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Seanad Éireann debate -
Wednesday, 1 Dec 2021

Vol. 281 No. 1

Covid-19 and the New Measures (Health): Statements

I welcome the Minister, Deputy Stephen Donnelly, to the House. I proffer our apologies to him as we had a little confusion about who was coming in. I know he is busy and we do not want to be keeping him waiting unduly.

I am delighted to be here to address the House on what was an important issue when the invitation went out and has become decidedly more so since the arrival of this new variant. I very much welcome the opportunity to update the House on the epidemiological situation and the national response. The current level of Covid-19, as colleagues will be aware, is having a profoundly negative effect on public health as well as placing an enormous burden on all aspects of our health service. The number of confirmed cases of Covid-19 in hospital including in ICU is still very high and more generally the overall level of infection continues to have a disproportionate and very disruptive impact across the system. We are seeing case numbers previously seen only in January this year.

We know the situation in Ireland is not unique. Countries right across Europe are seeing a surge of cases, and we have heard from the WHO's recent warning that Europe is once again at the epicentre of this pandemic. Many EU countries are introducing new coronavirus restrictions. This includes reintroducing measures that we have retained here such as masks and Covid certificates. Some countries are having to go further, including for example the lockdown reimposed in Austria and the partial lockdown in the Netherlands. The situation across the EU remains fluid and uncertain as we all know.

As we have seen throughout the course of the pandemic, Covid-19 continues to adapt and create very significant challenges. The pandemic is not over yet. The most recent challenge is of course the new Omicron variant, B.1.1.529. I would like to advise the House that a number of actions have been swiftly implemented to limit the potential spread of this new variant. People arriving into the State from overseas who have been vaccinated or recovered from Covid-19 will be required also to have a certified negative or "not detected" test result. This can be from an antigen test taken no more than 48 hours before arrival or a PCR test taken no more than 72 hours before arrival. The antigen test has to be professionally administered and certified. It is not just a question of a person buying a test, doing it themselves and showing a "not detected" result. This will be in effect from midnight on 3 December 2021. Air and sea carriers will be required to carry out pre-boarding checks for compliance, supplemented by border management unit and Garda National Immigration Bureau spot-checks on arrivals at ports and airports. This measure will apply for a minimum period of two weeks and will be kept under review with a view to removal as soon as possible, taking account of the overall epidemiological situation and what we find out in the coming weeks about the new variant.

These actions agreed by the Government are intended to limit the spread of the new variant while further evidence emerges relating to its transmissibility, its impact on disease severity, and its potential evasiveness when it come to vaccines and treatments. My Department, the HSE, the Health Protection Surveillance Centre, HPSC, and the National Virus Reference Laboratory, NVRL, have been meeting regularly to review the evolving situation. The epidemiological situation both here and internationally, and all emerging evidence regarding the Omicron variant, will continue to be kept under close review in respect of potential implications for the pandemic.

More generally, the Government has been quick to act on public health advice as we continue to manage this current wave of infection. Just yesterday, we agreed new advice for families in response to the very significant increases in the incidence in younger children in recent weeks. This includes asking parents to try to reduce indoor socialisation for their children aged 12 and younger over the next two weeks and a recommendation that face coverings be worn by children aged nine years and over on public transport, in retail and in other public settings where face coverings are currently mandated for older children and adults. Face coverings are also recommended in primary school from third class and above.

This follows the introduction of a package of additional measures on 16 November to reduce the current level of socialisation across the country and interrupt the spread of Covid-19 in the community. Measures include a move to working from home unless it is necessary to attend the workplace in person. Proof of immunity will be required for entry into cinemas and theatres. Bars, restaurants and nightclubs are closing from midnight. Household close contacts who are fully vaccinated and showing no symptoms should now restrict their movements until they have three negative antigen test results within five days. As colleagues will be aware, when they are identified as household close contacts the HSE is sending out the antigen tests to those people in their homes.

As the booster campaign progresses, we will continue to take a "vaccine plus" approach. This means we will obviously keep vaccines at the centre of our response but there is more that we need to be emphasising as well, that is, continued adherence to basic measures to protect ourselves and those around us. This includes: acting fast, isolating and getting tested if we have symptoms; wearing a face covering where appropriate; making sure that indoor spaces are well ventilated; maintaining social distancing whenever appropriate; and covering coughs and sneezes and keeping our hands clean. We know these measures work. Their impact was highlighted in a significant systematic review and meta-analysis published in the British Medical Journal in October, just last month.

That review showed that several personal protective and social measures, including handwashing, mask wearing and physical distancing, are associated with reductions in the incidence of Covid-19. The research analysed the findings from over 30 studies and found, for example, that there was a 53% reduction in the incidence of Covid-19 with mask wearing. This research highlights the continued importance of these basic protective measures.

Despite the current challenges, the steps we have taken together are working to protect our population from the worst of this virus. Our vaccination programme is among the most successful in Europe, with more than 90% of the eligible population fully vaccinated. More than 8.1 million doses of Covid-19 vaccine have now been administered since the programme began in December last year, with more than 800,000 booster vaccines and third doses for immunocompromised administered to date. We all know that every death from Covid is one death too many, and we must do everything we can to keep the mortality rate as low as possible. According to the latest data from the European Centre for Disease Prevention and Control, ECDC, Ireland has the fifth lowest overall Covid mortality rate out of the 27 EU countries, plus the United Kingdom. The booster vaccines are adding further protection. The impact of the recent booster vaccination on those aged 80 and older is evident as the incidence of Covid is no longer rising in this group.

The health system is being supported at this exceptionally challenging time through significantly increased funding, with over €1 billion extra being provided in budget 2022, bringing total investment to a record €22 billion. Before the pandemic, we had just 255 critical care beds, which, we all agree, was inadequate. We are addressing this lack of capacity as quickly as the HSE can add critical care beds. Some €52 million was provided for this year to add additional beds, an increase of 25% to the baseline. The HSE has advised that 42 of these beds are now open, bringing baseline critical care capacity to 297. More will be added over the coming weeks and months. The HSE has been funded to increase capacity to 340 by the end of 2022 or early 2023, representing a 33% increase to the base since the pandemic began. I have also secured a Government commitment to go significantly further than that and bring us beyond the total recommended in the 2018 capacity review. We have also added 11,309 staff to our health workforce since the start of the pandemic, including almost 3,000 nurses and midwives and around 2,000 health and social care professionals. We have permanently funded over 1,100 acute hospital beds, of which approximately 800 have opened to date.

I assure colleagues that the Government and I will continue to do all we can to respond to this stage of the pandemic and we will continue to boost capacity in our health service at the same time. I very much look forward to listening to Senators' contributions to the debate.

I thank the Minister for coming to the House. While he will not want it to be mentioned, it is important that Senators from all sides of the House show solidarity with him following the awful protest - I would not even call it a protest - that took place outside his home. There is no call for that. These are ignorant thugs-----

-----who have no respect for democracy. The Minister will find that there is solidarity with him and his family on all sides of this House. We need to take action. We are all in favour of peaceful protest but to do what was done outside the Minister's home and to his family is completely unacceptable.

As I am sure the Minister is aware, the difficulty with this pandemic is that there is no handbook. If we were able to predict the trajectory, somebody would be able to make a fortune out of the guidebook he or she could draw up. Nobody has been able to do that, however. That has been one of the challenges. On the points set out by the Minister, any reasonable person looking at how Ireland has managed the pandemic will see that we have not got everything right, but we have got a lot of things right. In particular, the vaccination programme has been a success.

What the Minister outlined regarding some of the long-term measures, including the increase in ICU bed capacity, is important. The message needs to get out that we are increasing bed capacity. It is not enough as yet but, in as far as possible, every additional bed that can be provided is being provided. The message also needs to be put out that the Minister is reforming the health service at the same time. The fact that more than 11,000 additional staff are now employed in health has not been getting out there. It is important that we start to stress that the Government is responding not just in terms of the immediate response on vaccines and so on, but it is also looking at the long-term issues. That is a communications challenge.

We also need to communicate more effectively about how the health service is going to deal with many of the other health issues. There are still challenges around elective surgeries and delays to waiting lists. People will obviously be concerned that if we continue to see variants, increases in cases and possible increases in hospitalisations, the other areas of our health service will be impacted. It is important that we communicate effectively on those issues.

I ask the Minister to address a number of specific points. I have always been struck by the approach taken by Dr. Mike Ryan of the World Health Organization who speaks very bluntly. He said we will not get everything right but speed is of the essence and that once we take a decision, we should go with it. We know that vaccines work. We know, from the early evidence, that the booster campaign is working. Will the Minister give an indicative timeline as to when the booster campaign will start to roll out to the wider population? When will those of us in our 40s, or younger, be able to access booster vaccines? There is a belief in society that vaccines are the best way of protecting us. I know there will be a few weeks here and there, but I ask the Minister to give us an assurance on the timeline for the next few age cohorts and outline when and where the booster vaccines will be available to these groups. That would be helpful.

As the Minister is aware, I hold a strong view, which I have communicated previously, that theatres and arts venues should be kept open, not just for cultural reasons but for people's mental well-being. I have had the privilege of being in a number of theatres around the country recently. They are all following the guidelines. They are checking Covid certificates and identification. They are very safe, secure venues. It is important that we give a reassurance to that sector. There is a whole schedule that has been planned well into next year. In as far as possible, theatres, museums and galleries should be allowed to remain open. These are the activities that keep us all sane during this period.

This is not an issue for the Minister directly, but he will be aware that because of some of the newer restrictions that have impacted on the hospitality sector, there will be issues with supports for business. The Government has always committed to continuing those supports. It is most important that we continue to commit to the provision of the employment wage subsidy scheme, EWSS, and other supports for those who are affected.

We need to look at those who want to take the vaccine but who, for medical reasons, are unable to take it. This is a challenge. They want to take the vaccine but cannot do so and cannot necessarily get a vaccine certificate. We must accommodate them. These people are not anti-vaxxers. They believe in vaccines but are unable take the vaccine for medical reasons.

It is nice to see the Minister. He is welcome, as always. I begin by completely condemning the thugs who stood outside his house. I offer my solidarity to him on that point.

We are short on time and I want to be constructive. I will raise a few key issues. The first is probably the most important. We know that the World Trade Organization TRIPS council is meeting this week. To date, the Irish Government has opposed waiving intellectual property rights for Covid vaccines that would enable countries in the developing world to develop their own generic vaccines to vaccinate their population. Large parts of the world have a vaccination rate of just 2%.

When I raised this issue with the Minister previously he has told me he was in favour of waiving the intellectual property rights. The problem is that the Government is not in favour of that approach. We know that to date, and right up until today, the Government and large sections of the EU have opposed the waiving of intellectual property rights. I want to hear the Minister state clearly that the Government will endorse and publicly call for the waiving of those intellectual property rights. I ask him to provide clarity on that point.

If the Minister is not going to support it then he should tell us straight that he is not going to support it. That conversation is happening this week at the WTO TRIPS council. I will be honest: the Irish public want to see a much better response from this Government on this key issue. The new variant brings it home to us like never before, nobody is safe until everybody is safe. For too long, the Government has been on the wrong side of this particular argument.

I will move on to some of the key points. I agree with some of the points made by Senator Malcolm Byrne. Let us be clear. Everyone should be scheduled for a booster jab at six months post the second job. I do not know why we are delaying. We know the need is there and we know it is safe. We know how to do it. We should just do it. I will use my time to make a clear call again to anyone who has not yet been vaccinated to get out and get the vaccines. They are the best route to safety for all of us. There should be no equivocation on that point.

We need clarity on the Johnson & Johnson vaccine, particularly for those aged over 50 who should have been boosted three months later. We also need clarity for those who are immunocompromised who, from what I can see at the moment, are being pushed and passed between the HSE and the GPs. We need clarity for childcare workers and those who work with unvaccinated and vulnerable populations.

On antigen testing, I have heard today of one family who are on day eight of waiting for the antigen test to be sent out by the HSE. There are real problems here. It would be much simpler to have antigen tests distributed locally through pharmacy services. I am trying to be constructive. There is a problem in trying to get those antigen tests out in a timely manner.

There are also PCR testing delays. We all know about this. A person can be waiting two or three days sometimes to get the PCR test. People are being pushed into getting private tests. I have heard that people are being charged €159 for a PCR test to make sure they are not going to work or sending their child to school while sick.

On the Covid-19 certificates, so far the Minister has not issued guidance on clinical exemptions. They are few but they do exist and are being ignored. This is being introduced in the North and I would like a timeline as to when the Minister is going to deal with that. It is an important point.

I must also talk about the schools issue. I want to be very clear that Sinn Féin's point of view is that no child should be denied an education because of the Government's failures in respect of Covid-19. The Minister will be aware that parents received alerts through their school apps late last night to say that it is now mandatory for children from third class and upwards to wear a mask in school all day, effective immediately. Proper air filtration and contact tracing is what is needed in our schools, not directives that assume non-co-operation from parents. The absolute inability of the Minister for Education to address the severe lack of substitute teachers, large class sizes, and the over-reliance on prefabricated buildings for classrooms is what the Minister for Education should be putting her energies into, not punishing children. I continue to be concerned and alarmed at the language used about children throughout the pandemic. From the start, they were described as vectors, which makes it so unfair that children have been targeted again. The Children's Rights Alliance and other organisations have called for clear advice to be issued to schools before any directive from the Government to ensure that schools can take account of each child's needs in accessing his or her right to an education. What transpired last night was actually the exact opposite. Parents who know that their child will find it difficult or impossible to wear a mask in school will now need a medical certificate from their GP to allow for an exemption from wearing a mask. This will place further strain on already overstretched GP practices, many of which have been scathing of this requirement.

Unfortunately, I am running out of time but let me say briefly that we need much better communication. There have been too many mixed messages in respect of antigen testing and schools. I also seek information from the Minister on anti-viral medications. These look like a real positive that should be available from early 2022. We need to know when they will be available. The Government cannot be found wanting when such medication does become available. There have been very promising clinical trials and this could play a key role in combating Covid-19 early next year. I am out of time now but I look forward to the Minister's response.

I thank the Minister very much for coming to the House. I join with Senators Malcolm Byrne and Gavan in condemning the protests outside every Government Minister's house, and in particular the Minister's own house. It is simply not acceptable in our democracy that the families of public representatives would be targeted in that way. I express that solidarity.

As the Minister will know better than the rest of us, a number of very serious changes were announced this week. There was the sudden abandonment of the subsidisation of antigen tests. There was the announcement late last night, just over 24 hours ago, of the required mask wearing in schools. We are now going to have the rush to reintroduce legislation for mandatory health quarantining. Of course, all of that is taking place with a cut to the EWSS today and a cut to the pandemic unemployment payment, PUP, two weeks ago. What kind of a message is all of this sending out? We are really in the middle of a war in the context of this global pandemic, and in the course of a war, communications are vital, as the Minister knows well. The Government has been all over the place in recent days. If the Minister wants to keep the public with the Government, then the Government really needs to up its game in communication, in ensuring that workers and families are communicated with clearly and that livelihoods are protected.

None of us want to see the reimposition of restrictions but we accept that because Covid levels have been so high some measures have had to be taken, for example with the night-life sector. Yet, the repeated message from the Government is that the PUP cannot be reopened and that it is okay to cut the PUP because there are labour shortages at present. What kind of a message does this send to a DJ or a bouncer on the door of a nightclub? Is it that they should go away and get a job in a cafe? We really must bring the public with us around whatever measures need to be taken to contain this pandemic.

The messaging from the Government has been alarming to me over recent weeks, given the lack of dignity and the lack of respect shown to certain workers in this country. I am struck that even IBEC called for a continuation of the EWSS into the spring of next year, and yet the Government has gone ahead and cut it. The Minister will say that he is responsible for the Department of Health and that is extremely onerous in itself, but the Minister also knows that this is a battle in keeping the public healthy and keeping people onside for the measures that need to be undertaken. Protecting livelihoods has to be a vital part of that message.

I am also struck by the five-day rule. Retail workers have approached us, as has Mandate, which is the representative union of most retail workers. Mandate has said that some workers have expressed to the union a real concern that they will not be able to stay at home from work for those five days, even though they are vaccinated and may be asymptomatic, if they are a close contact. They need to earn that money and particularly in the run-up to Christmas. At the end of the day, the Covid illness benefit is only 56% of the average earnings for a retail worker. It remains the case that as of today, we have no paid sick leave in this country. I am aware that the pre-legislative scrutiny of that legislation is currently being undertaken, which is great, but the Government is simply being too slow. We now have situation where we badly need that paid sick leave. We cannot afford for workers to feel that they have to go into work because otherwise, they would be out of pocket.

For many months now, many Members in this House and across the parties have been calling for antigen testing to be rolled out on a substantial scale in order to support many sectors in this economy and in society. There has been a degree of resistance. There was a debate between NPHET and the Government with regard to that. There was an announcement that we were to have subsidisation of antigens testing and that the Government was prepared to squander millions of euro effectively subsidising retailers for those antigen tests. Then there was the withdrawal of that proposal on Monday. Again, what message are we sending out with regard to antigen testing? The Government needs to negotiate with a number of manufacturers, be far more cost-effective, and ensure that antigen tests are made freely and widely available to people in order that such testing can become part and parcel of household life from here on out. It is vital to the support of sectors and for jobs and for schools to continue to remain open that antigen tests are deployed on a wide basis.

The Minister is very welcome to the House. Nobody here envies the very difficult job the Minister has to do and the recommendations from public health the Minister must implement.

We are 18 months into the pandemic and still firefighting to a large extent in dealing with it.

I think there is significant public buy-in. The fact that 95% of the public have opted to get the vaccine is a great news story and puts us above and beyond most other countries in the world, certainly within Europe. That has saved thousands of lives, even though that will never be acknowledged because it cannot, really. The fact is that per head of population, fewer people have lost their lives in this country than in most other countries in Europe. Our hearts go out to the people who have lost their lives and the people who suffer from long Covid. Many families, 5,000 or 6,000 at this stage, are grieving the loss of their loved ones. Everything we do here is to ensure we reduce the number of people who contract Covid and, in doing so, by extension, reduce the number of people who require ICU support and, ultimately, the number of people who lose their lives.

It has been flagged for some time now that a vaccine booster would be necessary for most of the population. The Minister might give me some reasoning as to why this happened but I cannot understand why the task force that was tasked with coming up with the recommendations on the vaccine roll-out was stood down over the summer. What was the logic and reason for standing down the task force, given the fact that a booster vaccine programme was imminent and that there was going to be advice from the national immunisation advisory committee, NIAC, in that regard? Booster vaccines are now being rolled out to the entire population. Why was the task force stood down?

I also cannot understand why people who were working in the vaccination centres were let go over the summer months and earlier in quarter 3 of this year, again, given the fact that we knew we would have to rely on a booster vaccine programme. What was the logic and the reasoning behind the HSE letting those staff go? Now the HSE is under pressure to try to re-recruit staff. Those people could have been kept on. There was plenty of work for them to do on the flu vaccine, the HPV vaccine and other work. I am just interested to know what the logic or reasoning behind letting those people go was because it should not have happened.

It saddens me to say that in the past two or three weeks, communication has not been at the level it should have been at. That is nobody's fault but it was not what it should have been. Unfortunately, there were a lot of mixed messages last week. Now we are dealing with a new variant, which will present its own challenges. We will be here on Friday dealing with the mandatory hotel quarantine legislation, which I think most people realise is necessary. I think there will be a public inquiry into Covid and its handling at some stage in the future. I believe things like the standing down of the task force and the letting go of the people working in the vaccine centres should not have happened and I would like to know why they did. As for the communications strategy, it is difficult to communicate to the public 18 months to two years into a pandemic because people are tired and weary, but we still need to ensure that the communications are distinct, clear and focused and that they work. I know that the Minister and his officials are doing their best, but there needs to be a step up in dealing with that.

I agree that schools are low-risk settings. The National Public Health Emergency Team, NPHET, has constantly said they are. There is no place where there is no risk, but certainly schools are low-risk. I support the wearing of masks in primary schools. Young people have seen their parents wear masks and have seen masks worn in the community, so I do not think it is as big an issue as people are saying it is.

I commend the Minister and offer my solidarity with him in respect of the behaviour outside his home on Sunday. It was appalling and that behaviour needs to be dealt with, as I am sure An Garda Síochána is doing. I wish the Minister well. He is leading the response to Covid on behalf of all of us and, overall, he is doing a very good job. We all wish him well.

I welcome the Minister and join others in condemning the protest outside his family home and, indeed, protests outside the family homes of any politicians of any persuasion. That is to be condemned. There is a time and a place for protest and free speech, and we have a proud record in this country of allowing protest to take place on our streets. We have seen examples of that during the Covid pandemic. It is right and proper that free speech be allowed but not in the form of protests at the private properties of politicians.

I do not listen to "Liveline" but I see on Twitter that one parent asked, "Where does it all end?" on the programme today in the context of her son being forced to wear a mask in primary school. Another caller called in and said, "For me, it ended with a sealed coffin for my dad." That puts things in context and was a powerful contribution from somebody who faced a father's death. I have not heard from principals in my area but I have heard from colleagues that some principals in their areas are saying they will not comply with the regulations and will not ask children to comply. It is not good enough. I agree with Senator Conway that many children in primary school will probably be delighted to wear masks. They see their parents and see everyone else wearing them and they might think, "That looks like great fun." It is a serious health issue, though, so I ask people to comply.

High-efficiency particulate air, HEPA, filters in schools have been talked about for some time. Maybe they are talked about so much that people believe they are the necessary safeguard that can solve all these problems. Are they? What are our counterparts in other countries doing regarding their school ventilation systems? Is it a cost issue or a science issue? I have said before in one of these contributions that we started off very well with signage in our businesses and places people frequent, but I think that has waned somewhat. As a member of the Houses of the Oireachtas Commission, I have been told that even compliance with hand sanitisation within these Houses has dropped somewhat, following inspection. I will not name places but I know shops in Galway where you see absolutely nothing in terms of messaging on Covid and nothing of prominence about the location of hand sanitiser dispensers. There are too many empty hand sanitiser dispensers in the country as well.

I welcome the progress that has been made on the booster campaign. We can be very proud as a nation of the high uptake of the vaccine here, comparing it internationally. Hot spots are being looked at in some areas where there may be a high immigrant population that may not have the language skills to know about the vaccine and its availability. Information is being provided in different languages to ensure that people know about that. That is important as well. Also, we are engaging with the COVAX facility in supporting other nations. This is not just a moral issue; it is also in our self-interest that the world gets vaccinated. It is important we accept that. We are trying to stay ahead of Covid via vaccination and while we have a very high rate of vaccination here, Austria and Germany, which are First World or developed world nations or whatever you want to call them, have much lower rates. It is worrying that they have such low rates compared with ours because, as the virus mutates, without sufficient levels of vaccination it will cause further damage throughout the EU and throughout the world and other variants in the future may reach these shores.

One could say that it was inevitable the new variant would reach Irish shores, particularly when it had reached the UK. Nobody is particularly surprised that it has arrived and obviously we must limit its spread. The more people that we can vaccinate with the new booster campaign the better.

Looking forward to next year, can we say at this stage whether St. Patrick's Day will be as it used to be? Can we say that the Galway Races will take place next July and August? People are worried about such events taking place. I hope we can get back to some level of normality but we must deal with a new variant at a time of year when people are most at risk of transmission as they will be confined and congregate together. I wish the Minister well in his work.

I welcome the opportunity to say a few words on this issue. I welcome the Minister to the House and congratulate him. He has had a very difficult period over the last two years as the Minister for Health. No Minister for Health in the history of the State has suffered as much he has or encountered so many difficult situations. It is a great task to get on top of this pandemic that befell the whole world and great credit is due to him, and the Government, on so many different occasions. With being hit by so many different variants at different stages it is not an easy time to be in his shoes.

No sector of society has been as hard hit as the hospitality sector. When one considers what some in the industry have gone through, and are going through, it is very difficult. The industry comprises great employers. They employ people who would never be employed. They employ young people and people who attend college. They employ people who leave secondary school and some people who attend secondary school. They give most people their first job. All of this has changed for them. People in the sector cannot work from home and these businesses need customers to come into their premises. Those are two factors facing the industry.

The schemes and support systems that have been put in place are very welcome and very much appreciated by the sector. However, in some cases, people fall between the cracks. I have one case where a pub provided drinks and then provided food. Schemes were brought in and it falls between the cracks so may not qualify for the employment wage subsidy scheme, EWSS. I have written to the Minister for Finance about one such case. The Government should look sympathetically at cases that are highlighted.

Let us consider the last couple of days. NPHET or the Government should have communicated with Ryanair. Mr. Michael O'Leary must be congratulated for operating the biggest airline in Europe and providing connectivity. As an island nation we should be most thankful to him for the connectivity that we have now around Europe. Connectivity has been made possible to a large degree by Ryanair. Mr. O'Leary has operated Ryanair through very difficult circumstances. He said very harsh things about the Government, and I suppose it is every man to his own trade in this business. However, Ryanair should have been contacted because it is not easy for an airline to change all of a sudden and implement the impositions put on it by the Government.

Last week, in my own area we were notified that there would be a walk-in service provided at Breaffy, Castlebar, County Mayo, which operates for the whole county. For several hours persons over 60 years could walk in. The over-60s were unfairly treated on one occasion where they were given AstraZenica but younger people were given other vaccines and before them. However, last week, the over-60s could walk into the vaccination centre if it had been five months since they received their second dose. If 152 days had lapsed double vaccinated people could get their vaccination there and then without notification. Today, I noticed that I got a letter but it does not state that there are any walk-ins for over-60s. There is a service for people who are underage, minors, schoolgoers and people who have received one vaccine and who can get a second dose. It seems that no provision has been made for the over-60s for the next couple of days. Some people under-50, who received a different vaccine from AstraZenica, have qualified to get their second dose. I would have presumed that there still would be walk-in centres in the western region and Castlebar area for people over 60 years in the next couple of days provided that everything was in order. Am I correct?

I welcome the Minister to the House and thank him for attending this important debate. Yet again we are at a crossroads in the context of Covid-19. It is a bit like Groundhog Day with a recurring pandemic that continues to baffle eminent immunologists and virologists. We must certainly keep our guard up.

I endorse the remarks made by my colleague and friend, Senator Burke, about the hospitality sector. The Minister is very much aware of the need for us to continue our supports for the hospitality sector. We know well that the sector has been badly hit by the pandemic. It is not in the gift of the Department but the Government can make a decision on whether to extend and retain the EWSS employment support at the levels we had for November. I ask that we give ongoing support, as we have done, to the industry in the first couple of months of 2022 in order to assist the employers in the hospitality sector to sustain livelihoods through the retention of jobs thus ensuring the survival of the hospitality sector.

I could read emails into the record of the House that I have received from friends of mine who work as employers and employees in the hospitality sector. Both the employers and employees are fearful and worried about the future of the hospitality sector and where they will be come January and February of next year. One person said to me that the exit plan announced a few months ago was based on a set of circumstances as predicted at the time but now we are in a different situation where quarter 1 of next year could be catastrophic. That is just an example. I will not dwell on the hospital sector too much more only to say that the rate of room occupancy has fallen and it is important that we support the sector.

I wish to make a point about the vaccination programme. Last Sunday in Cork, it took people four hours to progress through a walk-in vaccination centre, which is an inordinate amount of time. I appeal to the Minister to reopen Parc Uí Chaoimh and the Munster Technological University, MTU, where we had successful vaccination centres. I also appeal to him to consider using community pharmacies, pharmacies and GPs as a means to ratchet up the vaccination and booster programmes.

It is important to have a balanced debate on schools. I have spoken to school teachers and young students about the wearing of masks in school and found that the vast majority have no difficulty doing so. There are people who like to whip up hysteria and I do not understand why. We should ensure that there is an element of balance in what happens in the ongoing battle against Covid-19.

The measures announced by the Government this week are important. Our challenge is to protect each other and public health must trump everything we do. It is important that we get booster vaccines delivered as quickly as possible. I welcome that Brian MacCraith coming back. It is also important, in the context of the future of the vaccine roll-out, that we use every arm of the State available to ensure that vaccines are given to people.

We need an overarching debate on working from home in terms of public health measures and bed capacity. My overarching request to the Government is that we retain for the hospitality sector the employment wage subsidy scheme at November levels.

I welcome the Minister. Before coming here to speak, I printed off a copy of the Covid restrictions and the new measures being introduced. Reading through the list, I saw that the vast majority of our society is open. Quite limited measures have been put in place. As Senator Buttimer said, much hysteria has been driven by certain groups, factions and political parties. They are causing angst in people, which s very regrettable when we are dealing with something as serious as this.

I have a number of issues, particularly about the education system. The Minister for Education, Deputy Foley, will come before the House tomorrow to speak about education and I will direct some of my questions to her. There is an issue with regard to medical certification for youngsters in the context of wearing masks. Perhaps there was a slip of the tongue by the Minister for Education earlier. It is something to be addressed. Children who cannot wear masks because their glasses keep fogging up and who are not able to study properly should not have to get medical certificates. This should be a matter for common sense on the part of principals in schools.

Vaccination is the key to everything. Collectively, we have stood firmly behind it. We are up to a vaccination rate of 93%. Unfortunately, 7% of the population made the decision not to get vaccinated. We should introduce more measures with regard to using the vaccine certificate for certain services in order to try to increase the rate. I spoke to a nurse manager at one of the hospitals in Dublin where up to 60% of the beds in ICU and the hospital in general are taken up by members of that 7% of the population. What is more worrying is the fact that in the hospital in question, four of the theatre nurses are unvaccinated. These nurses cannot be rostered into theatre. They are still working in the hospital and earning their weekend rates or whatever they might have been getting when they were in theatre. They are putting more pressure on the existing staff, who are overworked as it is, by the fact they have not received the vaccine. The nurse manager must then try to get agency staff for cover them, while dealing with other staff members being out because of being close contacts. We need to make a strong decision on this with regard to everyone in the health service needing to be vaccinated. Other countries have done this. There might be kickbacks from mules, but Covid is not going to end in the short term. We will be dealing with it in the long term. The health service and health staff have worked extremely hard over long hours. Some of them have not had holidays. They have not done things with their own families. It is incumbent on the small percentage in the health system who have not been vaccinated. We have to take a serious look at this.

I concur with the comments of Senator Buttimer on the hospitality industry. I know the latter does not fall under the remit of the Department. Over recent weeks, we have seen huge numbers of events that were planned for over Christmas being cancelled. The businesses involved will take a serious hit. At Cabinet level, we must insist that the employment wage subsidy scheme continues. Otherwise, many of these businesses will not survive. There is also a responsibility on the hospitality industry to check Covid certificates of people going into their premises. A strong percentage are not doing so. All of us know the places we have gone. I have left places that have not asked for the certificate. I purposely showed my certificate. A significant number of places are not asking. The vintners and the Irish Hotels Federation have to have a strong campaign. If the Government is to support them, which I am pretty confident it will, they have to support the measures we are putting in place to make sure we look after our population and ensure we do not go back into a lockdown.

I want to ask about deaf pupils. It is an issue in schools. Today I spoke to an organisation that represents parents. There will be a severe difficulty for these children with regard to lip reading. Perhaps there can be discussions with the INTO in this regard in order that some concessions might be made.

The Minister is doing a good job. We are looking after our people and that is our responsibility as public representatives. We are ahead of almost every other country in Europe with regard to how we are dealing with it. As a Government, we are probably not communicating it properly to people. Much of this has to do with the fact that certain groups and political parties are trying to muddy the waters with the information going out.

I join all my colleagues in saying how upset and annoyed I was with what happened outside the Minister's home. A member of my family brought the matter to my attention and I watched the video. It is shocking. It is good to hear all sides stating we totally condemn it. I experienced this a few years ago as a Deputy. It was not as bad as this. It should not be happening anywhere. I know the Minister is a strong man but we very much think of his family in this situation. It should not be happening to any politician.

I agree with much of what Senator Carrigy said. Due to the fact that so many hotels and restaurants have contacted me about cancellations, I made the point on the Order of Business earlier that most of society is open. It is not open in the normal way, and we all accept this, but we are not living in normal times. There is no need for people not to go out and have a family meal or a meal with their friends as long as they adhere to what they are supposed to do. There is no need to call off everything. Most places have called off the big Christmas parties. The reality is that we are dealing with Covid.

With regard to the mixed messages, we cannot but have mixed messages with Covid. That is due to the way it changes from week to week. We were making progress, and now we have a new variant. We are not sure about where we will be with it for a few weeks. It is a new threat. The message changed. It is not the Minister, the Government or the medical people; it is just the way Covid has shaken us all. It has really turned the world upside down, whether we are speaking about business or politicians. It has changed everything - all aspects of life. We have to deal with it. The Minister is doing his best, as is the Government, to keep people safe. This has to be the bottom line. Of course, we will have hiccoughs with new situations with masks, and I heard a discussion on this not too long ago. There will be little issues but they will be sorted out.

I know the Opposition has a job to do, but I remember some Opposition politicians stating six months ago that the roll-out of the vaccine was a disaster. It turned out that Ireland ended up best in the world. The Minister kept his head down, as did the officials, and kept working on it. It is the same with the booster vaccinations. I will get my booster vaccine in the coming days. The pharmacists and doctors are at it. Last Friday, the Minister of State, Deputy Butler, was in Roscommon. The centre is in Kilbride in County Roscommon. The Minister has also been there and the staff appreciated his visit.

These are unusual times and difficult circumstances. It is causing turmoil throughout the world. We have very little control over it. Society is managing to function but it is functioning in a different way.

It is in everybody's interest to keep our schools open, but I am convinced that, with the good work of the principals, teachers and parents, the little hiccups that exist will be sorted in the coming days and all will be okay. The Minister is correct that any child who is uncomfortable with a mask will not have to wear it. That is fair enough. All the relevant considerations, such as those concerning children with a disability, are taken into account.

There is a challenge facing the hospitality and entertainment sector. It is appreciated that the Government has looked after it pretty well to date, but it is now facing something of a crisis. I am sure the Government will consider extending schemes and reassessing circumstances to ensure the livelihoods of those in question are not affected. One hotel told me it has had 75 cancellations. It was so joyful when there was a return to some sort of normal opening. Staff had to be retrained because some had been lost. Now the sector faces this all over again. Therefore, I appreciate the challenge.

We will have differences of opinion but politicians, the media and others should all be united in fighting this pandemic. It is a global threat. It is important, now more than ever, to have unity of purpose. Of course we will all have questions and disagree on points but we should remember that if we are to defeat this virus, we must be unified nationally and globally.

I thank the Minister for attending to discuss this important issue. I compliment the Government on the job it has been doing to date. Little did we think in February 2020 that we would be in the same situation in December 2021. I compliment those behind the roll-out of the vaccine programme. The vaccination centre in Limerick moved to a location just up the road from my house. Its work there started today. I was talking to somebody who works in the centre earlier and was told it has had a brisk day. This is good to see because the Patrickswell centre was not working.

We need a renewed campaign to get the message out. I have said before that when people see an advertisement ten times, it fades into the background and they no longer see the message. Some people still do not get the message so we need to find a new way of communicating the importance of getting vaccinated. While it is not proven that vaccination stops the disease from being transmitted, it certainly helps to reduce its severity. It is important that we encourage as many people as possible to get vaccinated. There is a small minority who, for medical or other reasons, could not be vaccinated. We must consider some sort of way leave for such people. There are those who have chosen not to be vaccinated but there are others who, for genuine medical reasons, cannot be vaccinated. We need to consider this.

I am glad the number of Covid cases in University Hospital Limerick is down. It was quite a worry for a while. The Minister will know there have been long waiting lists in the hospital. If the number rises again in the hospital, will private or other hospitals in the area be used so people will not be left waiting for various procedures? To date, they have been left waiting.

I cannot emphasise enough the plight of the hospitality sector over the past 18 months. We all agree that those in the sector are the most vulnerable. I would like the Government to consider keeping the employment wage subsidy scheme rate at its current level. Hoteliers and restaurateurs to whom I have spoken in the past 24 hours have had numerous cancellations. Cancellation is the customer's choice but the hotels and restaurants will have employed staff and bought food. They incur many losses. Therefore, we need to examine this matter with a view to supporting businesses. I thank the Minister for attending.

I pay tribute to the Minister on the work he is doing while having to put up with the behaviour of what I can only describe as Neanderthals. I am referring to how they have targeted him personally and politicians' private homes. I commend the Minister on the work he is able to do while having to deal with this. It is very much appreciated by Members of the Oireachtas of all political parties and none.

At times over the past 18 months it has been very easy to lose perspective. In this regard, consider where we are today by comparison with where we were last year. Last year we did not have vaccines, and antigen tests were not in use. We had to lock down the entire country when we had the number of cases we have today because we did not have any other way to combat the problem. Fast forward 12 months and we have one of the highest vaccination rates in Europe, which is incredible when one sees the problems Austria and other countries face in trying to vaccinate their populations. It is an incredible tribute to the Irish population that we have such a high vaccination rate. It is sometimes lost on people in this country how well we are doing in that respect.

We now have antigen tests. We are able to keep the vast majority of sectors in our country up and running despite the current case numbers. That is the perspective that is needed. I have said before that there are elements of the media that, for whatever reason, are happy to play Chicken Little and say the sky is falling in because of the prospect of a new variant coming along, only for us to find out the following day, from the small bit of evidence we have, that the symptoms are quite mild.

The second point on perspective is that I feel the case numbers announced every night are sometimes a little disingenuous because there are so many non-current cases included. It is difficult for people who are watching every evening to understand the trend. When one digs into the figures for the past couple of weeks, one sees a tapering off, a decline in case numbers, fewer people coming out of intensive care units and fewer people having to go to hospital. This is because we are vaccinated and because vaccinations have worked so well. That needs to be brought into the debate. We need to take a deep breath, take a step back and have perspective.

The term "living with Covid" has been thrown around so much over the past 18 months. My view on living with Covid involves vaccination, accepting Covid is in the community and doing our very best to keep the country open as much as possible, based on listening to the scientific evidence and the Government making decisions thereon.

On the potential new measures, I do not want to make any guesses. I do not believe there is a need at this stage for additional or tougher restrictions, especially when we see the direction of the numbers and how well we are doing. It is forgotten, because of the Chicken Little narrative of the sky falling in, that we are now in a much better place today than the best possible outcome for today that was suggested by the NPHET modelling. Therefore, we are in a really good place. It would be very difficult to argue in favour of further restrictions.

On school numbers, schools have not suddenly become crazy, unsafe places. The virus is thriving in places where people are not vaccinated, including schoolchildren between nine and 12. It is for this reason that we see a high rate in the schools.

I am conscious that we have to call the Minister at 6.20 p.m. but I want to try to give everyone an opportunity to contribute. I will allow Senators Cummins and Dolan a minute each, if that is acceptable.

That is fine. I thank the Cathaoirleach. I am in the cohort who received the single-dose Janssen vaccine, the Johnson & Johnson vaccine.

I welcome the Minister. He spoke about Ireland being the country in Europe with the fifth lowest mortality rate in respect of Covid. That is phenomenal and it is due to our high vaccination rate. He noted 42 additional ICU beds have opened this year. HSE recruitment, which he mentioned, has been sorely lagging, that is, there is a time lag between when the hiring process begins and the person takes up the post. He stated we have taken on more than 3,000 nurses and 2,000 health and social care professionals but can anything be done to shorten the timeline for recruitment within the HSE in order that we will see the impact of this budget on the ground?

I thank colleagues for their contributions and time. I always find debates in the Seanad really valuable, useful, thought-provoking, challenging and important, so I thank Senators as always for their time. I will try to address the various issues raised as best I can and I apologise if I miss some of them.

Senators asked about progress on the Delta wave. We are dealing with two different but related matters, that is, a Delta wave, which we have a plan in place to deal with, and the new variant, for which various actions are being taken. As has been pointed out, the latest information we have, which we received earlier this week from Professor Nolan's team, plotted what is happening versus the projections we were given a few weeks ago. As colleagues will be aware, we were given no-change future possibilities, with an optimistic and a pessimistic scenario. This was where we saw the issue that was most concerning to me, that is, that by Christmas week, we faced a range of just-Covid ICU patients of between 200 and 450. The implications of that for patients and the healthcare system are profound, so we acted and took various steps.

Probably the most important step was a message, which everyone in this House got behind, to say to people we had to reduce our social contacts, stick with the basic measures and use masks and the things we know work. Clearly, people have changed their behaviour, as they always do. I again acknowledge the incredible response from people. Individuals, families and communities throughout the country have adjusted their behaviour and it has had the desired effect of pushing back down the virus. Our case numbers now are significantly below what was likely to happen if there had been no policy change.

More encouraging than that again are the figures for hospitalisations and ICU admissions versus what was likely to happen if nothing changed. Here we can really see the impact of the booster programme, a subject I will return to given various colleagues have sought more detail on it. We are seeing a really important lower profile of hospitalisations and ICU admissions for Covid versus what it would be if nothing had happened. A combination of the booster programme, which is moving at pace, and, just as important, people acting in a safe manner to keep themselves and their communities and families safe has worked very well.

Many other measures are in place, as we are all aware. These are: PCR testing and contact tracing; antigen testing, which I will return to shortly; the Covid pass, which we have extended; the winter plan; the flu vaccine; the nursing home measures; the working-from-home measure; the midnight closing in the hospitality sector; household close contacts staying at home for five days and being sent antigen tests; and antivirals, which were referenced and which, while they have not yet been deployed, we are ensuring will be deployed here as soon as they are ready. All these measures are working.

It is human instinct for us, including Members and the public, to focus on the bits that are not working. That is right and proper and, obviously, there must always be challenge. It is important, however, not to lose sight of the fact the overall approach, this national effort from people throughout our nation, the Oireachtas, the Government, the HSE and industry, is working. It is important people know their efforts are bearing fruit and, ultimately, will save many lives, in the context both of Covid and of not having to cancel non-Covid care at a level that otherwise would be required. In summary, when it comes to the Delta wave, the plan is working, and again, it is a national effort. I am not trying to claim credit for the Government here. As always, this is a national effort and it has, broadly, been a cross-party effort.

A really important message for us all to get out, and I thank all the Senators who raised it, is that everyone should get vaccinated or boosted. I put together some figures for the debate. Right now, more than half of hospitalisations and more than 60% of ICU admissions in respect of Covid are unvaccinated. If people, therefore, choose at this point to be unvaccinated, they are putting themselves and the people around them at risk. It is taking up an awful lot of capacity within the system that otherwise would be used for other patients to get them the surgery and the procedures they need. It is important we do not enter a blame game; that is not what this is about. We need to try to reach out to these people to say vaccination really matters to protect them, other people, healthcare workers and our healthcare resource.

Another figure I thought was quite interesting is that currently, about two thirds of Covid hospitalisations and ICU patients are under 45 years of age. It is important to bear that in mind, given there is an almost 100% vaccination rate among the higher age groups and that falls off among younger groups. In fairness to younger people, the figure is nonetheless between 80% and 89% among the late teens and 20-somethings, still very high by international standards, but it is interesting that two thirds of Covid patients in hospital, including in ICU, are now under 45 years of age. That is an important message.

The most important message the public health experts are always trying to get out to all of us is that if one is symptomatic, stay at home and get a PCR test. I acknowledge there are delays. We would like to get everyone booked in the next day but sometimes it is taking two days or, in some cases, three. A total of 80% of self-referrals are being seen the next day. We would love that figure to be 100% but the vast majority are being seen the next day. In the case of priority referrals, which are from a GP or as a close contact, 97% of them happen within 24 hours. We always want to make it better and better but the core message is that if one is symptomatic, stay at home and get a PCR test. If one is going out, layer up with protection, that is, masks, distancing, ventilation, hand hygiene and so forth. That makes a significant difference. I referred earlier to some new research that shows how effective these simple and basic measures are.

On the booster programme, I am delighted to be able to share that more than 800,000 doses have been administered, between the immuno-compromised, who received third doses, and the booster doses. A total of 210,000 of them were administered in the past seven days and we are moving at speed. The initial focus, as Senators will be aware and I think will be bought in to, has been on everyone over the age of 60, those with underlying conditions, those with weakened immune systems and our healthcare workers.

I thank colleagues for their contributions and time. I always find debates in the Seanad really valuable, useful, thought-provoking, challenging and important, so I thank Senators as always for their time. I will try to address the various issues raised as best I can and I apologise if I miss some of them.

Senators asked about progress on the Delta wave. We are dealing with two different but related matters, namely, a Delta wave, which we have a plan in place to deal with, and the new variant, for which various actions are being taken. As has been pointed out, the latest information we have, which we received earlier this week from Professor Nolan's team, plotted what is happening versus the projections we were given a few weeks ago. As colleagues will be aware, we were given no-change future possibilities, with an optimistic and a pessimistic scenario. This was where we saw the issue that was most concerning to me, namely, that by Christmas week, we faced a range of just-Covid ICU patients of between 200 and 450. The implications of that for patients and the healthcare system are profound, so we acted and took various steps.

Probably the most important step was a message, which everyone in this House got behind, to say to people we had to reduce our social contacts, stick with the basic measures and use masks and the things we know work. Clearly, people have changed their behaviour, as they always do. I again acknowledge the incredible response from people. Individuals, families and communities throughout the country have adjusted their behaviour and it has had the desired effect of pushing back down the virus. Our case numbers now are significantly below what was likely to happen if there had been no policy change.

More encouraging than that again are the figures for hospitalisations and ICU admissions versus what was likely to happen if nothing changed. Here we can really see the impact of the booster programme, a subject I will return to given various colleagues have sought more detail on it. We are seeing a really important lower profile of hospitalisations and ICU admissions for Covid versus what it would be if nothing had happened. A combination of the booster programme, which is moving at pace, and, just as important, people acting in a safe manner to keep themselves and their communities and families safe has worked very well.

Many other measures are in place, as we are all aware. There is PCR testing and contact tracing; antigen testing, which I will return to shortly; the Covid pass, which we have extended; the winter plan; the flu vaccine; the nursing home measures; the working-from-home measure; the midnight closing in the hospitality sector; household close contacts staying at home for five days and being sent antigen tests; and antivirals, which were referenced and which, while they have not yet been deployed, we are ensuring will be deployed here as soon as they are ready. All these measures are working.

It is human instinct for us, including Members and the public, to focus on the bits that are not working. That is right and proper and, obviously, there must always be challenge. It is important, however, not to lose sight of the fact the overall approach, this national effort from people throughout our nation, the Oireachtas, the Government, the HSE and industry, is working. It is important people know their efforts are bearing fruit and, ultimately, will save many lives, in the context both of Covid and of not having to cancel non-Covid care at a level that otherwise would be required. In summary, when it comes to the Delta wave, the plan is working, and again, it is a national effort. I am not trying to claim credit for the Government here. As always, this is a national effort and it has, broadly, been a cross-party effort.

A really important message for us all to get out, and I thank all the Senators who raised it, is that everyone should get vaccinated or boosted. I put together some figures for the debate. Right now, more than half of hospitalisations and more than 60% of ICU admissions in respect of Covid are unvaccinated. If people, therefore, choose at this point to be unvaccinated, they are putting themselves and the people around them at risk. It is taking up an awful lot of capacity within the system that otherwise would be used for other patients to get them the surgery and the procedures they need. It is important we do not enter a blame game; that is not what this is about. We need to try to reach out to these people to say vaccination really matters to protect them, other people, healthcare workers and our healthcare resource.

Another figure I thought was quite interesting is that currently, about two thirds of Covid hospitalisations and ICU patients are under 45 years of age. It is important to bear that in mind, given there is an almost 100% vaccination rate among the higher age groups and that falls off among younger groups. In fairness to younger people, the figure is nonetheless between 80% and 89% among the late teens and 20-somethings, still very high by international standards, but it is interesting that two thirds of Covid patients in hospital, including in ICU, are now under 45 years of age. That is an important message.

The most important message the public health experts are always trying to get out to all of us is that if you are symptomatic, stay at home and get a PCR test. I acknowledge there are delays. We would like to get everyone booked in the next day but sometimes it is taking two days or, in some cases, three. A total of 80% of self-referrals are being seen the next day. We would love that figure to be 100% but the vast majority are being seen the next day. In the case of priority referrals, which are from a GP or as a close contact, 97% of them happen within 24 hours. We always want to make it better and better but the core message is that if you are symptomatic, stay at home and get a PCR test. If you are going out, layer up with protection, namely, masks, distancing, ventilation, hand hygiene and so forth. That makes a significant difference. I referred earlier to some new research that shows how effective these simple and basic measures are.

On the booster programme, I am delighted to be able to share that more than 800,000 doses have been administered, between the immuno-compromised, who received third doses, and the booster doses. A total of 210,000 of them were administered in the past seven days and we are moving at speed. The initial focus, as Senators will be aware and I think will be bought in to, has been on everyone over the age of 60, those with underlying conditions, those with weakened immune systems and our healthcare workers.

Here is where we are at on that. Those aged 80 or above, those in long-term residential care and the immunocompromised are substantially done or have been offered a booster. Approximately two thirds of healthcare workers and those in their 70s have been boosted and more have been offered those vaccines. We are moving very quickly now through those in their 60s. As of two days ago, approximately 20% of that group had been done. More of them are now eligible by virtue of it having been five months since their vaccine. It is not the original six-month target that we are using; it is five months, which is the shortest gap we can use. Obviously, it is three months for those who received the Johnson & Johnson vaccine. This week, we have walk-in clinics for front-line healthcare workers and the over-60s. Critically, one of the groups in respect of which I engaged with the HSE to ensure it happens as quickly as possible is that of people with underlying conditions. The vast majority of people in hospital with Covid have an underlying condition, so it was very important to me that we got those people done as early as possible. That is now happening this week. They are being contacted by the HSE this week.

In terms of antigen testing, there has understandably been a significant amount of talk about subsidisation or stopping the subsidisation. Let me explain that. I believe antigen testing has a very important role to play. The priority for me is ensuring that antigen tests are widely available and affordable and that people are supported in using them and receive good advice on how to use them and how to interpret the results. In other words, it is the green light-red light idea. We must ensure antigen tests are not used instead of PCR testing in the situations where PCR testing is the right thing to do. There are very good materials now available online on the HSE website and public communications campaigns have been launched. The tests are widely available. We send many thousands of them to houses all over Ireland every day for household close contacts. They are now going out to schools. They are in colleges. They are used in nursing homes, as well as many workplaces and healthcare settings.

The latest information we have is that approximately one in five people in the country is using an antigen test every week. They are now being widely used. I wanted to go further and make sure they were available at a reasonable price because, for me, €7 or €8 a test is not affordable for far too many people. I wanted to see the price brought right down and, therefore, we looked at subsidising them. Subsidising them is not a cheap thing to do. We are talking about a lot of tests. As part of that process, there was a significant and healthy engagement with the retail sector and various others on antigen tests and the price came down. It came down from approximately €8 to between €2 and €4. That is not the case everywhere. I saw it reported that a person said this has not worked because he or she found a pharmacy where the tests are €8. If the tests are on sale for €8, people should not buy them there. They should go elsewhere and buy them for less than €8. I want to make sure the price goes down further. We are continuing to engage to that end. Essentially, the policy objective was to bring about a significant and quick reduction in the retail price, and that has been achieved without having to deploy public money. That is the situation there.

There has been much discussion this evening in respect of masks for nine, ten and 11 year olds. We need to be very balanced in how we speak about this. This is a public health recommendation from NPHET. It is one that NPHET considered in great detail and it is driven in part by the fact that there has been a very significant increase in cases for nine, ten and 11 year olds. There has been an increase in cases among younger age groups, but the rate among nine, ten and 11 year olds is the highest in the country. It drops right back down again for 12 year-olds. I am happy to share those data with colleagues after the debate. I can ask the Department to send them on. The belief is that the huge drop from 11 year olds to 12 year olds is down to a combination of factors. It is down to the fact that 12 year olds can get vaccinated, but also that most or many 12 year olds are in secondary school, where masks are being used. That is supported by international evidence that shows the really important protection masks provide. We got a sensible and fully thought-through recommendation from NPHET on mask wearing for nine, ten and 11 year olds. That translates broadly to third class and up in primary schools. A decision was taken to make it third class and up, rather than having mixed rules in respect of mask wearing in classes containing nine year olds and eight year olds. That is the public health rationale. It is in place for one reason, which is to keep children safe.

I ask Senator Gavan to reflect on his usage of language such as "punishing children". I do not know if it is a line his party is taking. It is really unhelpful language. This is a public health measure coming from the Chief Medical Officer and NPHET with one objective, which is to keep children safe. I have a child in that age group and this morning he picked up a mask and went into school. Would they all prefer not to be wearing masks? Of course they would. Do we take very seriously any public health advice that affects children? Of course we do. However, there is only one objective here, and that is to keep children safe. I ask all present to keep that in mind when debating this issue. Obviously, they may challenge and disagree with the measures but Oireachtas Members in particular need to be very careful with the language they use. I disagree with the kind of language used by the Senator. I do not think it is helpful.

That is probably a good segue to the issue of communications. There is, understandably and rightly, a significant amount of focus on communication. In a pandemic, communication is, obviously, essential. I will be the first to admit that we must always do better. There are definitely things we can do better. I take on board the challenge and criticism that has been levelled from all sides and that is fair. I was thinking this through during the debate. Of course, every day and week we should try to do more. Right now, between Government, the Department of Health and the HSE we have public communications campaigns on broad public health measures, as all present will be aware and support, in respect of distancing, masks and hand hygiene. Those are core messages.

There is a public communications campaign on vaccines and first doses for people. We have a public communications campaign on the boosters, not just their importance but where people can go, who we are doing, when each cohort will be up and how people can engage. We are communicating on the new international travel measures because, obviously, they have a big effect on people. People need to know about them. We have public communications on testing and tracing. We have public communications on PCR testing, contract tracing, enhanced contact tracing, antigen testing, flu vaccines and more. Those are just some of the issues I wrote down this evening. I make that point not by way of excuse - we have to do better - but because I want to share the significant complexity of the health communications during the pandemic. That is not to say we cannot do more and should not do better. We can do more and we must do better.

I wish to address this idea that if NPHET advises something but the Government decides to do something different, that is somehow mixed messaging. It is not. NPHET provides public health advice and the Government makes decisions. That is how it works. We have taken the decision, with which I think all present probably agree, to publish the NPHET advice. It is published online very quickly. I believe people have a right to know not just what governments decide, but what the public health advice is. If we publish public health advice that we get on a Thursday and then meet as a Government on the Tuesday and take a few days to consider that advice, which we do, and we may make decisions on a Tuesday that are different, then I suggest to colleagues that not only is that not mixed messaging but transparent communications. Most of us know that and get that. It is quite healthy. That is part of it. I hear and accept the challenges and criticisms in terms of the public communications. We have to always try to be as clear as possible and get it right.

I will end on a positive note. The issue of antivirals was raised in this debate. A definitive position has not yet been reached. Engagement is still ongoing. As colleagues will be aware, a joint EU procurement programme, similar to that used to procure vaccines, is being considered. I have instructed the officials to engage directly with the pharmaceutical companies as well. The policy position is essentially to do whatever gets them here and in use the fastest. Good progress has been made on that. As the Senator will be aware, these antivirals have not yet been authorised by the European Medicines Agency but indications from the trials with regard to the role they may play, and that I believe they will play, is very encouraging. They will be another quite powerful tool for Ireland and other countries in helping people to avoid hospitalisation and really severe illness. Things look positive in that regard. When I have a more definitive position and when agreements are in place, I will update colleagues as quickly as I can.

Will the Minister refer to the TRIPS waiver?

I may have to come back to the Senator on that point. I had some notes on that matter. The short answer is that, as the Senator will be aware, I am on the public record as being in favour of such a waiver, as I have told him before. However, I am cognisant of the EU position. One of the concerns at an EU level is that there may potentially be unintended consequences if some of the incentive for these companies to move very quickly is removed. We can agree or disagree with that. This is a position that has been put to me. Let us say we remove intellectual property protection and then this new variant turns out to be serious. If it please God, it will not, but let us say that it does. Let us also say that the variant requires the vaccines to be adjusted. Will the pharmaceutical companies move as quickly in those circumstances? These are the kinds of concerns that have to be worked through.

My view is that we need a globally just solution to this. There is no point in us here in Ireland getting our first and second doses, our booster vaccines and who knows what else in the future unless a globally just solution to this issue is found. We must find such a solution for ethical reasons and reasons of justice and rights first and foremost, but enlightened self-interest is another reason to do so. It is in our interest to do so. It is not that this should be the motivating factor but it happens to also be in our interest.

Globally, Europe is at the centre of the export of vaccines to the developing world. A €1 billion proposal is being put in place to develop permanent production capacity in developing countries. This means those countries would not just be reliant on supplies being transported from other parts of the world. Let us forget about the EU for a second and ask what we in Ireland can do. We have donated several hundred thousand doses of vaccines. We have also donated more than €7 million to COVAX. It is the Government's intention to do more but, when one looks around the world, one sees that Europe is leading the way in exporting large amounts of vaccines to lower and middle-income countries.

More can be done. Perhaps Ireland can play a role in that, given our high vaccine uptake rates. Colleagues will be aware that the South African Government recently asked the pharmaceutical companies to slow down delivery of the vaccines because of vaccine hesitancy. Perhaps Ireland, as a small country, can play a role in that regard, given that there has been a very successful programme here which has been embraced broadly. I assure the Senator that I believe there must be a quick and just solution to this issue that makes sure that vaccines are distributed all over the world. However, we must do more than just distribute vaccines. We want to see permanent production capacity in these countries so they are not reliant on other parts of the world to send them vaccines. Ireland and other countries can provide additional support with regard to public engagement and the roll-out of campaigns to address vaccine hesitancy, leading to high take-up rates.

I thank the Minister. He has given us more of his time than he was scheduled to. I appreciate that. He gave a comprehensive reply. I met the Minister for the first time in connection with a health issue in Kerry. We were trying to recall the Seanad, which we managed to do. We also tried to recall the Dáil but did not succeed. The issue in question was organ donation. The Minister has been a champion of that for many years. There were reports in the newspapers and other media in recent days that an organ transplant operation had to be cancelled as a result of lack of available ICU beds. As the Minister will know, I am very passionate about the issue of organ donation. As we know, 600 Irish citizens are on the waiting list for an organ transplant. Many are taken off the list because they become simply too sick to receive an organ donation. As the Minister has said, we do not want to get into a blame game in respect of this issue but, when people get this opportunity only for it to be taken away from them at the last minute, it can be very hard to take. What are the Minister's thoughts on that issue? It obviously affects the whole health system but, in that particular case, a person had a chance to live a much longer life and to have an enhanced quality of life. People can spend decades on an organ transplant list. It is huge for them when an opportunity arises but, in this case, that opportunity was taken away as a result of something that would not happen in normal circumstances. What are the Minister's thoughts on that particular matter?

Are we getting supplementary questions?

The Minister has given us enough time. If he would like to come back another day, we can deal with the question at that time.

I am more than happy to do that. I am aware of the case. It is being looked at. It is absolutely soul-destroying for the patient, the patient's family and the family of the donor for that to happen. The anguish such a situation can cause is indescribable. It should never happen. We are making a lot of positive policy changes in respect of organ donation. Legislation is coming through which will essentially move us to an opt-out system rather than an opt-in system. Investment is being made in the infrastructure required. There may also be opportunities in respect of international sharing. We do some of this and I have asked the Department to explore opportunities to develop a wider international network for sharing.

As the Cathaoirleach will be aware, the situation he has mentioned came down to the availability of an ICU bed. We have to keep the pressure up, as we are doing, in order to get ICU and critical care capacity to a satisfactory level. We simply do not have that now. The baseline of 225 critical care beds was too low by a long way. We have tasked the HSE with adding as many critical care beds as possible. There is no issue in respect of funding. I have allocated over €60 million in funding over this year and next year just for critical care. It is not a straightforward thing to do but it is absolutely essential and will help with regard to the issue the Cathaoirleach has raised.

I thank the Minister for his time today and I thank all colleagues who contributed to the debate. When is it proposed to sit again?

Tomorrow at 10.30 a.m.

The Seanad adjourned at 6.49 p.m. until 10.30 a.m. on Thursday, 2 December 2021.
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