Roadmap for Living with Covid-19: Statements

I welcome this opportunity to update the House on Resilience and Recovery 2020-2021: Plan for Living with Covid-19. Before I begin, I want to acknowledge the enormous impact this virus has had on our society. Every corner of the country has been affected on some level and it has touched every county, community and family. We have had to stay away from friends and family members for months. Some people have lost their jobs and others have lost businesses that they had dedicated their lives to building. Some sectors have been particularly badly hit. The arts community, the people to whom we turn to keep us going, inspire and comfort us in dark times, has been decimated by the virus. The arts thrive on people gathering together for shared experiences and that is the very thing that Covid-19 forces us to limit.

The same applies to the hospitality sector, sports and many other areas of our country, community and lives. Those groups, like the arts community, have done everything they can to respond to the challenges of Covid-19. They have adapted, innovated and worked tirelessly but the inescapable need for less social interaction in order to suppress this virus has come at a high cost to all of these sectors in every county across the nation.

We have not been able to celebrate weddings, birthdays, communions and many other of life's milestones as we would want. At funerals, we have not been able to say goodbye, pay our respects and mourn the deceased as we need to.

We now have more than 36,000 confirmed cases of Covid-19 in Ireland. We have reported the deaths of 1,804 women and men from Covid-19. I express my deepest sympathies, as well as those of the Government, to the families and friends of every single one of these women and men.

I pay tribute to the front line workers who have worked tirelessly since early this year. Our healthcare workers have played an absolutely vital role in combating this disease and caring for those who needed healthcare when they were affected by it. Other public services, including An Garda Síochána, the Defence Forces, local authority staff and many others are to be commended by us on their commitment to this national effort. Tragically, some healthcare workers lost their lives while caring for others during this pandemic. I pay particular tribute to them, their families and their loved ones.

The virus is having a huge impact internationally. There are more than 33 million confirmed cases and in excess of 1 million confirmed deaths from Covid-19. We are not alone in trying to devise a strategy to limit the growth of this virus and its impact on our people, communities, economy and lives.

It is clear at this point that the virus is going to be with us for some time. While we cannot be certain how long that will be, we nevertheless have to plan our society and live with the virus in the meantime. Chapter one in our fight against Covid-19 involved closing the country down in order to flatten the curve. While that came at an extraordinarily high price for many people, it worked. It is not something we can continue to do. Therefore, we are taking a new approach.

This is chapter two, keeping the country open while suppressing the virus, moving early and targeting the virus where we know it spreads so as to protect lives, resume health care services, keep our schools, colleges and childcare facilities open and protect jobs. The resilience and recovery plan provides us with a way of navigating chapter two, allowing society and businesses to operate as normally as possible while continuing to suppress the virus. It is designed to help individuals, organisations and sectors to better understand, anticipate and prepare for measures that might need to be introduced as the virus moves through the country.

The framework in the plan brings clarity and certainty to how we will move forward with opening our society at this time. Inherent in the framework is a prioritisation of activities. It represents a move away from the short term emergency response that was needed to a medium-term risk management of the virus, including repairing the impact Covid-19 has had on our economy and society.

Given the constantly evolving nature of this pandemic, it is critical that a certain amount of flexibility is built into the plan to allow for a nuanced approach. This allows our public health doctors and the Government to take account of disease profile and trajectory at a given time and to make decisions accordingly. Each numbered level in the plan corresponds to the measures that will be in place as a result of the pattern and progress of Covid-19 in a particular county or region at a particular time. This is a framework to help guide decision-making by each of us individually as well as collectively and a society.

The measures at each level have been carefully developed by our public health doctors and specialists in infectious diseases. The national framework is built on three pillars. The first of these is healthy people. This involves taking personal responsibility and following the public health guidelines as a first line of defence. It also includes accessible and sustainable testing and tracing, the flu vaccine, non-Covid health and social care services and additional capacity for new ways of delivering non-Covid care.

The second pillar is strong businesses . These include the employment wage subsidy available to the end of March next year, the pandemic unemployment payment, PUP, which is remaining open to new entrants and has been extended to April of next year, loans, grants, rate waivers, vouchers and other support schemes for small and medium enterprises, enhanced restart grants worth more than €550 million, €200 million in training and support for people who have lost jobs, and €500 million in capital works. A stay and spend tax incentive is in place from October to April of next year. There is a six-month VAT reduction from 23% to 21%. The Covid-19 illness benefit has been extended until the end of March next year and local authorities will develop local recovery initiatives.

The third pillar is resilient communities. There will be a strong focus on the well-being and resilience of our communities and a programme of well-being activities and initiatives will be delivered locally, including supporting healthy living, physical activity, managing chronic disease, positive ageing and the needs of young people. There will be local community and voluntary group funding to enable them to adapt their services. Libraries will expand online and digital book delivery services will take place. There will be a permanent volunteer reserve corps established in every county, and individual mental health supports will be provided.

In tandem with the plan, I am working with the HSE to develop services as part of the winter plan to ensure that resources are devoted to those areas that will see the most benefit as we approach the seasonal impacts on our hospitals and other healthcare services. Central to all of our efforts is a robust testing and contact tracing strategy for the virus. The HSE and Department have worked intensively over recent months to put in place a comprehensive, reliable and responsive testing and tracing regime.

The HSE has increased resources significantly, including optimising and maximising our laboratory testing capacity on the island. The HSE is finalising its future service model for testing and contact tracing at this time. This includes recruiting a permanent workforce as well as other service improvements. The National Public Health Emergency Team, NPHET, continues to be a vital resource for the Government, advising on public health measures and strategies to limit the growth of virus in our society. It continues to monitor the emerging international evidence and the advice of the WHO and European Centre for Disease Prevention and Control, ECDC.

In the absence of a vaccine for Covid-19, the advice for the public continues to be to limit the number of people we meet outside our homes and the time we spend with people. It includes wearing a face covering on public transport, in shops and in other indoor settings, avoiding crowded places as much as we can, avoiding public transport where possible and walking or cycling instead – that is obviously not possible for all people at all times - avoiding places where we cannot keep 2 m apart from each other where possible, and working from home if possible. I recognise that many people, including many essential workers, simply cannot work from home, but there are measures that can be taken in some instances, such as social distancing.

We have seen very positive responses to the communication of this roadmap. The high number of people wearing face coverings, for example, demonstrates the solidarity in our society in respect of dealing with this virus. We must continue this solidarity if we are to suppress the virus.

We have come a long way since March. We have learned to live in a world with this virus. We have reopened many aspects of our society and economy. Around a million children have returned to school. Students are returning to college. Our health services are resuming. The majority of society is open, despite the highly infectious and dangerous disease circulating among us.

We succeeded in doing these things thanks to the collective efforts of all of us to adhere to the guidelines, as well as to the expert knowledge and advice from our public health doctors and specialists and the dedication and hard work of our frontline workers. Right now, we need individually and collectively to keep doing the basics right. This is what the vast majority of people are doing everyday. We have the power to adhere to the public health guidelines. The regulations in place are designed to assist each of us to make choices to reduce the risk to ourselves, our family and our vulnerable loved ones. I urge everyone to listen to the public health doctors, to the public health advice and I ask all Members of this House to use their influence to support this message, support our public health doctors and the national guidelines in place. Together we will suppress this virus. We will keep people safe. We will keep our schools and colleges open, protect jobs and continue this fight. I thank the House.

I thank the Minister and call Deputy Pádraig O’Sullivan.

Gabhaim buíochas leis an gCeann Comhairle agus cuirim fáilte roimh an Aire.

I greatly welcome the publication two weeks ago of the roadmap for living alongside Covid-19. Covid-19 has placed great demands on every one of us, as individuals, parents, families, workers and indeed business owners. The overall aim of this plan is to keep schools and crèches open in as many of these scenarios as possible. The Government prioritised that schools would remain open. We are all well aware that children depend crucially on education and learning. I recognise the great amount of work undertaken to make this possible.

The reopening of international travel formed a key part of this plan. The aviation industry is one of the industries that has been most affected by the Covid-19 pandemic. All airlines have suffered a severe depletion of revenue and are now facing significant financial challenges. I recently attended a briefing at Cork Airport where I was told that the passenger numbers there had declined by 95% due to Covid-19. Its impact on Cork Airport is expected to see the loss of over 2 million passengers this year and more than €23 million in lost revenue by year end.

Ireland’s approach to international travel has sought to protect public health. This has certainly been the correct approach in the earlier phases of the pandemic. It is now time to find a reasonable balance that combines public health requirements with those of a functioning economy. The Aviation Recovery Task Force published its final report recently and it contained several recommendations relating to the provision of further support to the industry. The European Commission has also published a proposal to promote a common approach to travel restrictions and movement within the EU. The Minister has previously stated that work is required to develop these recommendations into effective interventions and that this work is well underway. I ask that the Minister and his Department make this an urgent priority and would appreciate an update or general timeframe as to when these interventions will be in place. The importance of Cork Airport to our economy and to the region cannot be underestimated. I want to ensure that Cork Airport’s interests are to the forefront of this Government’s agenda.

On a totally different topic I will talk about messaging. I compliment the Minister and his Department in tackling in recent months what has been a national crisis. I understand the key messaging regarding the Covid-19 tracker app and the various tools that he has at his disposal. I urge that we look at other countries in Europe, such as Belgium, France and Germany, and even countries in Asia such as India, in order to complement our own Covid-19 tracker app, with a specific messaging service, be it through WhatsApp or through mobile providers. If messaging was made directly into people’s individual mobile phones every day or couple of days, with specific problems or problem areas highlighted and specific messaging around identifying cases and so on, this would be of great benefit.

Another point is regarding the local electoral area, LEA, breakdown and the figures that are available on the Health Protection Surveillance Centre, HPSC, website. The data on this website is updated every Thursday, so we will be waiting to have it uploaded later today, based on last week’s figures. Every week there is some chaos, as people are asking are we going into lockdown. Is the city, in the case of Cork, or the county, going into lockdown, or are both? I point people towards the HPSC website to look at their LEA but I urge the Minister and the Government, with a county the size of Cork which equates to the size of four or five counties, to consider seriously this point in future area specific lockdowns, be it urban or LEA. This needs to be looked at. I thank the House.

We move to the Sinn Féin slot where Deputy Cullinane will be sharing with Deputies Cronin and Ward.

Yes, and with Deputy Ó Snodaigh as well, a Cheann Comhairle, when he come in. We have a number of speakers. I will start straight away with my eight minutes.

First, I welcome the opportunity that we have been given to debate this plan. As he knows we have been looking for this debate for some time. As someone who has been calling for briefings and more interactions between health spokespersons and party leaders with Deputy Donnelly, as Minister, and with NPHET, I welcome an email I received from the Minister and his office yesterday saying that those briefings will be put in place. They are very useful and as much engagement as we can possibly have will be of benefit to all of us. Analysing, probity and scrutiny does not in any way underestimate the public health advice or indeed any decisions taken by the Minister. It strengthens the overall approach.

I also join with the Minister in calling on people to do whatever they can to play their role in suppressing this virus. Local leadership can play a great part. Look no further than Waterford, and indeed Tipperary and Limerick, as examples of that. I spoke to the CEO of Waterford City & County Council yesterday on this matter and he quite rightly pointed out that what we should be looking at is more localised input into the public health advice that is given, having local influencers, using the local radio station, using the local GAA, sporting, rugby and football clubs and getting as many people as possible to spread the positive message. Indeed this should include politicians, from councillors to Oireachtas Members. That is what we did in Waterford over the past number of weeks and we can see that the numbers have gone down. They have also come down in Limerick and in Tipperary. That needs to be looked at.

The national message is important. Sometimes the national message can get muddled if different counties are in different positions. The national public health officials and the Minister should also look at ways in which we incorporate more localised responses and leadership into the overall responses.

The plan to live with the virus has to do a number of things. It has to keep schools open which we all accept. I have two children going to school and I want to see them continuing to go to school for all sorts of reasons but mainly for their own personal development. We also have to ensure that we keep people in jobs and that people can go to work, which is of great importance to them. We have to protect our health services, which includes not just the acute services but mental health services as well.

We also, however, have to allow people to live. That is the more complicated part but it is important. Living means that people have to have social outlets and opportunities. We have to find ways where we can adhere to public health guidelines, keep socially distant, do all of the things that are required of us with the hand washing, cough etiquette, the wearing of a mask and all of the things that we need to do, but people need to live. When people hear that this will be with us for six, nine, 12 months or more, that is all the more reason that we must give people hope.

We also have to stop blaming certain sections of society, whether it is pubs or restaurants, or young people, for the spread of the virus. Some of the commentary that I have seen in recent times about young people has been unhelpful. We need to speak to young people and to acknowledge that young people play a role of great importance in suppressing the virus. When mistakes are made these should be pointed out, but it has to be balanced and proportionate. We have to understand that young people need social opportunities. It is a big issue for them when they cannot go to college, when it is online, when they cannot interact with people and when they cannot go and meet their friends in the way they did before. We have to accept that and explain that it cannot be the way that it was. We also have to give people hope that it can be better. That is what the plan should be about.

I need to put a number of questions to the Minister and I will give him two minutes to respond to them. One concerns comments from the acting CMO yesterday that the window of opportunity for it not to be a national issue is closing. Can the Minister reaffirm for this House that he was not talking about all counties going to level 3?

That is a very important point. There was a significant amount of speculation on social media about what the acting CMO said. It is very important that there is clarity. The plan has five levels and different counties will be at different levels. If the Government is looking to move the whole State into level 3, that should be communicated. If it is not looking to do so, then the acting CMO needs to explain better what he meant by referring to this becoming a national issue in the context of the various phases. It is important that there is no misrepresentation of what is being said. I am giving the Minister the opportunity to clear that matter up from the Government's perspective.

My final question relates to a comment made yesterday by the Tánaiste, Deputy Varadkar. He seemed to indicate that we should only use the incidence of hospitalisations to determine whether a county goes up a level or down a level, as opposed to all the other factors of which NPHET would take account. To me, that would be a departure from what is in the plan. That statement needs to be explained. Will the Minister explain what the Tánaiste meant? It is important that we do not have very senior politicians flying kites after the Government has published a plan that sets out guidelines. I ask the Minister to respond on those two issues.

This is not a question and answer session.

I was allowing the Minister to answer in the time allocated to me.

I am afraid the Deputy may not do that.

Does the Minister not wish to answer?

It does not matter whether he wishes to answer. The Order of Business allocates this time to statements, not a question and answer session. We cannot make up the rules as we go along.

I wish to raise the case of a young constituent of mine in north Kildare. Céilí lives in Naas and she is not doing well with Covid-19. She is three years old and profoundly deaf. As a result of a heart condition, she cannot be fitted with cochlear implants, so she relies on two hearing aids instead. Without them, the only sounds she can hear are vacuum cleaners and lawnmowers. As she is young, her hearing aids need to be adjusted regularly and her hearing needs to be tested regularly. The moulds must be snug in her ears. Just like Goldilocks, Céilí needs her hearing aids just right. However, for months during the summer she could not get them adjusted because of the bizarre political decision made in March to redeploy the highly skilled paediatric audiologists on whom Céilí depends as Covid-19 contact trackers. I have heard of service dogs smelling the virus, but I have never heard of audiologists hearing the virus.

Children such as Céilí were told to go whistle and her hearing aids certainly did that. Her mother could hear the hearing aids whistling on the ground floor while she was on the first floor of their home. Céilí did not get an appointment until seven months later. Her mother is now seeking assurances that there will not be a repeat of this lack of service because Céilí is missing out on the tiny opportunity she has to learn how to speak in order that she can keep up with her peers. I spoke to her mother last night. She is frantic, and rightly so, because she knows her daughter needs to take this chance.

Will the Minister guarantee that these highly skilled and desperately needed audiologists will be free to work with children such as Céilí who need their specialist skills, rather than wasting those skills contact tracing? When I think of the thousands of people who volunteered under the Be On Call For Ireland initiative, it seems to me that the past six months have been wasted. To give Céilí the chance to speak, I ask the Minister to listen to what she and her parents are saying. Will he guarantee that the audiologists will be available to carry out this necessary fitting?

If this was a real roadmap for living with Covid, I am afraid we would be turning into dead end after dead end when it comes to people seeking supports for mental health. I am a member of the Special Committee on Covid-19 Response. I listened to expert after expert tell the committee that we are facing an avalanche of mental health issues. The experts stated that mental health services that were already out of date and not fit for purpose prior to Covid were facing unprecedented demands on their services. The many years of underinvestment in mental health supports are coming home to roost.

The previous Minister for Health, Deputy Harris, spouted at every opportunity about how he got €1 billion spent on mental health last year. I remind the Minister that that is the same amount that was spent in 2009. The fact that there has been no substantial increase in mental health supports for more than a decade shows the indifference of the Government and previous Governments to mental health supports.

Tonight on RTÉ1 there will be a special broadcast of a programme entitled "The Next Normal". It will relate how 33% or one third of the people surveyed for the programme have suffered with their mental health in the past six months. Mental health providers have stated that they are inundated with people crying out for help. The warning signs are stark, but there is no mention of mental health in the winter plan that has been developed to prepare for and manage the anticipated pressures this winter. That plan will be discussed later today but I will not have the opportunity to contribute on it. Where is the winter plan for mental health? Where is the roadmap for mental health supports? It is simply not good enough that we are forced to rely on non-governmental organisations and charities to plug the gap in State mental health supports. Only yesterday, the St. John of God group, which has provided mental health supports for more than a century, had to give notice to the HSE that it can no longer operate due to its financial difficulties.

We are facing a tsunami of mental health issues due to Covid-19. Not only is the Government standing on the beach watching the wave approaching, it is also burying its head in the sand.

In the little time I have, I wish to raise several points with the Minister. The Labour Party welcomes the roadmap. We consistently stated that it is necessary. The Minister should have had the acting CMO with him when it was announced. It might have helped with the deep issues that came across in communications. I was glad that he recently projected we need to be planning for this for six to nine months. It was with that in mind that I told the Taoiseach that we need to deal with the next six months differently from the way we dealt with the previous six months. I would like the Minister to listen to these remarks and maybe pass them on to Dr. Holohan who will be returning to his post. I acknowledge Dr. Glynn for the way he stood in for Dr. Holohan. Covid came at the best time for Ireland. We had a very good spring and then it was summer. Now we face six months of bad weather in autumn and winter.

We need to give people hope. We need to prepare in two three-month projections. I am asking the Minister to set out such projections and give people hope that they will be able to enjoy Christmas, see their loved ones again and possibly travel outside the country. People need reassurance that they will be able to have a Christmas that at least resembles a normal Christmas. If all Deputies work together on the matter, would the Minister consider preparing two such projections? It is just a suggestion to give people hope. The Minister is a reasonable person. I know it is a suggestion that comes from the Opposition, but would the Minister consider preparing a plan for the weeks between now and Christmas, setting the situation out county by county, and stating that if we all pull together, we can have a Christmas when loved ones will be able to see each other. Another plan would be released in early January to bring us up to St. Patrick's Day. That would break the back of it and we would then be back into spring and summer and we would then see where we would be.

On lockdowns and changing phases, I appreciate what is stated in the roadmap, but there is no doubt that some counties are adapting. My own county has one of the lowest rates, but as I stated on local media in an attempt to show leadership, that could change pretty quickly. Will the Government give consideration to more localised lockdowns, particularly in urban areas, rather than locking down entire counties? Has modelling been done on how that could work? Dr. Glynn stated that he was concerned about the amount of traffic in Dublin, but in an interview an hour or two ago, the Minister stated there was a lesser amount of traffic. We need to make sure the messaging is consistent. My principal question regards whether more localised lockdowns could be used and whether that has been modelled.

On moving from phase to phase, the Government needs to give notice of such changes, especially when an area is moving into a more stringent phase. The hospitality and tourism industry needs more notice. Yesterday I discussed budgetary measures with the Taoiseach. We need to ensure there are budgetary measures in place to support sectors that are impacted by decisions to move to stricter phases. The hospitality and tourism sector, including those providing food and accommodation, lose out immediately when such decisions are made. We need to customise and mould the response to such circumstances.

Similarly, students have paid their fees and also paid for accommodation, and then everything suddenly moved online.

Turning to older people, my parents are both aged over 80. I have spoken about this issue before, and this situation has not been good for people in that category. We need to give those older people hope. During the phases to come, we need to give older people the capacity to socialise and have normal lives. They have given the most and paid the most taxes, but unfortunately they have the least amount of time left with us, on average. We need, however, to give those people hope and to do that we need a plan for that group of people. We also need a plan, and I want to see this in the budget, that will ensure that people with disabilities, particularly those with intellectual disabilities, who are our most vulnerable and those we should be most concerned about, are looked after during the phases of this roadmap.

I will move on to the last issues I want to raise. It has always been said that we follow the public health advice and the Government has always said that it follows the public health advice. We now know, however, about a date when the CMO wrote to the Government stating that the issue of sick pay had to be dealt with, but the Government did not follow that public health advice. The Government did not follow that advice, it is as simple as that and that is an anomaly. We are asking people to follow public health advice, so when NPHET asks the Government to do things and but it does not, I ask that the Government to please explain why it is not doing what has been recommended. I ask that because I see that as a complete contradiction.

One issue I really want to get to is the area of testing and tracing. It is obvious that we must let those therapists and specialists who are doing some of this work back to their day jobs. I understand that the Minister agrees with me. I have some ideas about how we could undertake the recruitment necessary for that roll-out, but I want to present them to the Minister personally and privately. I do not have time to do that in detail here, but I will do it separately.

In addition, we also need to look at other technologies, such as rapid testing. We need to examine how we are going to facilitate people coming in through the airports. I met some of the people who look at this testing and I have had a Covid-19 test, which has a high level of accuracy, and I had the result in ten minutes. The test was done in front of me. We need to look at what other technologies being used across Europe and the world. We must examine how can we use them if we can get them through the regulatory process quickly enough and if Dr. Cillian de Gascun and his team approve them. Might it be possible that we could model it so that we could bring such testing into some sectors, test and check the process several times and then use that method?

I state that because we need that type of technology rolled out into society to allow people to go about their business a little bit more freely. I encourage the Minister to look at other technologies. We have the analogue version of testing, but we also need to look at the digital version of testing. They may have other issues, but we need to check them all out. If we can use those technologies then they may have a positive impact on some of this roadmap, how we move through the phases and how we open up society and allow businesses to operate. I ask the Minister to please take on some of my suggestions.

Deputy O'Connor is sharing time with Deputy Lahart.

Covid-19 restrictions were initially put in place as it was feared that the unknown nature of the virus would overload our healthcare capacity which would, in turn, cause a downward spiral in healthcare provision and increase the level of deaths. These measures were initially introduced with a short timeframe of several weeks in mind. The virus remains in our society today, but more is now known about it than when it first came to Ireland in March. According to our current knowledge, a vaccine for the virus will not be available within the next 18 months, at a minimum. Considering the rate of fatalities from Covid-19 compared with other established human illnesses and the potential long-term consequences for society, I feel that a reassessment of the objectives of how we manage the virus should be considered.

The capacity of our ICUs is a critical metric for determining the significance of the level of cases. While it is understood that it is beneficial to reduce the number of cases in general as this ultimately reduces the number of deaths, the ratio between the number of cases and deaths and our ability to impact on that ratio should be considered and the necessary investment in healthcare capacity should be prioritised by the Government to deal with that issue. If we have an adequate level of ICU provision to deal with the level of cases within society at present, then we should look to balance this against the level of restrictions throughout our society and the impact that such restrictions are having on the quality of life of our citizens.

It must also be noted that the nature of restrictions must be questioned. Under the medium-term nature of the restrictions, as compared with the short-term measures in March, people are likely to forgo social interactions and reduce their social contacts. This can be seen in the increase of uncontrolled social gatherings. A logical conclusion to draw from that, therefore, considering the balancing act required between ensuring hospital capacity is not overrun and the level of societal damage that restrictions are causing, is that a strong case can be made for reopening controlled environments such as restaurants, hotels and pubs.

Overall, clearer objectives regarding the significance of the meaning of the level of cases need to be considered alongside the potential long-term consequences of restricting part of our economy. If capital investment is required in the healthcare sector, the initial upfront cost will be mitigated by the potential savings of lost economic growth arising from maintaining a level of restrictions. Regarding damage to our economy, a 2020 report from the World Bank recognised the need to incentivise a switch to more sustainable production processes, including a move towards a great digitalisation and green investment which will enhance the productivity of our economy. There must be a recognition that the dynamic of the economy has changed and it is not sustainable to continue to support industries in their current form. A realignment of resources should be undertaken during the budget.

At the same time, we must be conscious of the economic scarring of certain sections of our society in adapting to this changing work environment. Systems must be put in place to ensure that reskilling and job reactivation schemes are put in place so that the levels of inequality within the economy do not widen, as stressed within the World Bank report. Large capital investment programmes should be pursued across several areas where the economic return on the investment will be redeemed over time. With current Irish borrowing costs at record low levels, this is an excellent opportunity to raise the capital necessary to pursue such initiatives.

Turning to the impact on young people, this must be more of a priority for the Government. The long-term development of the country is dependent upon young people buying into the institutional structures of our State. If the level of trust that our young people have in this State is diminished, that can make it harder to have a functioning institutional framework within society and to mobilise knowledge and the productive capacities of a significant sector of our society. If this issue is not addressed, it will make it far more difficult to return to the level of economic growth required to return our economy, country and society to the standards of living we enjoyed previously.

I am delighted to have the opportunity to contribute to this debate, and I commend the Minister on the task he has been given to undertake and deliver on in the most trying and challenging of times. The Minister is doing a fine job. He has the best wishes of this side of the House and, I hope, the other side of the House. The Minister is in the position at a unique time in history when we are faced with a pandemic for the first time in a century. That is quite a burden and responsibility to deal with. He is entitled to the support of his peers and he certainly has it.

I want to focus on one facet of this plan, because I know some of my colleagues have dwelt on the different aspects of the Roadmap for Living with Covid-19. The strategy has much to recommend it and there is much to read in it. Clearly, there has been much thought and planning and an awareness of the impact that phase one of Covid-19 had on people. There has been a huge amount of learning and I want to come back to one specific aspect of that.

In a previous professional chapter in my own life I practised as a psychotherapist and I took a particular interest in the literature and research around loss. Generally speaking, the public - I hope I am not underestimating them - tend to associate loss and grieving with the loss of a loved one. The literature, however, tells us that we can go through the same stages of grieving, if perhaps not so acutely, when we lose many other different things that we take for granted in life. That can include loss of health, loss of status, loss of routine, loss of friendships, loss of work colleagues, loss of work, loss of business, loss of a partner present during labour and loss of having a partner present during pregnancy-related appointments.

It can include loss of hugs, loss of granny, loss of granddad, loss of work colleagues and loss of joy. My sister sent me a photograph on WhatsApp recently of myself and herself and her husband outside Mulligan's this time last year celebrating the drawn all-Ireland game and the picture really hit me right between the eyes. What I saw in one little moment encapsulated what has been taken away from us. There we were with not a care in the world drinking our pints and the people around us very happy, and all of that has been robbed of us. In the literature, they tend to say, generally speaking, that there are five stages in grieving a loss. The most underestimated response to loss is anger when people do not get to express their feelings around the loss that they have just experienced. I have elucidated just a few of those kind of losses. We could have a much longer list than that. As a parliament and as a society, we need to watch out for anger. There is a significant amount of unexpressed anger in society at present.

I am particularly taken with the emphasis and the research work done. I am looking forward to what the Minister will produce in practical terms because there is a good roadmap in, I think, section 6 on resilience and community. I am taken with the work that SpunOut has done, particularly with the generation aged 16 to 25. As Dr. Tony Bates said in an article in The Irish Times this morning, people in this age group have suffered more than most because it is the time when they develop primarily through contact and interactions with their peer group and that has been denied to them. Do we begrudge them when they break out of the rules a little? I would side with Dr. Bates on this. We need to practise the rules but we need to be human too and resist pointing the finger.

We need to give people hope. How does one give people hope? Generally, when we get bad news, we learn to live with it, cope with it, absorb it, internalise it, digest it, grieve the consequences of it and move on. There is no moving on with this pandemic because we do not know when it will go. This means that there will be continued losses carried on by society. I often think of how useful Dr. Maureen Gaffney's morning piece with the late Gay Byrne on the radio used to be years ago. She psychologically analysed the nation and dealt with its problems. I know that much of this stuff happens on social media and it is really positive. I think the Government needs to step into this space. There is one useful thing we could do. It is not for the Minister; it is for the Cabinet. We need to do something special for people this Christmas, such as give city and county councils significant budgets for fantastic public lighting displays that people can go out safely and admire. We need to put some thought into this. It will be a Christmas like no other and the State needs to step in.

I refer to all the messages people are receiving from the State. I looked at the make-up of NPHET this morning. It is such a fine body of people, generally from a medical background. I hope I am not being harsh on them when I say that the people who have a psychological, mental health or well-being background are on the administrative side rather than on the medical side. In Ireland, we tend to separate physical and mental health from each other instead of looking at them as one integrated piece. We have a big task as a Government on the mental health and well-being piece. People across society, even people who have been virtually unaffected by the virus, have suffered losses. It could be that they cannot go to see their son or daughter playing the local sport. That is a loss. People are angry about that. The Government needs to acknowledge that. In our messaging, we need to find a way to give people hope. Hope has been missing from much of the messaging coming from the Government. We need to devise a way to give people something to cling on to or hope for, whether it is the promise of a great festival the likes of which has never been seen in the country or whether it is devising ways of memorialising those people who have been lost to Covid, even now at distance in our churches, in our places of worship or in a humanistic way.

There is much good. I am looking forward to the outworkings of the SpunOut investigation into the needs of younger people, but this is a cross-society requirement. In bringing this back to his Cabinet colleagues, the Minister should watch out for anger, which is the most underestimated response to loss.

Deputy Paul Donnelly is sharing time with Deputy Ó Laoghaire.

First, I pay tribute to all the front-line workers and all those who have been working so hard over the past number of months. I express sympathy again to the family and friends of those who have passed way and those who have suffered throughout this pandemic and crisis.

Covid-19 has seen the decimation of many small businesses across the State, certainly across my constituency. I have been in contact with many of them over the past number of months since the initial shutdown and also as the guidelines changed and came out and we went into different phases. I am sure all Members will be aware of this. I am sure many of these businesses and similar ones in the Minister's constituency have been in touch with him time and again. They are terrified of what is to come. They are terrified at what has happened. They are afraid for their businesses, for their employees and for their employees' families and loved ones and how they will see their way through this. As the Minister will be aware, all of these business people work extremely hard to pay their bills, keep their businesses going, pay their employees and create local employment. Many of them have dug deep into their reserves financially, psychologically and emotionally to deal with the Covid-19 crisis, to reopen their businesses and to get their workers back to work so that they can also pay their bills. Some of the businesses that come to mind in my constituency include the gym that I go to, Ger Conroy Fitness, and a wonderful water babies group in the swimming pool in Junction 6. There is also a salt cave, which was a brand new business that had only opened in February. Those involved had put their heart and soul into it. These are people who had come to the country, had an idea and wanted to build a future in this country. I have seen many such businesses struggle with it.

The overarching theme I am getting from constituents is that there is confusion over the guidelines and that is what we need to get right. There is fear around how they can continue to open up and close down. That is what happened many of the businesses that have been in contact with me. I will mention as an example a café which is right next door to a bookies. The café is closed to people inside. They have tables outside to try and keep the business going and they offer a takeaway service, but the bookies next door has virtually no guidelines or rules. Up to 30 people are allowed in depending on the size. There are no names being taken. There is no rule on how long the customers can remain within. Two businesses are operating side by side under the same guidelines but there is confusion about why in one case, customers can stay all day if they wish because there are no rules to say that they cannot and in the other case, customers cannot even walk in the front door and have to stay outside. People are looking for clarity and an understanding of where they need to be. That is where we need to be in relation to moving forward.

There are two issues I want to raise with the Minister. I will be as brief as I can. The first is in relation to Cork. There is little other talk than concern around the potential move to level 3.

There is also the very serious situation in hospitals. Dr. Ronan Boland told Claire Byrne's show on Tuesday that there were just three acute beds left between the Mercy University Hospital and Cork University Hospital, CUH, to treat any acute case that might arise among Cork's 500,000 people. Yesterday, the Mercy hospital said that patients should seek care elsewhere due to the pressure on the system. It is clear there is a particular issue regarding hospital beds in Cork. Currently, there are issues with regard to community hospitals and issues like that, which I know have been discussed in other areas, and that due to the pressures they may not be admitting additional patients. Can we look at that with a view to resolving some of those issues, even at a later stage, because beds in community hospitals and step-down beds relieve the pressure on acute hospitals? Whatever the case, we need to find additional capacity in hospitals in Cork.

The other issue I want to raise is that schools are open. I welcome that and give credit to the people involved in that, including many people in the Department and the Minister, but we need a specific plan to keep the schools open. The Minister knows that teachers and school staff are very concerned about the difficulty with regard to social distancing. We have 1,300 schools in the State with classes of more than 30 children. There is a need for a significant investment to fund and deliver additional space and the staff required for them. We need additional space to ensure that schools can adhere to social distancing and safety for the children, the school staff and everyone connected to the schools because there is a great deal of concern and it needs to be addressed. There are issues around communication also. I have corresponded with the Minister on that but it needs to be addressed.

At the outset I commend Deputy Lahart on an excellent, thought-provoking and challenging contribution. It was really good and very moving. There was so much in it and I hope his Government colleagues were listening because there are major issues about loss in many different ways, the real fear that that will engender anger and the absolute need for people to be given hope. I want to thank the Deputy for that. I believe his contribution stopped many people in their tracks and made us think.

I have a few points to make. The Minister referred to this document as a roadmap. He is probably the only one here referring to it as a roadmap. It is generally referred to as a plan. The previous document we had was a roadmap going from stage to stage. This is a plan and it is more accurately described as a framework because it sets out a structure or framework where we can see that if we meet certain unspecified criteria in terms of danger we will move to the next level. It is helpful from that point of view and, hopefully, people will become more familiar with it and motivated to pull together in order to go down the levels.

I have to say that this is not a strategy; I have said that already to the Taoiseach. I am not sure at this stage, seven months into the Covid-19 pandemic, exactly what is the strategy. It is not clear to me and I believe it is not clear to many people. That is critical to keeping people with the Minister. What we have done is concentrated, supposedly, on having a very good testing and tracing system. That has been a patchy experience. Ultimately, however, the approach that is being taken is that every time there is an upsurge there is a lockdown. That is not a sustainable strategy by any means, not least for business, but for everybody in living their lives. I ask the Minister again to ensure that consideration is given to suggested strategies and learning, in particular, from the experience in other countries. There are many elements in terms of what we should be doing to try to minimise the incidence of Covid-19. There are many things we are ignoring in that regard, and I will come to them shortly, but it must be to come as close as possible to eliminating the virus. People talk about zero Covid-19. Those same people are saying that the aim should be at least zero. By doing that we identify all of the high-risk areas and then take action on those. That does need to be the approach but there needs to be at least debate on what is the best strategy and the pros and cons of different approaches. That debate has not taken place.

The second point I would make is that messaging is key in terms of keeping the public with the Minister. The launch of this document was a missed opportunity; we have said a good bit about that. It was a time when people were listening in but the messages were very unclear and confused. That was a missed opportunity but we now need to make up for that. The Taoiseach mentioned a couple of weeks ago the possibility of using influencers. I thought that was a very good idea and I suggested that it would have our support. It is not just about influencers on social media for young people. It is about influencing all different categories of people, including those older and middle-aged, people with different interests, sports people, people with an interest in music and different ethnic groups. The message needs to be tailored to those different cohorts. We should be using influencers because with all due respect, many people have switched off watching the standard six o'clock news or reading the broadsheets. People access their news or information on different platforms and in different media and we need to get to people through those different media by using people to whom those different cohorts will listen. What is happening about that? We have been talking about it for a long time.

The next point I would make is on decision-making. NPHET has very significant power. It is making major decisions that are affecting every part of our lives and our country. I said a long time ago that we needed to broaden out the decision-making and that we needed a task force that drew expertise from different areas. It is regrettable we did not do that. We need to have people who understand sport, business, logistics and travel in there who also have an expertise in risk assessment because every aspect of our lives carries risk in respect of Covid-19. It is a matter of assessing the level of that risk and then balancing that risk. In the absence of that kind of expertise, there is an element of guesswork and closing down everything is not sustainable.

Also in terms of the decision-making, I find it very hard to understand the reason the Opposition has been completely excluded from any kind of debate, and I am talking about engaging debate, not shouting across the floor of the Dáil. I am talking about bringing people into a room and looking at different aspects of it. As the Minister knows, there have been hardly any briefings since this Government took office. That is a big mistake. Party leaders and spokespersons want to be involved in that. We have legitimate questions and proposals to make and there should be a forum established. The Taoiseach said two weeks ago that he would give consideration to that. We have heard nothing since.

It is absolutely essential that the 14-day tracing back happens. On travel, and I will talk more to the Minister about this later, I refer to the example that was given at the briefing last night of two people who had been away coming back, mixing with others and spreading the virus to 30 other people. We have to go back to the source. I take it those people were abroad. It would be very interesting to know where they were but when we look at the figures of people coming into the country at the ports and airports, effectively, there is no oversight or monitoring of where the people have been or what they do when they come back. That is a glaring omission in terms of any approach to tackling this virus.

I thank Deputy Shortall. We now move to another Government slot. Deputy Cathal Crowe is sharing time with Deputies Alan Farrell and Emer Higgins.

We are apportioning our time by taking four, four and three minutes. The Minister, his Department and, importantly, the very many front-line HSE staff are doing a great job in grappling with the Covid-19 pandemic, which it now appears we will be co-existing with for some time to come. Covid-19 has thrown a major curveball at this country. Ways of life have changed utterly, and possibly forever, and politically we are now dealing with very real and deep issues in our constituencies and communities.

I would like to bring public orthodontic and dental care to the Minister's attention. With up to 40% of HSE community dental staff currently redeployed to help with contact tracing and testing, there is a backlog of those waiting on public lists for essential treatments. Those who can afford private care to short-circuit that delay are doing so but at great personal cost. I ask the Minister to propose at Cabinet some form of enhanced tax rebate for parents who ordinarily would have brought their child to the public dentist or orthodontist but these days are paying for private treatment.

The next issue I wish to raise concerns Covid outbreaks in schools. It was great to see 1 million students return to school last month. The reopening-of-schools roadmap has been one of the major successes of this Government. The Irish Primary Principals’ Network has a major concern, however. When there is a suspected or confirmed case of Covid in a school, the principal seeks advice from the HSE as to what actions he or she should take. The HSE, at that moment, effectively takes over the management and communication of the event, and the principal defers functions to it. Ideally, the HSE would communicate rapidly and clearly but, in some cases of which I am aware, it has taken up to 24 hours for the communication to filter out from the HSE. In that 24-hour period, the principal is effectively gagged. There may be a member of staff with an acute underlying health problem or living at home with an elderly or high-risk parent but the principal is prevented from having a cautionary word with his or her colleagues. I ask the Minister to take this up with HSE. We cannot have principals stewing and stressing over having knowledge of a Covid case in their schools without having the sanction to inform their staff.

I welcome the fact that the Government's winter plan will inject unprecedented support into our health system this winter. This €600 million will definitely help to resource our health system better over the very tough months ahead. The funding, while welcome as a medium-term measure, does not fully address the challenges that we in Clare and the wider mid-west region face in terms of hospital care. Before Covid hit this country, University Hospital Limerick was consistently the worst off hospital in terms of trolley numbers. The much-needed fix here is very obvious; it lies in increased funding and supports for the other hospitals of the region, namely Ennis General Hospital and Nenagh and St. John's hospitals. I am glad the programme for Government commits to hiring more consultants but I would like to know the strategy that exists to send some of them west of the Shannon. That is certainly a concern we have in Clare.

I wish to address the issue of maternity hospitals. Generally speaking, being pregnant is a medical condition, not an illness. Most women attending for scans or antenatal appointments are in good health. On this basis, maternity hospitals need to be considered to be somewhat different from other hospitals. I hope public health guidance will change in the quickest time possible so more men can attend appointments with their partner or spouse. I was fortunate to be able to attend appointments with my wife when our three children were expected. Some leave the room full of jubilation and butterflies in the stomach but, for those who get bad news in the scanning room, it can be a devastating moment and people need considerable support. Either way, it is a landmark moment in someone's life and the expectant mother needs to be fully supported. I hope current arrangements can be revisited urgently.

I welcome the opportunity to speak on the roadmap. I will start simply by echoing the statements of other Members on the direction of the roadmap regarding businesses closing, reopening and then closing again and the long-term consequences not only for our economy but also for those who work in the businesses and industries that have been devastated over recent months. As we know and have accepted at this stage, we will be living with Covid for well in excess of 12 months, if not more. Even if a vaccination or feasible treatment is developed in the next few months, it will probably take 12 to 18 months to roll it out to the country. We have to take that on board.

I want to focus primarily on mental health, fatigue associated with Covid, messaging and the lack of positivity, among citizens as opposed to the State, regarding how well we as a country have managed to deal with this virus. In spring, there were camaraderie and togetherness in communities throughout the country, with people working together to help the vulnerable, including the elderly and the immunocompromised. The exceptional weather probably helped to raise people's spirits but we are now approaching the winter, when we will be facing 14 or 15 hours of darkness per day. In the context of mental health, the manner in which people are being bombarded with information, often negative, in the guise of necessary information is problematic. NPHET and the Minister need to spend a little more time talking about the fact that citizens in general have done exceptional work in stepping away from one another and taking the responsible steps of wearing a mask, washing hands and respecting cough etiquette.

To echo the comments of the previous speaker, it is problematic when the media, to a certain extent, and others regard younger people or other groups as the cause of a resurgence of Covid-19. We are all in this together, or so we have been saying for the past seven months. We have to take responsibility. The scenes from Galway over the past couple of days really make one's heart sink. The scenes in nearly every village and town I visited in the past few months would make one's heart sink.

To be constructive, however, I want to reiterate what I have said to the Minister. In fairness to him, he has already implemented some of the requests made of him regarding the provision of information allowing people to see where there is Covid in their community. Most people - 1.8 million, in fact - have a Covid app that allows NPHET to communicate directly to them. That app and the opportunity it presents are not being used properly by NPHET. There is an opportunity to convey information directly to people about localised outbreaks and what people could and should be doing to prevent them. I have not yet seen what I suggest and it is critical that we now take that step.

Irish people are defined by their music, arts and culture. We thrive on this identity not only domestically but right across the globe. The arts, however, have been decimated by this pandemic and we must rebuild them. We can start small by allowing dance classes to return. We know that dancing bolsters physical and mental health. It improves posture and flexibility. It lifts our mood and it eases our anxiety. For children, dance classes offer so much more than just dance. They provide an opportunity to make friends, learn a new skill and, most important, build confidence. Kids in my area - Lucan and the rest of Dublin Mid-West - are desperately missing their Dancity classes, their Irish dancing classes and the beats of Zumba. Dancing is a fun activity that sharpens the mind, increases strength and builds social bonds.

For older people, dance classes may be the highlight of the week but, owing to Covid, they can no longer rely on that social outlet. Loneliness is often described as being more detrimental to older people's health than physical illness but not every older person wants to play bridge, bingo or bowls. Some want to dance. Let us face it: human beings of all ages, cultures, religions and countries all love to dance. Dance, whether it is Irish dancing or the Maori haka, is a part of life.

While many of us have got used to dancing in our sitting rooms during lockdown, there is nowhere better to dance than at a live gig. The live entertainment industry is bursting with talent. It is an industry that has offered employment to everyone from sound engineers and roadies to musicians and dancers. All are real people and all are missing their income and outlet right now. All are in need of hope right now. The Minister has the opportunity to give them hope. We have plenty of opportunities to facilitate smaller, more intimate crowds in large venues using social distancing. We have the ability to tweak the pandemic unemployment payment rules so people can do the odd gig or resurrect their dance class without losing the payment that has become a lifeline for them. Let us reignite the arts by thinking outside the box and by moving outside our silos.

Music and dance are so much more than jobs or hobbies; they are passions. I do not know one artist who would not jump at the chance to play to a crowd again, no matter how small. They live for performing and so does the next generation of artists and dancers, who should be preparing for their Christmas concert right now. We must offer them hope and trust so we can get dance back in our legs, music back in our ears and creativity back flowing in our veins.

I thank Deputy Higgins for that uplifting contribution. I do not know if anyone feels like tripping the light fantastic after that, but the next contributors are Deputies Conway-Walsh and Wynne.

I want to concentrate my remarks on front-line staff and their situation in terms of burnout and stress. Front-line staff are at burnout and cannot continue to work overtime in understaffed conditions. This is not safe or fair to the staff or the patients they care for. Trolleys line the corridors and there is not enough staff to look after patients. Staff are being moved from one area to another. I welcome that extra capacity has been provided, as in the case of Mayo, in terms of the stepping down of patients from Mayo University Hospital to the Sacred Heart home, but extra staff are also needed and nobody seems to understand that.

There is also an issue around communication with staff. Decisions are being made without staff being consulted. We do not need reports and expertise to know of the issues in our health services. We need only to listen to the front-line staff. We need to listen to nurses and the health care assistants who are on the wards coping with the people coming in and out of the hospitals. Unless managers listen to the front-line staff, I fear for what is going to happen this winter.

It is only 1 October and in Mayo there are already trolleys lining the hospital corridors. There will be many more trolleys lining those corridors and not enough staff even to look after patients in the corridors. This is a serious situation. Staff tell me that every night they go into work they do not know where they are going, who will be left with them or where they are going to be. Emergency meetings are happening without them. They are being treated like pawns on a chessboard in terms of trying to deal with a really serious situation. We want people to live with Covid, we do not people to die from it. Many nurses are in fear of losing their registration because of the stress that they are under and the mistakes that they may make. The message that I want to go out from this debate is that we need to listen to the staff. They have the answers and they are willing to work. They are already working very, hard and I thank them for the work they are doing.

I would like to address the House briefly on the new Covid roadmap announced by the Government a number of days ago. We all appreciate that this framework was needed and that it is a roadmap for living with the virus over the coming months. However, it quickly became clear that the announcement was not as clear as was hoped. From day one, we heard Dublin was being placed on a type of level 2.5. It has since moved to level 3.5 or thereabouts. All of us in this House appreciate the need for this type of roadmap as we learn to live with the virus. While this framework reduces the numbers of people permitted to attend weddings and sports events, there is no mention of reduced class sizes in our schools.

The Government has been forced to extend the deadline for new applicants to the pandemic unemployment payment. It must be accepted that this payment and other wage supports need to be secured for the foreseeable future while there is a possibility of rolling lockdowns and closure of businesses. There has been no mention of people with disabilities in these guidelines. These people are being left behind by the Government in terms of reduced capacity in our care centres and reduced respite services. Prior to Covid, people with disabilities were attending classes five days per week. Many of them have seen either a reduction in the number of days or hours that they can attend, or both in some cases.

Regarding visitation rights in our hospitals and care homes, I appreciate that the framework allows for visits across the health care system, and I particularly welcome that it allows for visits on compassionate grounds. We need to ensure that this continues as we cannot underestimate the need for family support for people at the start of life and at the end of life. As a mother of five children, I had the experience of having my fourth child completely on my own. Thankfully, everything went okay. I cannot imagine how that experience would have been or is for any woman left completely on her own in a clinical environment.

The announcement of this roadmap was welcomed but it only ever appeared to give a broad outline of the procedures by which we are to live. The specifics of it were never detailed. For example, I have heard from principals of schools in Clare that they are winging the guidelines, with some of them carrying out temperature checks and others not doing so. They feel that they are burdened with ensuring that the guidelines are being adhered to. The messaging around the guidelines has not been clear, concise or coherent. This needs to be rectified.

Deputy Boyd Barrett is sharing time with Deputy Barry.

The people are losing faith in the ability of the Government to deal with the Covid-19 crisis. They have endured incredible hardship and they are facing a grim outlook for the foreseeable future. Despite all of the suffering and hardship they have endured, the situation, once again, is deteriorating. The message that we are all in this together, which underpinned the huge efforts that people made in the early stage of the pandemic, has been blown out the window by the Government. Day in and day out young people are being lectured about their behaviour or supposedly endangering public health because of family gatherings or other gatherings in their homes. They are being berated yet it is deemed disproportionate to ask a judge of the Supreme Court who attended a party to resign. It is one law for society and another law for those who are supposed to uphold the law.

The Government is allowing the banks once again to crawl over the backs of people who have lost their jobs and income as a result of Covid. The pandemic unemployment payment is being cut as these people face into further restrictions and the likelihood for many of their jobs and income being severely reduced for the foreseeable. At the same time, Ministers of State are given shocking pay increases on already excessive salaries and politicians are to receive pay increases. All of this does nothing to underpin the solidarity that we need to face the threat of Covid-19. The Government manages, in a PR, self-protecting way, the information about what is actually happening with Covid-19 rather than being honest with people and trusting their intelligence by giving them the information they need and a part in the debate on what type of strategy is necessary when it is very obvious that the strategy is failing.

I held a briefing last night with the zero-Covid island group which believes we are heading back towards lockdown because of the failing Government strategy, yet the Government does not want to entertain an open and honest debate about that strategy. The Government needs to change or it is going to lose the faith of the people. In fact, I think it is already losing the faith of the people.

Last Monday morning taxis from all over Cork city and county arrived in the suburb of Mahon as taxi drivers prepared for the biggest taxi protest in living memory. They were attempting to draw attention to the terrible financial plight that they face with their families and the lack of action on the part of the Government. If Cork is moved to level 3, their financial position will worsen, as will the financial position of many other working people.

People need supports, including the supports that have been taken away from them. Those supports must be put back in place. I refer, among other things, to the cut in the pandemic unemployment payment. People had €50 or €100 per week which they need taken from their pockets last week. That must be reinstated. Incidentally, taxi drivers and other people who are aged over 65 years need that payment too.

Yesterday, the Department of Housing, Planning and Local Government released information about the numbers living in emergency accommodation in the State at the end of August. The number in emergency accommodation in Cork had increased from 376 adults at the end of July to 400 adults at the end of August. It is insane to force people to go traipsing around the city looking for accommodation instead of keeping them in their current accommodation. The blanket ban on evictions, which the Government ended at the beginning of August, must be reinstated now, at the start of October. That is not special pleading for Cork or Dublin. It must be done nationwide.

Catriona Twomey is a well-known figure in Cork. She is the head of Cork Penny Dinners, a soup kitchen for needy people. She recently expressed her fears and concerns to The Echo in Cork about the effect of a continuing pandemic coinciding with the winter season on the mental health of the people with whom she deals. She said:

We have already lost so many people. Now we're worried that we are going to lose more. ... This [the issue of suicide] hasn't levelled off since March and the Government is going to have to take it seriously.

Implicit in those words is a feeling that the Government is not taking it seriously. The spend on mental health in the State must be doubled immediately. Catriona's call for on-street, one-to-one mental health supports must be acted on straight away.

I am sharing time with Deputy Jim O'Callaghan.

As a member of the Special Committee on Covid-19 Response, I have had, perhaps, more opportunity than many Members to hear the different perspectives on this pandemic and the many opinions on how the Government should deal with restrictions, health interventions, testing regimes and the devastating economic and social impact on society. There are those whom one might describe as the Covid hawks, who want zero tolerance and maximum restrictions. On the other hand, there are those who might not quite be calling for herd immunity but who are seeking to tip the balance towards living with the virus more than public health restrictions allow. My view is that the Government has treaded a middle course between the two in dealing with the pandemic. It has sought to protect lives and livelihoods in equal measure. In many ways, we have protected the most vulnerable in society from this virus, and the financial intervention for those who are working and not working has been unprecedented.

I welcome the plan. It helps us look forward for the next six to nine months. The strategy is to suppress the virus. It is a public health-led plan which involves acting quickly and locally and targeting the spread of the virus to protect lives, health services, schools, colleges and jobs. It has easily understood geographical boundaries for restrictions and easily understood levels of restriction. Each level is not a judgment on how a particular sector is operating or even how safe that activity is. Instead, it is a judgment on how that activity increases discretionary social contact or decreases it. That is the guiding light in this plan. That is the coherence and beauty of the plan.

Undoubtedly, this virus has had a massive impact on mental health. Sport is a great outlet to help deal with that. I understand the restrictions, but I call on the Minister to review the restrictions in level 3 for fitness classes, which I believe can be meticulously balanced for fitness classes that help mental health and have safe regimes. I have been contacted by entrepreneurs who have invested in sport and business in my local community. They are on their knees. I believe we can help them while still protecting against the virus. We can also do the same regarding sports matches without spectators for children. I call on Sport Ireland to have a level playing field in how it governs restrictions for all sports codes.

I welcome the publication by the Government of the roadmap for living with Covid-19. It is a valuable contribution to the debate. It is also a valuable contribution to the public in terms of how to deal with this crisis. I also welcome what the Minister, Deputy Donnelly, said earlier, that in this chapter of Covid-19 the State is seeking to open up the country while, at the same time, trying to suppress the virus. It is important that Members of the House discuss this issue and how the country should propose to deal with it.

Many issues must be taken into account when deciding, as a society, how to respond to the pandemic. Obviously, public health must predominate, but other factors must be taken into account as well, such as mental health, particularly of younger people, and the economic impact of the restrictions on society. I believe we probably have three options, and the Government has done well in identifying the roadmap it is setting out in the Covid-19 plan. I do not have great wisdom on this matter. No Member of the House is absolutely sure what the correct answer is. Although this is not an unprecedented event, it is an extraordinary one. Some individuals advocate that we should take the elimination route. I have great respect for the individuals who advocate that, but I am concerned about how attainable it is. When one sees how this virus is spreading around the world and sees its spread in Ireland in light of the restrictions we have been imposing for six months, my opinion, and I could be wrong, is that we will not be able to eliminate the virus from this country in the short term.

A second option is to reduce human activity to a considerable degree in the hope that the reduction will result in a reduction in the case load of the virus and consequent deaths. We are seeking to do that in a measured way under the Government, but we must also recognise there are consequences to that. Deputy McAuliffe mentioned the impact it is having on sport. For the life of me I cannot understand why we cannot let children play matches. One of the great public health measures for children is to enable them to get involved in sport. What we learn from this pandemic and our reaction to it is that our response in any area is not risk-free. There is no risk-free response we can take to this virus. I am concerned about reducing human activity and if we are going from one level up to another and down again. It is going to have a consequential impact on mental health and other public health issues. There are other public health issues facing the country, be it mental health, cancer or heart disease. All are very serious, and that is not in any way denigrating the seriousness of Covid-19 as a disease and pandemic.

A third option is what the Government has set out, which is trying to live with Covid-19 as best we can while suppressing it. That is the approach we have adopted. We must ensure that it is a measured approach. Obviously, it will have consequences for people if it is the case that we are moving up levels all the time. As time goes on, we will be able to see what the impact is of moving up a level and whether it will simply reduce the numbers in the short term and when we go from the higher level to a lower level the numbers return again. We are all learning as this develops and we need to keep a close eye on it.

We should not try to fool ourselves into believing that we can deal with this pandemic as though it is some other political issue such as housing, homelessness or unemployment.

The language we use in respect of it is that we are going to fight this. I hear people say we are going to crush it into the ground. I do not think we are ever going to be able to do that. We need to recognise that around the world they have tried to control this virus through coercion, regulation and law. Regrettably, that approach has not succeeded yet. That does not mean it will not succeed and I am not advocating that we go down the route of complete libertarianism where there is no regulation. There has to be strict regulation in respect of it. However, we need to recognise that where coercion and regulation have been used around the world, to date they have not succeeded. I know people who disagree and refer to China, Taiwan and New Zealand. Certainly they are at present in a different, much better position than Ireland although I am sceptical as to what is the actual position in China. In other countries around the world, particularly in Europe, we can see that notwithstanding the enormous efforts that have been made by societies and countries to try to ensure that we get on top of this pandemic, as the restrictions have been lifted the numbers have inevitably risen. The reason that has happened is that we are social animals. We have to cut down on our sociability but we made a decision centuries ago that we were going to live proximate to other humans. That is what cities and large towns are about. It is what schools and collective community activity are about. It is very difficult to tell people to pull away from that proximity to other humans. It is a huge ask. We have done extremely well in this country to date and we should recognise that. It is difficult.

Deputy McAuliffe spoke about sports and others have spoken about young people. I have spoken probably too much about young people. There are two groups that have suffered very much from this. One is young people and the other is the elderly, who have been put in a position in their lives where they are very fearful about going out and meeting younger persons and their relatives. I suppose they have to be very careful. NPHET was before the Covid-19 committee yesterday and gave us some very valuable information. The median age of the 1,803 people who have died to date is in the late 80s. Obviously elderly people need to be particularly careful. I know it is a dangerous disease that affects everyone but people who are elderly need to be particularly careful, especially if they have underlying conditions. The roadmap is a good map. We need to give it time. We need to listen to the public health advice we are being given. However, we also need to recognise that we cannot close our minds to the societal and economic impacts, the other public health impacts and the mental health impacts of the restrictions. We can see the consequences of the pandemic by looking at the tragic figures representing those who have died in Ireland and around the world. What we cannot see are the repercussions of the restrictions around the world and here. They will be measured in mental health and other public health issues, the impact on children and elderly people and in moving from a society we have built up over many centuries.

During Covid, life has been very difficult for everybody. I do not think we ever really realised how important sport is. For those watching and participating in sport it has been immensely important in so many ways. However, the public health guidelines for team sports are very unclear, as Deputy McAuliffe mentioned. There is much confusion and unanswered questions for clubs playing soccer. I raised this issue with the Taoiseach yesterday and his sidestep was very impressive but that was all. I got no real clarity. Different sporting organisations are interpreting the rules differently. It is possible to play or train with a rugby or GAA club but not a soccer club. St. Pat's CYFC women's team cannot play their matches but the same players can play for their GAA club. Juvenile soccer players cannot train with their clubs unless they are part of the elite structure yet the same kids can train with their rugby or GAA teams. These examples are replicated across Dublin to Aungier Celtic, Liffey Wanderers, Kilbarrack and Clontarf. Right across Dublin clubs are being excluded from playing their sport. The Government has taken a back seat on this and has only added to the lack of clarity around public health rules for national sporting organisations. The wording of the guidelines is not clear enough. If it was, all sports would be treated equally. The Government needs to give clear guidance to sports organisations. Why can amateur GAA sports clubs and amateur rugby clubs play while amateur soccer is excluded? No one is willing to answer this question. Playing sports should be open to everybody. Thousands of kids are missing out on football and it is impacting on their mental health. Covid does not attack amateur soccer players and leave amateur GAA and rugby players alone. All sports clubs, whether rugby, soccer, GAA or hockey, should be open or closed at the same time. All sports must be treated equally.

Today is International Day of Older Persons, a group of people who have been left behind in the many roadmap announcements over the past few months. I have asked on numerous occasions in this House that the Government consider older people when formulating plans and that it consider those who have different abilities. We cannot continue to ask them to live like hermits. We need a balance between physical and mental health. They need to be allowed to have a quality of life. Day care centres need to reopen. They are an invaluable service and we should be investing in them. A lady called into my office the day after the roadmap for living with Covid-19 was announced. Her words to me were very telling. She said that if people were not confused, they were not paying attention. I ask the Minister of State to save our money, ditch the PR firm and talk to the National Adult Literacy Agency for advice on delivering messages in plain and easy to understand language. On this International Day of Older Persons I commend all groups working with older people on ensuring they have an improved quality of life and that their voices are heard at the highest level. I have met many of them and hope to meet others over the next few weeks. It will most likely be online due to the current restrictions. I would particularly like to commend my former volunteering colleagues in the Vincent's shops in Kilcullen and Athy. Many of the older volunteers were the backbone of these important fundraising outlets. I urge everyone to keep donating and purchasing from these charity shops.

There is no doubt that we have seen unprecedented times over the past seven months and unfortunately we continue to experience them. There was no previous roadmap to deal with Covid, which makes our task all the more challenging. I welcome the publication of the Government's plan to deal with the virus over the coming six to nine months. It is important that we as public representatives work together to ensure that correct decisions are made on how to safeguard the people of this country first and the economy second. At all times the health and safety of our people must take absolute priority over everything else. This virus does not distinguish based on age, gender, health or vulnerability. It simply looks for the next victim regardless. Unfortunately I fear we will be living with this disease for the foreseeable future and as such we need to plan for this scenario. There was no roadmap for dealing with a pandemic like Covid. However, we know that we as individuals have the power to control this virus by following the health guidelines. It is important that this message is constantly given and that the public is made aware of the importance of it. I feel that over the past couple of months this message was lost and the public let its guard down. As a result, the virus has started to take hold. The public health measures must be at the front of any campaign. Even in this House we must reiterate their importance. These measures include washing our hands properly and regularly; wearing face coverings on public transport and in shops, shopping centres and all indoor settings where social distancing is difficult to achieve; having good coughing and sneezing etiquette; always maintaining social distance; reducing social interactions; working remotely where possible; isolating immediately and contacting our GP if we experience any symptoms; and downloading the Covid tracker app.

If we, as a group of people, can observe these actions then there is no doubt we can control this virus and protect the most vulnerable in our society.

The next area we need to look at is protecting our economy. Without a functioning economy we will not be able to maintain our public services. I welcome the supports put in place for businesses already but certain sectors will need more support than others. The hospitality sector has been badly affected and we must ensure every support is given to ensure its survival. This sector employs a great number of people and we must protect their jobs. The tourism sector in my constituency has been badly affected. The north of the county, including the Carlingford and Cooley region, has seen the number of tourists greatly reduced and the knock-on effect has been felt by many businesses there.

We must ensure at all costs that our businesses are given every opportunity to survive. We will hear many people say we cannot afford to keep supporting the economy in the way we have. My view, however, is that we cannot afford not support them. If businesses are allowed to fail then they are gone; jobs are lost forever. This will be a greater cost to the economy.

Over the past number of weeks, the number of incidences of Covid-19 in my constituency increased to alarming levels. This was particularly true for the north of the county. One measure we need to look at is restricting cross-Border travel to essential travel only. I do not advocate closing the Border but we need to address the issue of large Covid-19 numbers along this area. Restricting travel to essential travel, as happened in Dublin, will probably help to control the numbers.

Another issue is that of the mental health of younger generations during the pandemic. From working with many of our younger generations I know of the pressure this pandemic has brought on them both emotionally and physically. We must be able to reach out to them and offer real support.

Finally, I wish to put on the record my support for the Government in its efforts to beat this virus and urge all Deputies from all sides of the House to work together in this regard. We must protect the most vulnerable in our society and help them at the most critical time. We must offer hope to everyone that there is an end to this pandemic and that everyone working together will defeat this virus.

I call Deputy Tóibín. A third speaker is mentioned.

If the third speaker arrives, I will be happy to give way.

This is a serious illness. It is a significant threat to life and health and to the country. We need to do all we can to make sure we reduce the numbers and be careful and cautious. I hear both sides of the debate about this on a regular basis. The truth of the matter is that nobody knows what will happen in the future with regard to Covid-19 so we need to be careful.

It is an absolute disgrace that the Minister, Deputy Stephen Donnelly, did not see fit to remain in this Chamber to listen to Deputies from all sides with regard to the most serious issue that is happening in our country. Right now, there is absolutely no democratic accountability for the significant decisions being made in this country. We have a society where businesses are being massacred. Hundreds of thousands of people are being pushed into poverty and significant sections of our health service are being decommissioned from their normal activities and reorientated.

Today, 480 people got cancer and 24 people died of cancer. Today, approximately 27 people will die from heart disease and a similar number will die from a stroke. That number is roughly the same as the entire number of people who died from Covid-19 last month. I do not say that one is more equal than others. All those deaths deserve an equal response from the State to protect those lives but they are not getting it.

I spoke to a doctor recently who told me that, thankfully, none of his patients had died from Covid-19. He had, however, three cancer patients. All had delayed diagnosis and delayed treatments and he was of the view that their lives were lost. I spoke to another doctor recently who has a patient with serious heart disease who has been waiting for treatment since last April. He has been told he will not get it until next year as a result of this.

The Minister for Health has stated that between 20% and 50% of the capacity of the health service has been taken out from normal serves and reoriented towards Covid-19. These serious decisions need to be teased out, discussed and debated. The truth of the matter is that I asked the previous Minister for Health what research has been undertaken by the State regarding the level of mortality and morbidity in all the other elements of society.

Right now, 200,000 women are affected by the cancer screening backlog in this country. The previous and current Minister have admitted to me that no research has carried out at all by the State with regard to the cost of the current plan. When we try to ask questions of the decision-makers - NPHET, which is the most powerful organisation in the country at the moment - we are not allowed. I know of Deputies who must ask journalists to ask NPHET questions about what is happening in the country at the moment. We are having a debate at a time when the Covid committee has been wrapped up and the Minister for Health will not bother his arse to sit in this Chamber and answer questions from Deputies. It is an absolute disgrace. Perhaps he has a busy timetable where he has to be away somewhere else and that is fine. It should, however, have been possible to schedule Deputies' engagement with the Minister for Health in some way that we could ask questions and give our views.

This is a serious illness and we need to do our best to reduce the numbers. NPHET has an important job, and I believe it is doing the best it can, but its terms of reference are narrow. Our terms of reference as a Dáil and as a parliament of the people is to deal with all the issues in society. We need to make sure that cancer, heart disease, stroke and mental health patients are not put to the back of the queue. We need to make sure businesses can operate at some level and that workers and children are not pushed into poverty. We need to be able to live with this illness. To do that, we need to be able to make decisions collectively as a Dáil. That right, which the people gave us when they democratically elected us back in February, has been taken away from us and it is absolutely wrong.

I ask Deputy Tóibín to withdraw the unparliamentary language.

I withdraw the unparliamentary language but it is an absolute disgrace that the Minister is not here. I believe everybody will agree with that.

I thank the Deputy. I will move back to the Government. Three speakers will share 11 minutes. The first speaker listed is Deputy Murnane O'Connor.

Two Deputies will speak for four minutes and another will speak for three minutes.

I thank the Minister of State for being here. I am disappointed with those last remarks from the Deputy. We are in a Covid-19 situation and we are all working together. Deputy Tóibín's biggest problem today was criticising the Minister for Health. All of us are working here together.

We are not working together.

It is about all of us working together and the Deputy is criticising the Minister for Health.

We are being ignored. We have no opportunity to work together.

It is unacceptable. We all have our part to play working together and that is what we are here to do.

It is important that we arm our society with the tools to live with Covid-19. We cannot afford rolling lockdowns. Locking down within hours has really hurt businesses. Going forward, if there must be restrictions will the Minister please give us fair warning because people's livelihoods are at risk? That is important. Recently when we had restrictions I saw the effect on businesses and the confusion about what was happening. It is important that we give more communication to the areas that are restricted, perhaps via local radio, newspapers, local authorities or politicians. I repeat that all of us working together to play our part is what will get us out of Covid-19.

We are being excluded.

In my area of County Carlow we have been responsible in keeping the numbers down. I also want to congratulate the older people because their numbers have seriously decreased. That is important. Again, the elderly are playing a great part. I mention that today is international older people's day and fair play to them. They have done everything they could and have stuck by the guidelines. They have done their best and we need to congratulate them.

On Tuesday at the Covid committee I asked if there was an active recruitment campaign for a dedicated test and trace workforce and I was told there was. However, I was contacted by someone who tried to apply for such a position and he was told the recruitment was internal. Are we recruiting? Who are we recruiting? What is the timescale on recruiting? It is vital that we employ those who returned to answer Ireland's call and are now unemployed. It is vital that we recruit people with several languages. We are a multinational country and we cannot use language barriers as an excuse for not tracing properly.

We need to get in front of Covid-19 and not continue to react to it. There may still be things we do not know but we have learned an awful lot in the last seven months. I repeat that the HSE staff and all those front-line services, our advisers and all the public health officials have done a tremendous job so let us do what we must and learn what we must. It is a learning curve.

I wish to talk about schools. With regard to school cases, a total of 4,328 children and teachers have been tested for Covid-19.

The rate of positive results in schools has been 1.9%. If we are to live with Covid, how are we to reduce the number of negative tests and target more accurately? I would be very careful and wary of that. It is great that our schoolchildren are back in school because everybody needed it. Whether it is mentally or physically, we all need a proper roadmap in the sense that we know there are supports available for people who need mental health services and other services.

With all the talk about living with Covid, we seem to have forgotten the other major disruption in our lives, which also has a relationship to our food industry and supply, and that is Brexit. Beef farmers are living without any certainty on beef prices and markets. Our economy has suffered major losses because of Covid-19 and we are faced with potential tariffs that could cost €740 million.

I thank the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputies Feighan and Butler, for facilitating today's debate on the Roadmap for Living with Covid-19. This document is a useful guide for business planning and provides hope for future economic recovery. The onus is on us as parliamentarians to display leadership and hope. It is more important than ever that we focus on the language of economic recovery. In times such as this, a rising tide lifts all boats.

This document and the Return to Work Safely Protocol will be fundamental documents in the months ahead for employers and their staff as we adapt to the challenges presented by the pandemic. Many of my constituents in Mayo ask when things will return to normal. While none of us can definitively answer that, I take solace in the roadmap's plans for resuming public service delivery as well as building economic and community resilience.

The importance of our rural post offices is not covered in the roadmap document. They are facing problems significantly compounded by Covid-19. Post offices in Mayo, from Binghamstown to Shrule, and from Louisburgh to Bunnyconnellan, are often the only places where Mayo residents engage with public services. Having a strong network of local post offices, thereby avoiding people having to travel to large urban centres, is more important now than ever. Many of us have spoken about the importance of our older people being able to remain connected during the Covid-19 era, and our post offices play an important role in that.

The roadmap refers to the European Commission's plan to promote a common approach to travel restrictions and movement within the EU. Something similar should be done with the common travel area. Ideally both plans should be aligned as much as possible. Such a move would greatly benefit airports such as Ireland West Airport Knock as all its flights operate to the UK and EU countries.

I particularly welcome the focus on community well-being, including mental health support and supports to encourage community working. Many community organisations will need support to resume as close as possible to normal services. I note the commitment to support local community development committees in assisting local community and voluntary groups to adapt their operations to fit into the new Covid-19 reality. However, I hope the Minister of State will be able to provide further details on such supports for community well-being. Many voluntary organisations provided useful services in pre-Covid times and their work is now critical in this pandemic. I especially think of Castlebar voluntary social services, including the meals on wheels service, which many older people rely on as they limit their movements.

I thank the Minister for his attendance earlier today and for the time he spent at the Covid committee along with members of NPHET yesterday. We had a frank and open discussion, including suggestions from members for how we might further engage with the public. As has been said in this session and in others, we are in uncharted waters. Nobody has the right answer. We are learning as we go. It is important to listen to suggestions and take them on board. We all need to work together.

I also welcome this opportunity to discuss the Government's resilience and recovery plan, the Roadmap for Living with Covid-19. I note that the national framework is built on three pillars: healthy people, strong businesses and resilient communities. I will touch on those in the time I have. With the roadmap, there is a doubling of the public health workforce and the publication of the guidance on visits to long-term residential care. The doubling of the public health workforce is critical because we need more staff there. I welcome that the recruitment is under way. On the guidance on the long-term residential care, many if not all of us have had contact from constituents who have loved ones in nursing homes. They want an easing of restrictions so that they can visit them. I welcome that that is contained in the plan. It gives a clear roadmap for those families who wish to visit loved ones in residential care settings.

I hope the Government will be able to develop an all-island response, both North and South. I know the acting CMO here in the Republic is in discussions with his counterpart in the North. That is a very important part of any future plan.

Care and assistance in our communities, which is one of the three pillars in the roadmap, is critical. The local authorities are playing a crucial role in this. As I have mentioned in the Chamber previously, the local authority community calls represent an essential part of engaging with those who are isolating or cocooning. Volunteers in sports clubs and other groups have given their time to deliver groceries and medicines to people. I also commend the library service which is delivering audiobooks and engaging with those who cannot or do not want to leave their homes.

I hope the Government will take this on board. As we work with this roadmap in the next six or nine months - it could be longer - we need to bear in mind outpatient appointments and screening services. Many people with other ailments may be nervous of going into a hospital or healthcare setting. It is very important to keep those services running as much as possible, irrespective of the level we are at. It is equally important that partners and husbands are permitted to attend maternity appointments. That issue needs to be dealt with.

Earlier my colleagues spoke about sports. While training is taking place and it is very important for children, it is critical for mental health. The green ribbon campaign was launched today. The two of them are part and parcel.

I hope there will be improvements to the Covid app. I suggested some improvements through the parliamentary question system and the Minister might take them on board.

I register my disappointment and annoyance that the Minister, Deputy Stephen Donnelly, has fled the Chamber again. As the Leas-Cheann Comhairle will know from being a Member of a smaller group speaking at the end, it is very annoying for the Minister always to run away. This is a serious issue throughout the country. I mean no disrespect to the Minister of State, Deputy Feighan, but the Minister, Deputy Donnelly, just disappeared and he has a habit of doing that.

This is a very frustrating situation and above all our people need hope. I compliment Deputy Lahart on his powerful speech earlier. People need hope. The demonising of students in Galway and the demonising of old people and the fear that has been peddled and portrayed on RTÉ morning, noon and night are wrong. I would love to know how much the local radio stations are getting for advertising. I will be asking questions about that. It is shocking. We seem to want people frightened, wearing masks, cowering in corners and afraid to move. It is shocking. It is the wrong way to deal with it.

Have we looked at European best practice or how issues work in Europe? Based on OECD data, Denmark with a population of 5.8 million has had 27,464 cases, about 33% less than Ireland, and 650 deaths, about 70% less than Ireland. Hungary with a population of 9.7 million, approximately twice Ireland's, has had 26,461 cases, about 67% less than Ireland, and 765 deaths, about 80% less than Ireland. Finland with a population of 5.5 million has had 9,892 cases, more than 50% less than Ireland and 345 deaths, a staggering 80% less than Ireland.

There is something wrong here. We are manipulating the figures and I have evidence of this. People have been in touch with me whose loved ones died and were recorded as Covid deaths although they had tests which were clear. We need to get honest here and level with the people. The people showed the meitheal spirit and did everything they were asked to, as did all of the GAA clubs, the community development associations and everybody else, and in that respect I want to salute again the Garda Síochána community policing units in Cahir, Clonmel and all of County Tipperary. However, mind games are being played now with the people and they are getting fed up with it or are already fed up with it because it is not good enough.

As I said, before we start clapping ourselves on the back for a job well done, we need to have a national debate on why Ireland has a Covid-19 case rate so much higher than the three countries I mentioned. Additionally, and perhaps more alarmingly, we have dramatically higher death rates than they do. What can be learned from these comments? I hope the Minister for Health and the Minister, Deputy Harris, are listening. Has the Government been in touch with these countries to find out how we can improve? Are we just cocooning here and saying we know best? We have a bad history with the HSE. The CMO, Dr. Tony Houlihan, is coming in back and I hope his wife is well but he has a bad history in the HSE with the cervical smear deaths and the death sentences perpetrated on women. We have not got a great history on a plethora of issues. Consider the waste on the national children's hospital and the scandals that went on.

We need to discuss and scrutinise these numbers. We cannot have a situation where anyone who speaks out or questions the system is shut up or sacked from senior positions, and that is what is happening. One such individual who spoke out recently was Dr. Martin Feeley, the former clinical director of the Dublin Midlands Hospital Group. He called for a debate and raised some concerns at the imposition of restrictions and the approach being taken several weeks ago. What happened to him? He was fired almost instantly. He was sacked and it is not good enough and we have to ask why. What kind of suppression are we trying to get here? Is it going to be a complete communist state? That is the way it is heading.

Sections of the community have got nothing. The elderly, the publicans and those over 66 have not got a penny in any payment whether they were bus drivers or business people or whatever. Look at our only source of help, namely, artists and the creative and music industries. They have been blackguarded and they are not getting a shilling. Now the moratorium has been lifted from the banks and they can mercilessly take those people's houses, vans and equipment. That is what is going to happen. There is something sinister going on here and something rotten in the State of Ireland.

Dr. Martin Feeley has since spoken out on the RTÉ "Prime Time" programme this week and called for a full debate on the ongoing strategy and restrictions. I support him in this call because I believe in democracy, including freedom of speech which we are suppressing too. Dr. Feeley said the cost to the community, financially and socially, is enormous, as we know, and one of the difficulties with this is we cannot measure those costs. We cannot. It is international mental health day today or suicide awareness day. I want the Minister of State to write this down because I want answers. Has the collating of figures on self-harm and suicide been stopped? I want a specific answer to that, please, and the Minister of State might take note of it. It has been asked here before and I did not get an answer. However, I can say, again according to Dr. Feeley, that most people are depressed and the country is depressed and this is why we need a debate on this. We have no debate and discourse here. There is no engagement with party and group leaders. It has stopped. The damage to our children, our youth, our mental health people and everything else is just enormous. We must have meaningful debates and answers to questions, not a Minister who floats out, especially when I come in, because I will ask the questions without fear or favour.

A Leas-Cheann Comhairle, on a point of information, which figures is the Deputy looking for? Those on mental health or those on Covid?

Self-harm and mental health figures. As I understand it, collation of them was stopped in April. I want the Minister of State to refute that and give me the figures.

I thank the Deputy.

The impact has been enormous. Mention was made by other Deputies about people waiting for cancer smears, bowel screening and prostate cancer. It is all stacking up and people are dying. The figures were given of people dying from all the other ailments. It is one every hour for cancer and 27 a day from stroke and heart disease. There is no talk about it, and some of these are being put down as Covid deaths.

I have one last question for the Minister of State. One day the figures were corrected downward by 500 from about 1,700. They were corrected by the HSE. That was the day the Tánaiste, then the Taoiseach, was out sunning himself in the park on the day before. The figures are back up again and the figures that are being peddled on RTÉ and everywhere else are not true should be corrected. Why perpetrate lies and untruths to spread the fear?

We are discussing the framework and the five levels which provide the context in which we hope to lead our lives and live with Covid and the three pillars that underpin them. One overarching area where we could improve things is to make every effort we can when moving from one level to another to give businesses more notice. The Minister of State knows as I do that many businesses have lost heavily because they only get 24 or 36 hours' notice. People feel they are only back up and running again and the rug has been pulled. It is not so much that the rug is pulled but the speed at which it is pulled and the uncertainty around the financial loss that many people experience. While I understand Covid moves swiftly, I would make that general point first.

Before I address the framework itself, I have a comment about some of the debate today. There is a lot of debate about what the figures tell us about the second wave of Covid. While every single death is a tragedy for the individual and their family, the argument is being made nonetheless that because deaths in August were 14 and September were 27, somehow the second wave is not as deadly because the ratio of infections compared with the number of deaths is less than it was back in April and May. However, that misses the extremely important point that we are testing far more people now than we did in April and May, so any comparisons we make of figures have to be valid. Otherwise conclusions that flow from them are simply invalid.

The one thing we cannot do is lose control of this virus because we know what happens if we do. I do not know how some people can have forgotten what happened in northern Italy, the scandal of people walking out of care homes in Spain and other countries and the terror that was New York. Members may know the phrase "it has not gone away" and Covid has not. People really need to be careful about what they are saying and the messages they are giving out.

Many things have changed, however, and one area where we remain behind the curve is testing and subsequent tracing. I am convinced we can do much better and we must do so if the Government's three pillars are to stand and its framework is to hold. As the Minster of State knows, there are new tests on the market. There is pilot PCR testing taking place where between ten and 20 people can be tested at a time. If it comes back positive, all of these people have to be tested individually, but if it returns negative, then at least ten tests have been done in one go. Given that the positive testing rate is around 2%, it means that kind of test statistically should work very well. As such, if we can move forward with our testing and upgrade and update our regime, the pillars of the Government's roadmap will, as I said, be much more likely to remain in place and give us a fighting chance of living with Covid. Otherwise we will be looking at looking at living at level 2 the odd time, but more likely level 3 to level 4.

The Minster mentioned the three pillars and I will return to pillar 1 when we are discussing the winter plan later. For the few minutes I have however, I want to concentrate on pillar 2. I have said it before and will say it again, we need to increase the PUP to what it was. This is a safety net for so many people so that they can continue to pay part of their mortgage and so that their lives do not simply fall apart.

The Minister of State and I know these people cannot work because sectors are closed. We speak to them and hear from them all the time. They have no understanding of why that payment has been cut. It is an act of solidarity. As I have said previously, we must pay it because it keeps families and households afloat. That is what we are asking for if we are to live with Covid.

The Minister, Deputy Donnelly, mentioned a cut in VAT rates. The Minister of State and I come from the Border region. We know the importance of lowering the VAT rate in the hospitality sector from 13.5% to 9%. I ask again that the Government considers it.

While the employment wage subsidy scheme is good, it absolutely needs to be revised because it is a cliff edge for businesses. If their turnover drops by 30% or more, then businesses can access these supports, but if their turnover drops by 15%, 20% or even 28%, they receive no assistance for employing people. Many businesses have contacted me about this. If two businesses are side by side and the turnover of one drops by 30% and the other by 22%, one of them will get full support and the other will get nothing. I ask for a graduated approach. For example, if turnover drops by 10% a business might get €50 per employee, a drop of between 10% and 20% would mean €100 per employee, a drop of between 20% and 30% would mean €150 per employee while a drop of more than 30% would mean, as it does now, €200 per employee. This would be a much fairer system for businesses and would significantly improve the workings of the scheme.

I thank the Deputies throughout the House for their contributions in this vital 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. We have seen the statistics from the WHO in recent days that worldwide case numbers have passed 33 million and worldwide deaths have exceeded 1 million. In many parts of the world, the pandemic is returning at an increasing and alarming rate and we do not want this to happen in our country. The resilience and recovery plan sets out a very clear framework for decision-making with regard to this public 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 certain sectors of society at this time in the knowledge that we will be able to return to normal life in future.

We have now moved from the initial emergency response phase and objective of flattening the curve to the next chapter of opening society while living with the virus. That said, the objective remains, as it always has been, to eliminate and eradicate the virus wherever it is detected. This is the reason for the robust testing and tracing strategy put in place by the HSE. The plan has a framework for decision-making by the Government. We also to continue to promote the very clear public health advice for individuals, much of which has not changed for many months. These include good cough and hand hygiene, wearing a face covering where required by law and when visiting vulnerable people, avoiding crowded places, including public transport, as much as possible, and working from home if possible, and I recognise that for many people this is not an option due to the nature of their work. As a society, to suppress transmission of the virus and reduce the impact of the disease, it is important for all of us in all walks of life to heed this advice. While the Government can legislate for mandatory face coverings on public transport and in retail settings, we cannot legislate for every situation. We must all take an element of personal responsibility.

We have contained outbreaks of the virus in Kildare, Laois and Offaly, and more recently we have seen how the efforts of the public in Limerick, Tipperary and Waterford have turned the tide of the trajectory of the disease. We succeeded in doing this thanks to the collective efforts of the public, who adhered to the guidelines, as well as the expert knowledge and advice from our public health specialists and the dedication and hard work of all front-line workers. We need individually and collectively to keep doing the basic things right, which the vast majority of us are doing already.

I will now deal with some of the issues raised by Deputies. Deputy Harkin outlined the fact that businesses need more notice. We will take this on board. It has been an issue in recent months, certainly in the north west and Donegal. Many businesses did not get enough notice. It is something we have taken on board. The Deputy also spoke about northern Italy, Spain and New York and the new tests and pilot testing. There are certainly options. She spoke about the employment wage subsidy scheme and that businesses that loses 28% of turnover get nothing. Perhaps there can be a better system than a cut-off point. The Deputy also spoke about the VAT rate reducing from 13.5% to 9%. I hope this will be considered in the budget.

Deputy Mattie McGrath spoke about Deputy Lahart's contribution. He also praised the Garda, the GAA and various organisations for the work they are doing. He stated that figures on mental health and self-harm have not been collated since April. I will try to get the figures for the Deputy through the Department as soon as I can.

Deputy Shortall spoke about considering the experience of other countries with regard to minimising Covid-19 and the messaging is key. She spoke about influencers and that the GAA in Dublin could be serious influencers on the ground. We find that a certain cohort of people, perhaps those aged over 50, still get their news from the old traditional news outlets, such as local and national newspapers or the news on television at 6 p.m. It is a very effective way but it is not getting through to younger people. We do need to use different outlets.

Deputy Cathal Crowe spoke about dental care and the backlog for orthodontic services. He asked about a tax rebate for people who have to get private treatment. There is merit in this. He also spoke about communication when a school has an outbreak and that perhaps communication between the HSE and the principal might be a bit quicker instead of waiting 24 hours.

Deputies Alan Farrell, McAuliffe, Boyd Barrett, Barry and Jim O'Callaghan spoke about mental health and fatigue . It is an issue we are facing after many months of living with Covid and with regard to businesses and industries. We may have to look at a different way of approaching it. I know NPHET and the Government are working together. Somebody said that perhaps businesses and other people could be brought onto NPHET. The NPHET team is primarily from the health sector but they also have knowledge of sporting events and business. Just because somebody is from one area does not mean to say they do not have knowledge. It would be ideal to bring in people from sporting organisations but the NPHET members also have links with sporting organisations.

Deputy Higgins spoke about the arts and dance classes for young and old. It would be great to get those classes back. She also spoke about opening venues that are capable of bringing in fewer people than they used to and that the Covid payments could be tweaked so sound engineers, roadies and musicians could get back working. She absolutely has a point.

Deputy Conway-Walsh spoke about staff burnout in Mayo University Hospital and the need to listen to them. Deputy Wynne spoke about visiting hospitals and other health services on compassionate grounds. She has a point too.

Deputy Boyd Barrett talked about trusting the people and giving them the information they need. Deputy Barry spoke about taxi driver protests and their financial plight, as well as emergency accommodation and suicide in Cork. It is an issue which I heard loud and clear.

Deputy McAuliffe spoke about protecting the vulnerable in society. Deputy Jim O'Callaghan had some interesting views that we could crush the virus into the ground but we need to open up sport. It is spreading around the world but reducing human activity may not be the right approach. Young people will gladly listen to messages but it is having a serious economic impact.

Deputy Andrews spoke about team sports and the difference between soccer, Gaelic football and rugby. Hopefully, soccer might be included in the sports allowed. I would have thought it was but maybe junior soccer is an issue.

Deputy Fitzpatrick talked about the health and safety of people. We need to protect jobs. Deputy Tóibín spoke about cancer screening and cancer patients. There are many other areas in the health services from where people have gone to work on the Covid-19 issue. It is hard to get the right balance.

Deputy Murnane O'Connor spoke about older people. Deputy Dillon spoke about leadership. Hopefully, we can return to normal. Deputy Devlin spoke about uncharted waters but we need an all-island response. That is what we are doing. I know the various teams from the health Departments in both jurisdictions are working together. There is another meeting between them tomorrow. We need to work collectively, across the island of Ireland, North and South, east and west, to sort out and attack this virus as quickly as possible.

Sitting suspended at 4.03 p.m. and resumed at 4.23 p.m.