senators, I get almost daily requests from businesses from around Kildare. What assurance can the Minister of State give those businesses that they will be able to operate in the run-up to Christmas? Is his Department planning any additional health advice for the general public as to how they might safely go about shopping locally? I am sure he would support these local campaigns but I am equally sure that these business owners are looking to him and the Government for guidance and help at this time.

I will use this opportunity to again mention those who are suffering from long-term and terminal illnesses. I will raise the issue of medical cards for such people. It is an issue I have brought up before with the Minister of State and the Minister. The campaigner, John Wall, has received a letter back. Perhaps the Minister of State could give us an update on what is happening. I believe a report is about to be issued. I support Mr. Wall's campaign totally.

I welcome the Minister of State. He is obviously no stranger to this Chamber. I welcome his new position. This debate is very welcome. How we live and interact with Covid will be a significant issue in the future. The Houses of the Oireachtas need to consider holding debates like this, or perhaps even a rolling debate. The issues we have seen over the last seven or eight months have been frightening. The general public and the State have reacted amazingly to these issues and we have tried to change our lifestyles and behaviour to survive this crisis. We are effectively living through history and, because of this, we have come across things we never thought we would. We are wearing masks and are involved in other things every day in which we never thought we would be involved.

There are a few issues I would like to raise with the Minister of State. One, which is directly related to his Department, is the issue of nursing homes. There are major restrictions on nursing homes. I understand the criteria behind them but we need to consider people who have dementia and who suffer from Alzheimer's disease in particular. Their only way of making contact with people is through physical touch. A family has been in contact with me regarding loved ones in nursing homes whom they have been unable to physically touch since last March. This is an unfortunate side-effect of the Covid crisis. Time is very limited for these people. Will they see another Christmas? I hope they will but they might not. Not being able to hold a person's hand, let alone hug them, is a major issue for these people. As we try to live with Covid, perhaps the Department needs to review how interaction could be allowed for the small number of people who have dementia or Alzheimer's and have no other way of communicating. Meeting online unfortunately does not work for these people. The holding of someone's hand is literally their only form of communication. We need to look at those issues if we possibly can because, unfortunately, time is not on these people's side. Some of them are parents and their children feel helpless. They do not know how they can interact with their parents in the last few months of their lives. I know I have raised this issue with the Minister of State before but he might respond to it, if not today then in due course, because it is a key issue which we need to examine.

As we try to live with this disease another cohort of society that is trying struggling is the generation that has gone back to school. I refer in particular to children in first, second and third class, as I have personal understanding of what they are going through in school. What Covid means to them is that they can no longer see their grannies on a weekly basis and their mothers and fathers are at home full-time, which, in many ways, is a good environment. Last September, they went back to school and Covid hit them like a brick. They are continuously sanitising and some are sitting behind screens. The lack of knowledge for those seven-, eight- and nine-year-old children became apparent to me. There needs to be a focused campaign on how we can interact with these schoolgoing children so they understand that Covid is not going to kill them. Unfortunately, in my household, after the first two weeks of school my children thought it was going to be the end of them. It took a lot of engagement to calm them down and to make them understand if they do the right thing everyone will be okay. I believe we need a campaign, which should be something like an animated cartoon, to bring it down to children's level such that they can have an interaction at their basic level. They have fierce understanding but they will interact with that campaign. A campaign of this nature to inform our primary school children would be beneficial. I am asking that the Department of Health would examine with the Department of Education the introduction of a campaign for our primary school children in particular who need a real understanding of Covid and what can be delivered on the ground. I believe it would be a game changer.

The third issue is what will happen in regard to Christmas, in particular Christmas week. We will have debates about pubs opening and so on. I believe we will have to put in place protocols around the management of religious affairs and access in that regard during Christmas week in particular. The week of 25 December is a special occasion for families and communities. If protocols are to be put in place we need to start talking about them now such that those who might need to put in place structures will be made aware of them. Communities want to celebrate Christmas, Christmas Eve and Christmas morning in their particular way. Time is of the essence. The Minister needs to issue a strong statement regarding how we can celebrate those religious affairs.

When it came to my attention earlier in the week that a debate on living with Covid was scheduled for today, I thought it was only right and proper that I should take the opportunity to contribute to that debate. Like thousands of people in this country, I have lived with Covid for two weeks and it is important that I put on the record of the House my experience of it. I was lucky. I did not have many of the symptoms experienced by most people. In terms of how the HSE and my GP dealt with it, the structure in place is phenomenal. I rang my GP on a Monday and on the Tuesday at 5 p.m., 24 hours later, I had a test and I got my result on the Wednesday. I was symptom-free so I was surprised when I received a text message which confirmed that I had tested positive. I had been self-isolating since the Monday. The turnaround was impressive. The following day I was contacted by the HSE to discuss my close contacts.

Last week in the Seanad and again today I heard people calling for the opening up of the country to a certain level and saying that there are particular sectors of society and particular areas that are special cases and should be seen as such. I agree with what people are saying in terms of opening up churches and particular areas but in my own experience, my first reaction when I found out I tested positive was guilt in regard to those people to whom I might have spread the virus. In terms of close contacts, I had two, my wife and my child. For anyone in politics to have only two close contacts in the space of 48 hours is pretty much unheard of. When I reflect on it, the reason for that was the measures introduced by Government and the constant message not to meet people, to lock the office and to reduce one's contact as much as possible. Everyone worries about contact, whether with their parents or their young children. I was extremely lucky and I put that down to very difficult decisions that were made in the last four to six weeks in terms of moving to level 5. Not everyone was in favour of it because it is putting businesses and many people under huge pressure but it is about saving lives and keeping the numbers down.

I commend the Minister and the Department on their work. It is only when one tests positive one understands the fear in terms of where it might have spread beyond oneself. It is great to see that the numbers are reducing. We need to reduce them further. There are two weeks remaining of the level 5 lockdown and there will be a review before 1 December in terms of changes that have to be made. I agree with colleagues that we need clarity as quickly as possible. Businesses, pubs and retail outlets are all hoping and have their fingers crossed that they will be able to open and do some sort of business during the Christmas period. We need to give reassurances to them as quickly as we can. I know that is extremely difficult. I support my colleagues' comments in regard to churches and mass. Christmas is a really important time for people in my community in Grange and in Tipperary and everywhere else. It is a really important that people can celebrate Christmas, in some way normally if they can. Not all churches are big and many will not have huge numbers in attendance so they would be well able to facilitate holding mass during the Christmas period. The Government has been extremely good in terms of clarity and direction in the last month in regard to level 5. I would stress to the Minister of State the need to continue that in whatever level we move to in December.

On a personal level, I thank the Department, the HSE and NPHET. From my experience, the plan works and people do come out the other side of Covid.

There are no other Senators offering. Before I call the Minister of State, Deputy Feighan, to respond, as I have not been in the House previously when he was here I take this opportunity to congratulate him on his appointment and to wish him every success.

I thank all Senators for their contributions to this important debate on the Government's response to Covid-19, including the plan for living with Covid-19, Resilience and Recovery 2020-2021. Our overall goal is to reopen our society and economy as safely as possible. This is a challenge facing Governments the world over. Senators will have seen the responses to the pandemic that have been undertaken by countries across the world. With over 50 million Covid-19 cases now detected and the numbers rising daily, clear and decisive action is required.

The resilience and recovery plan sets out a clear framework for decision-making in regard to this Covid health pandemic. Our objective is to strike a balance between what is safe and what may risk increasing transmission of the disease. Therefore, we are prioritising particular sectors of society in the knowledge that we are working towards the restoration of normal life in the future. The measures set out for level 5 are judged to be those that give us the best chance of limiting the spread of the virus, while at the same time keeping the priority areas of society and the economy open. Not every sector of the economy can open at this time and we would like to have more contact with our loved ones and our friends. It is important to remember that these restrictions are necessary to keep the most vulnerable members of our society as safe as possible.

I understand what Senator Lombard stated about nursing homes and people with dementia. We would like to do far more but, unfortunately, many of these restrictions must be kept in place. It is very difficult for people in nursing homes. Indeed, my mother is in a nursing home and we have not had physical contact with her since last March. I pay tribute to the staff and those trying their best in very difficult situations to address that very difficult issue. As always, we will be guided by the expert advice of NPHET, the World Health Organization and the European Centre for Disease Prevention and Control. We acknowledge the leadership shown by the European Commission and recognise the value of collaboration with it and other EU member states.

We will continue to promote clear public health advice for individuals. Much of the advice has not changed for many months. I hear what Senators are saying regarding communication, cartoons and messages like that. The HSE and the Department of Health have very clear structures governing how to get that message out. It is no harm to sometimes look at other ways of doing that. Other countries may have different ways of getting the message out. Deep down, we have to get the message out. Most people have worked in collaboration. We need to keep that united team, although doing so is becoming more difficult because we are now seven or eight months into this and it can be difficult to get that message out. The message is about good cough etiquette and hand hygiene, wearing a face covering as required by law and when visiting vulnerable people, avoiding crowded places and public transport as much as possible and working from home where possible. As a society, in order to suppress transmission of the virus and to reduce the impact of the disease, it is important for all of us, in all walks of life, to heed that advice. Although the Government can legislate for mandatory face coverings on public transport and in retail settings, it cannot legislate for every situation. We must all take an element of personal responsibility. We are human and we are all trying to do the best possible but sometimes we may err in our judgment. I call on everyone to continue to fight that battle. There are encouraging and positive signs that level 5 measures are beginning to have the intended effect. In the past two weeks we have succeeded in reducing community transmission and disease incidence.

Senator Currie referred to nursing home testing, the Covid app and waiting for contact tracing teams. I or my officials will get back to her on those matters. I refer to issues such as when the vaccine is rolled out. There will be challenges in rolling out the vaccine, first to more vulnerable people and front-line staff and then more generally. The Senator also referred to maternity hospitals and measures to protect mothers' mental health. That is an issue of which we are very aware.

Senator Buttimer commented on reopening the country and contact tracing. He also referred to the 18 December cut-off in schools, the advertising and getting the message out. It is necessary to get the message out.

Senator Wall referred to supports for older people. I wish to pay tribute to all the organisations that are dealing with this issue. I would like to think there is funding in place. If there are issues, Senators should please write to the Department and we can address those local issues. There has been a worrying increase in domestic abuse. I pay tribute to Women's Aid and the Garda Síochána. They are very concerned about, and aware of, that increase. We are getting the message out that there are people there to help. Those affected should never feel they are alone. I hope the structures and systems are in place to deal with that issue.

The Senator also referred to paying student nurses. That is an issue we are trying to address. Outpatient numbers have increased but we are now dealing with telemedicine and such supports. Covid has brought in many opportunities to change the way we do business. Reference was made to eprescribing. It was brought in in a matter of two days. There are many things we can learn from this awful virus.

Senator Lombard referred to Christmas, as did Senator Ahearn. Church representatives and faith leaders have met with the Taoiseach and I would like to think they have in place a system to protect parishioners. I have seen it myself. I hope that in the coming weeks we will be able to open up churches and other places of worship. Very robust systems have been put in place. They will be adhering to public health guidelines.

We have succeeded in saving people's lives thanks to the collective efforts of the public to adhere to the guidelines in line with the expert knowledge and advice of our public health specialists, and also thanks to the dedication and hard work of front-line workers. We need, individually and collectively, to keep doing the basic things right. That is what the vast majority of people are doing. Now is not the time to be complacent. We must keep driving down the disease in order that it is brought further under control. We must keep going.

I extend my sympathies to the family and friends of those who have died in recent months as a result of contracting Covid-19. I wish to acknowledge once again the contribution of front-line workers to the national effort. I know all Senators will join me in thanking every individual for their continued hard work and resilience at this time. In light of the good news on vaccines, it is to be hoped that they will be rolled out, possibly before Christmas or in the new year, and that at this time next year we will be talking about the Covid-19 response. I believe the country has mobilised. We do not always get it right, but I think we have been ahead of the curve globally. I hope we will be vigilant. I thank Senators across the House for their co-operation in these difficult times.