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Dáil Éireann díospóireacht -
Tuesday, 24 Nov 2020

Vol. 1001 No. 3

Covid-19: Statements

It has been nearly nine months since the threat of an unprecedented global pandemic became a reality. Since then, Ireland and every country in Europe and throughout the world have had to take dramatic action to contain the terrible toll that this virus can take. Every aspect of social, economic and cultural life has been upended as we have worked to shield those most at risk and to limit the damage. There have been many ups and downs and the second wave of the virus, which has hit Europe in the past two months, has been divisive in many countries, with societies divided between those who accept the need for continued action and those who want all restrictions lifted.

Thankfully, levels of compliance and social solidarity in Ireland have remained very high. While there are some who prize a return to certain activities over the safety of society as a whole, the overwhelming evidence suggests that the people accept the need for vigilance, personal responsibility and targeted restrictions. Let no one be in any doubt, thousands of lives have been saved by the combination of these restrictions and the personal commitment of the people to limiting the spread of the virus. Almost 3,000 people on our island have lost their lives because of the virus. This is a terrible number in itself, but it would have been many times worse without the dramatic actions that have been taken. The level 5 restrictions, which we implemented to limit the impact of the second wave in Ireland, will be reviewed by the Government in the coming days. As we decide on the next steps, I am determined that we have an open discussion about actions to date and what needs to be done in the months ahead. This is why I have requested the preparation of a detailed review of actions, the progress of the virus and key challenges facing us. It is also why I requested the holding of this debate, and I see this as an opportunity for Deputies to contribute to discussions before key decisions are taken and to be able to give their perspectives on how we will move forward.

From the moment the Government took office almost five months ago, our work has been dominated by the need to manage the direct and indirect impact of the pandemic. A pandemic such as this does not come with a handbook to follow at every stage, and a defining characteristic of Covid-19 has been how the specific challenges it has presented have constantly evolved.

The very worst thing one could have in the response to this pandemic is a consistent and unchanging approach. If we look throughout the world, many countries promoted during the first wave as the models to follow are in much worse positions today. I am proud of the fact that we have been willing to respond quickly to new challenges, review actions and look for new ways forward. I thank all of my colleagues in government for their willingness to accept an unprecedented intensity in the review, development and implementation of policy. Together with public servants, who are absolutely dedicated to serving the interests of the Irish people, this work has made a very real impact.

This morning's figures from the European Centre for Disease Prevention and Control give a very clear picture of the progress our country has made during the second wave of the virus. Ireland has the second lowest incidence of infection in the European Union, with case numbers and deaths very substantially below both the average and what might have occurred if patterns from the first wave had been repeated. Deaths are 90% below the level of the first wave. At the same time, many more critical public services have remained active, our schools have been open, and economic activity, while still badly affected, has been higher. This did not happen by chance. It happened because the Irish people accepted the need to alter their behaviour and accepted key restrictions.

Masks are a key tool in limiting the spread of the virus. The introduction of the mask guidelines in July increased the numbers wearing them in shops, on buses and in other indoor spaces from 37% to 90%. Travel is also critical to the spread of the virus, including different strains of the virus. The decision to limit the easing of travel guidelines in July and August was inconvenient for many, but the figures suggest it has made an important contribution to avoiding the levels of travel-related infections seen in other countries. Testing capacity is critical to understanding and catching the virus. When figures were very low in August, we decided not to scale down testing and to keep in place critical sectoral testing programmes. More than 1.8 million tests have been completed, with a weekly testing capacity of 140,000 in place. There have been occasional problems but, in general, the testing capacity has been fast and effective. We have one of the more high-performing systems of testing across Europe and globally. A total of 62% of the positive cases identified in the testing have had no underlying clinical conditions. Contacting, testing and isolating asymptomatic cases are a critical part of limiting the spread of the virus. I acknowledge the incredible work of the HSE and other bodies in leading this critical part of the response. I also want to acknowledge again the work of our health professionals. They have moved swiftly both to develop and adopt new approaches to managing Covid cases. Success in treating severe cases has improved remarkably fast. At the same time, major efforts have been made to restore non-Covid activity in our hospitals. The return of children to schools was a core priority for us and it is worth mentioning again today. It was a daunting logistical and public health challenge and enormous credit is due to everyone involved. It is not possible to have zero spread of the virus among more than 1 million people, but the fact that its spread appears to be at a lower level in schools than in the community as a whole is a remarkable achievement. Evidence has shown the great pressure which school closures placed on children and their families. Almost one fifth of women with children in school were unable to work during school closures and a much larger number of parents faced increased pressure and limits on their ability to work.

The economic recession caused by the pandemic has required a range of unprecedented measures which we continue to update and review. Within a month of taking office, we prepared, published and implemented a dramatic stimulus package to protect as many jobs as possible. This was built on in October's budget, which provides a foundation for the recovery that I know we can rapidly achieve. The biggest impact on containing the second wave was, of course, the decision to move, first, to an enhanced level 3 and then, in light of the escalating problem in Europe and the need to exercise added caution, to move to level 5.

The second wave is not over by any means. If there is one thing we know now, it is that taking the virus for granted is the foundation for its spread. Infection rates can very quickly get out of control if people believe it is no longer a threat. Ireland's relative success in the second wave has been because we were willing to act. We had a less comprehensive reopening than many other countries. Individually, we continued to modify our behaviour. When the threat of high levels of transmission appeared, we acted. After nine months, the one overwhelming fact about this deadly virus is that it thrives in social settings. Therefore, we must respect social distancing. We have to limit our social interactions. The very thing we value most in our society, which is our sense of family and community, can be a major threat when we hold social gatherings and move in hospitality settings. That is a hard message when we have endured so much this year, but it is one we simply must understand if we are to continue to limit deaths and serious illness in this pandemic.

As we look forward to the next stage, complacency will remain our enemy. We are not yet in a position to return to normality or close to normality. Our approach will continue to be to go as far as possible but no further. I accept the goodwill of every group that is calling for the relaxation of restrictions impacting on them. They care passionately about their businesses and their sectors. I fully accept their statements that they want to respect guidelines. However, the reality is that, for some activities, the guidance will be that there is too much risk. For all activities, there are core guidelines and restrictions on how we act that must be respected.

In the past few weeks, there has been great news about promising vaccines. An effective and widely used vaccine is the final route to recovering from the pandemic. I want to say again that the Government will do everything to make sure the Irish people have rapid, fair and comprehensive access to the vaccines. There remain vital checks to be completed before the vaccines are authorised for public use. However, we have begun critical steps. In the summer, we joined an EU joint initiative to place advance contracts for purchasing different vaccines. This EU initiative is vital for smaller countries in ensuring fair access. The major logistical, medical and ethical issues involved in the roll-out of a vaccine are being addressed by a cross-public service task force which we have established. Its external chairman, Professor Brian MacCraith, has run a major university and is an internationally respected scientific leader.

Between today and when the vaccines are widely administered, we must remain vigilant and we must accept the need to limit our activities. As a country, we have worked together to achieve great things in limiting the spread and impact of this deadly virus. That work is not over yet but we have shown how much we can achieve. In the coming days, we will decide and outline in detail the next phase of our national response. I have no doubt that if we maintain our national solidarity, we will be able to look back at our shared response to the pandemic as a moment when we faced great danger together and came through it with strength and determination.

It has been some time since I have given my views on Covid and I welcome the opportunity to share some of my thinking with the House today. As we all know, the Government faces a difficult decision in the week ahead. As we approach the end of six weeks of level 5 restrictions, we sail between Scylla and Charybdis in trying to set the right course. In doing so, we know for certain that increased human interaction will result in more people getting infected, thus increasing the chances of a third wave. The year 2020 has been a write-off for many families and many businesses and for young and old alike. For others, it has been a year of grief, with 3,000 lives lost across Ireland. We should never forget those who grieve and I extend my condolences to them once more.

While we have not done everything right as a Government or as a society, I believe we have managed the pandemic well compared with our peers. We acted quickly in our response. Today, the 14-day incidence of the virus is the third lowest in Europe. Even though we use the widest measure to count deaths, recording even suspected cases, we rank 34th in the world, and falling, in terms of mortality. It is clear now that the second wave has been very different from the first. While the number of cases detected has been many times greater, the numbers of hospitalisations, patients requiring admission to an ICU and deaths, fortunately, have been much lower. Indeed, there is no evidence yet of any statistically significant increase in excess deaths in the second wave in Ireland. Of course, had we not acted as we did, this would almost certainly not have been the case and we would have experienced high levels of excess deaths such as are now being seen in other parts of Europe.

There are many reasons the second wave was not as serious as the first. These include more testing, a younger cohort of people getting infected, the older and infirm being better protected and better knowledge of how to treat the disease. Those trends are likely to continue. The fact that the second wave was so different from the first is significant and should guide us in how we go forward. First of all, it is clear that there should not be an overemphasis on case numbers, particularly daily case numbers.

Cases translate into hospitalisations and deaths, but not at rates previously projected. Once again, our health service never came close to being overwhelmed. It also seems there is a seasonal component to SARS-CoV-2, just as there is for other coronaviruses. This is bad news for now but good news for the spring, when it comes.

Level 3 was probably more effective than we thought at the time. Level 5 was not as effective as was modelled, but was needed to get the numbers down lower. It is worth noting that the objective set out by Government five weeks ago was the R number consistently below one and cases and hospitalisations falling, rather than NPHET's model-based target of an R number of less than 0.5 and cases of less than 100. Trajectory is also important and the situation can deteriorate rapidly and return to exponential growth. While we know much more about the virus, it is just as contagious and transmissible as it was previously.

I believe we should seek to ease restrictions next week but not so much that it requires it to return to level 4 or 5 for a prolonged period in the new year. A short third period of enhanced restrictions may well be necessary in January or February, but we should try to avoid it being a prolonged one.

Our strategy of suppression is perhaps best described as one of "delay and vaccinate" and I do not believe we are too far away from seeing it succeed. Safe and effective vaccines are on the way, and when we vaccinate those most at risk, such as nursing home residents and healthcare workers - approximately 200,000 people - we will change the calculus for future decision-making. It will reduce the R number, case numbers and mortality rates even as we extend the vaccine more widely to other groups, as we must, to achieve herd immunity. Antigen mass testing, notwithstanding its limitations, will have a role to play in 2021 in identifying more cases, more quickly and reducing the risk of spread.

It is well-understood that there are risks associated with international travel. This is particularly so when it comes to travel from areas of high incidence to areas of low incidence. The European traffic light system, which Government has adopted, linked to pre and post-travel testing, does not eliminate this risk but it does reduce it. We need to embrace it and enforce it.

Another real risk that we cannot ignore is North-South travel within Ireland. The incidence of the virus in Northern Ireland is a multiple of what it is in the State and so is the mortality rate. Northern Ireland is a different jurisdiction and makes its own decisions under the Good Friday Agreement. We respect that, but we would be in denial not to recognise that a less intensive approach to the virus there, since the start, has had its consequences.

Our public health authorities collect very good data on cases imported to Ireland due to international travel and even cases related to imported cases. Such data do not exist for cases linked to cross-Border travel on the island. This is a gap in our data that needs to be closed as it affects our ability to make evidence-based decisions.

As Minister for Enterprise, Trade and Employment, my responsibility is to protect jobs, businesses and livelihoods, to create the conditions where we can safely return to work and stay at work and to give everyone with a job confidence for today, as well as hope for the future.

The Government has put in place extraordinary measures to protect incomes and keep businesses alive - the pandemic unemployment payment, PUP, restart grants, low-cost loans, a commercial rates holiday, lower VAT, wage subsidies and the weekly payment for businesses that are closed and the Covid restrictions support scheme, CRSS. It is essential that these interventions should continue as necessary and should not be removed too quickly. For this reason, we have set aside €3.5 billion for 2021 in the form of an unallocated recovery fund so we can respond to the twin challenges of Brexit and Covid. While the pot is limited, and has to last the full year, we should not be afraid to deploy it.

When it comes to decisions on reopening, the Government has a particular responsibility to provide clear guidance to the public and to businesses. We also need to marshal our agencies, from the Garda, to HSE environmental health officers to Health and Safety Authority, HSA, inspectors, to improve enforcement. Last Friday, to assist, we published an updated Work Safely Protocol, which sets out the actions that need to be taken to reduce the spread of Covid-19 in the workplace.

Unfortunately, many see the debate about what to do in December as a conflict between protecting lives and protecting jobs, as if our society and our economy were in some kind of contest. This is a false dichotomy and always has been. It is as though the people who work in shops or own a small business do not also worry about their own health, and that of their family and loved ones and as if the people who are most at risk from Covid do not also yearn for the company of other people, to be able to do some shopping or to enjoy some Christmas cheer.

In an ideal world we would be able to provide certainty to businesses and to consumers, and give plenty of advance notice but, sadly, we cannot. There are, unfortunately, too many moving parts, too many factors beyond our control and too many new things to take into account every day but we will give as much notice as we can. Covid-19 behaves in unexpected ways so we have to plan for every eventuality, and make decisions based on changing evidence, new developments and new facts.

During this period of restrictions, many of us have become frustrated and downcast, annoyed by examples of people breaking the rules, and impatient for things to reopen and return to the way they were before. Too many lives have been lost. Too many lives have been put on hold for too long, especially for younger people. No one is immune from feelings of anger, resentment, fear or frustration, but we will not fight community transmission with anger, blame or finger-pointing. We will beat it with community spirit – just as we did before. As a country, even in the darkest days, we never lost hope. We have a little way to go still but we should not lose hope now.

As a Government we will do everything we can, but this will not be a normal Christmas. We will have to limit ourselves and our movements. We will have to be patient. We will have be tolerant of each other and understanding of lapses, while all the time reinforcing, renewing and resuming our efforts against Covid-19.

For centuries, people have debated the true meaning of Christmas - the original wish upon a star. At its most meaningful, it is about thinking of others and about bringing happiness to others, about hope and good news. This year will be a Christmas like no other, but it can still be a good one if we keep the faith.

I am sharing time with Deputy Cullinane.

This year has tested us all. It has tested our mettle, our resolve and our resilience. None of us could have expected that we would live this reality, with our people and our communities robbed of the simple everyday things that make up our lives. It has been a year of stress, worry and uncertainty brought by a global pandemic.

People have lost. People have missed out. Thousands have lost their jobs and their incomes. Many have lost their businesses and their plans for the future. We have all missed out on precious time with our families and we miss out on our simple routines.

Most tragically, thousands of families have lost a loved one to this awful virus, and while we all may wonder what kind of Christmas we will be able to have this year, we know that for these families Christmas this year will be defined by the pain and sorrow of the empty chair. We, therefore, send our heartfelt condolences and good wishes to every grieving family.

It is also important to recognise how much effort has been made - the work of our front-line staff, the fantastic work in local communities, and the patience and discipline shown by all our people, especially by our young people. While it is usually those moments where people make mistakes or fail to live up to the public health standards that make the headlines, the truth is that our people have been inspirational and we are enduring and will endure and prevail because of their kindness, their compassion and their social solidarity.

Recent news of progress with vaccines has brought much needed hope as we finally see some glimmer of light at the end of the tunnel. However, this Christmas will be like no other and we must acknowledge that.

We must also acknowledge that being with family will take on an additional significance this year for people at home and abroad. Of course, people will not travel home from abroad as they do in other years, but common sense and compassion need to be applied, especially for families that have had a particularly bad year such as those who have suffered a bereavement but who could not come home to grieve and families with elderly relatives, perhaps isolated all year struggling with separation and mental health challenges.

For them, coming home this Christmas is an essential journey. I am calling for compassion and common sense to guide all public health advice on Christmas travel, family meetings and socialising this season.

There are people who have not seen a day's work since March. Their family income has been decimated and they face into Christmas very unsure not just about Christmas but about their future. On 21 October, we entered into level 5 restrictions. This was a tough but necessary decision to suppress the spread of the virus, stop people getting sick and prevent our health services from becoming overwhelmed. It was a huge body blow for everyone. People had made enormous sacrifices during the first lockdown to flatten the curve and to get transmission of the virus down to manageable levels. This dedication and collective effort bought the Government time and space to do the things necessary to give us the very best chance of avoiding yo-yoing in and out of damaging lockdowns. However, if "We are all in this together" was the Government mantra in the initial months of this pandemic, that was torn up by the decisions the Government made this autumn.

When entry into level 5 was announced, we said it would be unforgivable for Government to waste a second opportunity to do things right. We said that the lockdown must be used to put in place everything needed to get the virus under control and to keep it under control. We said that the aim of all must be that what we do now helps avoid future lockdowns. We said that it would be devastating to tell businesses that they can open up now only to shut them down again in a couple of weeks. We said that could prove to be a body blow for some from which they might not recover and we asked the Government to put in place measures that would provide much-needed certainty for workers and business. The lockdown was tough but it was the Government's opportunity to get on top of the virus. Now the question is whether the Government has done enough. Is testing and tracing now fit for purpose? Is mass testing on the cards? Is testing at our airports and ports to be delivered? I think the answer to all of these questions is “No”. This is compounded by the fact that we still do not have an all-Ireland plan for tackling the virus. The deficit is much more than one simple data set; we need a full strategy and plan.

All of these failures leave us vulnerable to infection and lockdown in the new year and that is not good enough. We need to agree on that and that we can do so much better. The plan for the roll-out of the vaccines must be comprehensive and carry with it all necessary urgency. Economic and income supports need to stay in place while there is any prospect of restrictions, so that workers and businesses have the best possible chance to come back next year. By the way, arbitrary deadlines do not work on these matters and lead to very great uncertainty. While I welcome the extension of the pandemic unemployment payment, we need to ensure that any cuts the Government may have had in mind are not proceeded with.

People have been through so much and now we look forward to Christmas and being together with family again. As we head into the new year, we need to give people hope that we can emerge from this unprecedented crisis stronger, fairer and better. We must prioritise affordable housing, improving our public health system and addressing youth unemployment. We must prioritise those who have lost jobs and livelihoods, the forgotten carers and the young people now worried about their futures. We must learn from Covid. We need to learn what really matters and then act on that.

The task ahead for the Government, indeed for all Members of this House, must be to break the cycle of lockdowns. This can be achieved by exiting restrictions safely this year, with the protections in place to avoid future lockdowns in the new year. That means getting the basics right and requires testing and tracing with a dedicated workforce; mass testing; a proper system of travel restrictions with robust airport testing; adequately-funded public health departments; and, vitally, all-island co-operation. All plans must be guided by public health advice. This is the only way to keep people safe and this can only be achieved if we keep the case numbers low.

Understandably, people will want to travel home for Christmas. It is clear that not everybody will travel home this year. However, we need fair and proportionate approaches for those travelling home on compassionate grounds. This means stepping up testing at airports and clear communication on public health advice for those who do travel. We must ensure common-sense and effective travel restrictions North and South and cross-Border co-operation. Our island should be a single unit for dealing with this virus, yet that is not being reflected in the Government’s approach so far. Contact tracing across the Border, which is far from the most difficult task, does not seem to be happening. There is a memorandum of understanding in place which we supported and which is helpful, but I have been asking the HSE for months how this is being implemented in practice and I have yet to receive an adequate response.

Income supports for workers, families and businesses are vital in the year and time ahead. Many workers, families and businesses have made huge sacrifices. We all accept that. There are some businesses which have been closed since March. There have been many workers who have been out of work. Many people have seen their incomes decimated. Even with the pandemic unemployment payment, they are down huge amounts of money and struggling to pay bills. It will be a very difficult and challenging Christmas for all of those individuals. Many have lost everything and the Government support has been inadequate. We pointed that out several times during the summer months when the Tánaiste and the Government he led were busy cutting payments like the pandemic unemployment payment when it should have been investing in testing and tracing. Under pressure, the Government reversed some of those cuts. My colleague, Deputy Louise O’Reilly, will address some of these important issues later.

This week has been emblematic of this Government's approach to managing Covid-19 and many different issues. A decision on what will happen next was essentially announced on Monday by the Taoiseach and reinforced today by the Tánaiste. We are now debating that fundamental decision. Tomorrow, we were supposed to engage with NPHET at the Joint Committee on Health on its advice to Government. I am assuming NPHET has not given that advice yet but will give it in the next number of days. That meeting was cancelled because, again, NPHET was not in a position to appear before the health committee. On Thursday, we were to hear what that advice was. A normal process would have the advice come first, then committee engagement, followed by a debate before a decision is reached. It is fair to say that, thanks to the sacrifice of the Irish people, cases have been somewhat brought under control. We all celebrate the fact the numbers have come down, albeit not as fast as we might like. They are not exactly where we want them to be but they have come down. Despite Government spin to the contrary - I address this point to the Tánaiste as well - NPHET has called this right every time it has called it. I am not convinced this Government has a handle on things. Of course NPHET gives advice and of course the Government has to make wider societal and economic decisions, but making decisions in advance of getting the advice from NPHET seems to be problematic.

There are still more than 800 workers redeployed to tracing when the Government has had six months to ensure a dedicated workforce was in place. This is causing complications across our health service. I commend each and every one of our front-line healthcare workers who have done Trojan work in recent months. The decision by the Government to redeploy staff to testing and tracing from other areas is having consequences. It is delaying rehabilitation for stroke victims.

It is delaying care for children with scoliosis. It is causing waiting lists for access to disability services to skyrocket. The Government has committed to hiring 10,000 additional healthcare staff next year, or so it says, yet 1,500 people who have been in Be On Call for Ireland pool and available to work have not been offered any contract for seven months or more. Where in God's name is the logic in this when at budget time we had the Minister for Health speaking about recruiting 15,000 staff? All of these staff are still in a pool waiting to be hired. These are people who came home from all corners of the world. The Taoiseach is shaking his head but these are the figures and that is the reality.

The unfairness at the heart of the Government's attitude to healthcare workers does not bode well for that relationship. Our healthcare workers have been through a very tough year, in fact the toughest yet. They worked hard and tirelessly through a difficult winter last year, and then through the spring, summer and autumn of this year, without rest as they tackled Covid, and now another difficult winter looms. We are in their debt. Whatever decisions we take, and whatever decisions the Government takes, they cannot add more pressure to our public health services in January, February and March of next year. We cannot allow the chaos in our hospitals that we have seen previously to become even worse next year. The Taoiseach shakes his head in bemusement-----

I am not shaking my head.

-----or perhaps he is concerned about what I am saying. The facts speak for themselves. In January and February every year, record numbers of people are on hospital trolleys, including under the watch of the previous Government, which the Taoiseach supported.

I want to finish very quickly, if I can, on the development of several effective vaccines, which is exciting news. It is vital we get distribution and administration right. It has to be rapid and fair with clear processes in place. I welcome the high-level task force put in place. I have asked for the persons involved in the task force to come before the health committee.

Let them get the job done, for God's sake.

It is not just me but also members of the Taoiseach's party who have called for this.

The Taoiseach is not really into people answering questions.

We are calling for that to happen on 16 December. We read in the media that the Taoiseach will produce a plan a week before that. Is he saying it is not the job of the health committee to scrutinise it and make sure the infrastructure is in place?

Of course not but let them get the work done.

This vaccine could come very quickly. The Taoiseach seems to be allergic to people coming before committees or before the House. He should not be looking down his nose at people who call for it.

I am all for it.

Since Covid-19 landed on our shores nine months ago, we have been living in a type of suspended animation. More than 70,000 people have contracted Covid and, sadly, more than 2,000 people have lost their lives due to this virus. On behalf of the Labour Party, I express solidarity with all of those who have been impacted by Covid-19, especially those who will have a loved one missing from the dinner table this Christmas.

The Government has to make some extremely difficult decisions this week when it comes to Covid-19 and exiting level 5 restrictions. We want to see, as does the public, that the experiences and learning of the past eight months have been taken on board for planning the exit from level 5. There needs to be a slow, methodical, evidence-based step-down approach and a moving through the levels. There needs to be proper messaging on public health guidelines, social distancing, mask wearing and handwashing, and clear and concise communication from the Government on the nature of the restrictions at each point of the scale.

It is pleasing to see the Taoiseach and the Minister for Health engaging at present. Perhaps it would be useful if they listened to what Opposition Members have to say.

Christmas in Ireland will officially start when the "Late Late Toy Show" is aired on Friday, and whether or not one is a Christian, it is a special time of celebration here. We need to be acutely aware of the added complications that will come with the festive season this year. Our contact tracing system must also be able to cope with any increase in cases before and after Christmas. We have seen a number of private companies set up testing sites at various locations throughout the country, with further sites due to open within weeks. While this expansion of testing is welcome, the tracing system needs to be beefed up to ensure it can cope with additional demand over the festive season and into the key month of January.

January worries me, as I think it worries everyone in the House. We had a worrying but avoidable situation unravel in October, when thousands of close contacts of positive Covid cases went uncontacted and the contact tracing system became overwhelmed because it was not properly resourced and planned. There can be no excuse if our contact tracing system becomes overwhelmed again. We have been here before and we should know what level of demand the tracing system can take and what needs to be done to make it fit for purpose. The Taoiseach and his colleagues in government need to ensure the necessary staff are recruited and ready for the festive period and that, if necessary, the Defence Forces are placed on notice that their skills and services may be called upon.

Private testing companies do not carry out contact tracing and our tracing system must be able to cope with the additional demand. There are thousands of competent people who can be brought in to carry out contact tracing if necessary, such as retired public servants, retired health professionals, people who have been made unemployed as a result of the pandemic and people who could be seconded from various organisations. The Labour Party is calling for assurances that everything that can be done is being done regarding support for our contact tracing system.

A true national effort is required to avoid future level 5 escalation. We need to hear that the Government is prepared to go into areas affected in the early stages, identify the index cases, aggressively test, trace and isolate and vigorously hunt down the virus to limit its spread. This is the type of policy approach that has been sadly lacking to date.

The news that we now have three vaccines which are testing well is giving us all a lift and it is a lift we all need at present. We need to know about the planned roll-out of the Covid vaccine in detail and the discussions with the European Commission on the contract to purchase 300 million doses of the Pfizer vaccine, when it will be available and how much of it will come to Ireland. There needs to be co-ordination across society and an indicative plan for healthcare. I hope we will be able to administer it a whole lot better than we are at giving out the flu vaccine because we need to dramatically improve our approach before we roll out the Covid vaccine.

As a Dáil, we need to stand up to ill-informed anti-vaccine discourse more generally and strongly. Vaccine hesitancy is one thing but in the past decade there has been a small but vocal minority decrying all vaccines. It is dangerous. That is dangerous talk. This vaccine has the potential to be a game changer and bring back some normality to our lives. We should let the science speak clearly. The Labour Party calls for a strong public information campaign on a vaccine when it is introduced on the Irish market to debunk any misinformation.

This year has been an extremely difficult year for so many but let us all hope that with the Government response and a real sense of national unity and solidarity, as the Taoiseach stated earlier, and the personal responsibility we all need to show, particularly over the coming weeks, we will see better days ahead in 2021.

I will take this opportunity to update the House on the Government's ongoing response to Covid-19. Right now, as we look to exit level 5, we are at a critical juncture. From a healthcare perspective, we are facing the most challenging winter in living memory, and the solidarity and resilience that have been shown by our healthcare workers and the entire country will be more important than ever in the coming weeks. We are five weeks into the level 5 measures and, like many countries, Ireland has faced big decisions on the measures we need to limit the virus and on the impact these measures have on individuals, families, communities and businesses. More than 70,000 people have now tested positive and more than 2,000 have died. Every one of these represents a mother, father, son or daughter who has tragically passed away and who is mourned by their families and friends.

Two weeks ago, the Special Committee on Covid 19 Response published its report, having listened to several months' worth of evidence and I thank the committee members for all of their work. Many of the issues the committee highlighted are being seen around the globe. We know the disease is having a devastating effect internationally.

Over 58 million cases of the disease have been reported to the World Health Organization and, tragically, almost 1.4 million deaths have been notified. Many countries have had, and continue to have, big challenges in their response to the disease. Some are facing significant and damaging impacts on their healthcare systems as more and more Covid patients require hospitalisation. Thankfully, we are not at that level in Ireland. In Europe, only Finland has a lower 14-day incidence rate. Our 14-day rate was 310 per 100,000 four weeks ago. That has gone down to 109 today and is continuing to fall. It is the biggest decline anywhere in Europe. The people deserve huge credit for the work that has gone into making that happen.

There are, however, signs that progress has slowed. By the end of the third week at level 5, the reproduction number, or R number, had fallen right down to 0.6 but it is fair to say that the fourth week was not a great week. I think people were tired and compliance fell. We could not blame anybody as it has been a very difficult year. However, the result was that the number of cases flatlined, the R number was recalculated and while it stayed below 1, it had gone back up to 0.8. It will be recalculated late tomorrow night or early on Thursday, and, hopefully, we will see it come back down again. We really need to double down on the last seven or eight days of level 5 to push it right back down. The evidence also shows a recent increase in the level of social contacts. A small extra effort by everyone to limit and reduce our number of contacts will make a big difference right through to the end of the year.

At present, there are 98 clusters in residential care facilities which remain open, of which 48 are in nursing homes, so it is still a high number. There have been some large outbreaks in hospitals, as colleagues will be aware, and we are tracking numerous other outbreaks across the country, including those associated with funerals and other workplaces.

All of this remains a concern and is being monitored daily. Another area we are looking at is the number of close contacts who have not taken up the offer of testing. I would ask for the help of colleagues in the Chamber to get the message out. Many people who were deemed close contacts are being tested but some are choosing not to get tested. It is very important that everyone deemed a contact volunteers for testing. The testing programme has expanded hugely and we now have capacity, if we need it, to do up to 140,000 tests per week. That gives us one of the highest capacities anywhere in the world. The HSE deserves huge credit for being able to do that from a standing start. Over 1.8 million tests have now been done and the serial testing in nursing homes, in direct provision and in meat processing plants is ongoing, as well as mass school testing, when it is deemed appropriate by the public health leads.

Contact tracing is a big focus for colleagues and for me. The numbers have ramped up very significantly and we have gone from 231 tracers in mid-September to 700. We are on our way to 800 in total. These figures do not include the contact tracers who were already working in public health departments, who are responsible for more complex contact tracing. I am delighted to share other news here as well. I recently announced a doubling of our public health workforce in the country. I am delighted to share with colleagues that, right now, over 200 interviews are ongoing and a further 200 interviews are scheduled. Good progress has been made in this regard as well.

Much of the contact tracing effort, here and abroad, focuses on forward contact tracing, that is, identifying people who may be infected by the people we know about or, in other words, finding out who their close contacts are. Our public health departments also do what is called backwards contact tracing, retrospective contact tracing or source identification. This involves understanding not who a person may affect, as that is the forward tracing, but going backwards and trying to identify the sources of infection. That is to do two things. It is to help us understand what sort of environments are driving infections but also, if we can get to them quickly, we can find other ways of contacting the people who were at those events and tell them that they too are deemed a close contact and they need to get a test and restrict their movements.

There is growing evidence of super spreaders. This is the idea that a small number of people or a small number of events can lead to a very high number of cases, and it is making backward contact tracing even more important. I am very happy to be able to share with colleagues that the HSE has done a huge amount of work in this regard. In fact, I was on a call with the HSE earlier today. Backward contact tracing is now moving well beyond where it has been deployed to date with the public health departments on complex cases because we now have this workforce of 700 and growing.

Encouragingly, as colleagues will be aware, we have seen the emergence of very positive results in terms of vaccine candidates. The reported positive trial results from AstraZeneca, BioNTech and Moderna provide reason for optimism, if cautious optimism. However, it should be noted that all proposed Covid vaccines will require approval from the European Medicines Agency. Colleagues will be aware that Ireland is participating in the process led by the European Union to procure vaccine supplies. It is an advance purchase agreement being led by the EU and, as of this morning, we have signed up to five such vaccines.

A good amount of work remains to be done before we have a full understanding of the effectiveness of the vaccines, how long they provide immunity for, whether the effectiveness differs across particular age groups and whether it is more effective with symptomatic people, for example. Most importantly, we need assurances as to the safety of the vaccines. There are grounds for a real optimism. We are beginning to see the breakthroughs needed to move Ireland and the world on from a world dominated by Covid-19. However, until a vaccine is here and until it is widely distributed, we have to continue to rely on the tools that are available to us right now.

The scenes unfolding across Europe in recent weeks provide a stark reminder of just how bad things can get. The Dutch, for example, have had to transport patients to Germany amid a surge of cases there, Italy’s death toll, tragically, has surpassed 50,000 people in recent days and there are some really difficult things going on in countries across the European Union and across the world. These are the scenes we wanted to avoid. That is why the Government agreed to the extensive measures required in recent months to limit the spread of the virus, to keep people safe, to keep the schools open and to ensure that the hospitals and the intensive care units are not overrun. As colleagues will fully appreciate, if our health facilities were to be overrun, not only would this have a very serious impact on Covid-19 patients, but it would have a massive impact on non-Covid patients as elective care would have to be curtailed, which would lead to some very serious results.

Ultimately, the measures taken, the efforts from our front-line workers, the efforts from every person, every family, every community and every business, are all about saving lives. If the virus did not kill people, we could, for example, argue in favour of a herd immunity strategy, depending on how much damage it did. However, it does kill people, and all of the efforts, all of the measures, all of the hygiene, all of the contact tracing and testing, and everything that has been done, has been about keeping people alive and limiting the number of fatalities. It goes without saying that any one loss of life is one too many. It is worth reflecting, however, that if we look at the fatalities in the first wave versus the second wave here in Ireland, there has been a reduction of more than 90% in fatalities. For every ten people we lost in the first wave to Covid-19, we have lost one in the second wave. It really is worth re-emphasising that this comes down to our healthcare workers but also to front-line workers right across the country and the sacrifices that everybody has been making.

The question now is how we exit level 5 in a way that keeps the virus as suppressed as possible and we all know we will not have the same level of suppression when we leave level 5, while at the same time opening as much as possible.

The next few months will be challenging and there is no point in stating otherwise, but there is much to be optimistic about. I look forward to continuing to listen to colleagues' ideas on how we exit level 5 and work on moving forward in the coming weeks and months.

People are anxious to hear the advice the Government will give for those living abroad who are thinking of travelling home for Christmas. The approach for travel into and out of Ireland must be guided by the public health advice. The emphasis should be on adhering to the public health advice, advising against all non-essential travel, continuing the excellent work of keeping Covid-19 numbers down and avoiding the risk of importing cases but we also know that people have sacrificed a great deal this year. For some people, for example those who have suffered a bereavement, are struggling with their mental health or isolation, coming home for Christmas is an essential journey. While many will choose to stay abroad this year, we need to exercise compassion and common sense and the State needs to prepare for those who do travel. Central to that preparation is clarity and advice and ensuring that people who intend to travel know what is expected of them in terms of the traffic light system, restrictions of movement etc.

Equally important is the system of checks and controls we have at ports and airports to minimise the risk of importing the virus. The system we have in place is not fit for purpose and there are no plans to improve it before Christmas. On contact tracing, the passenger locator form and follow-up is entirely inadequate. On testing, PCR testing is available at airports, which is something, but it is expensive. That is a problem. Also, it is entirely voluntary, which is an even greater problem. I am very concerned that many people will opt out of the airport testing system, which is allowed. In fact, the Minister's Government is expecting it. In the Dáil on 12 November, the Minister of State, Deputy Naughton, and the Tánaiste, Deputy Varadkar, said they are expecting demand for testing to be in the region of 150 to 300 tests per day. When people, myself included, were confused about that figure in terms of whether it was expected demand or expected supply, the Department of Transport clarified that it was the expected demand. Based on October's figures, 150 to 300 tests a day would equate to less than 3% of travelling passengers. It might not be 3% but it is a long way off 100%. If too many people opt out of testing and we have no follow-up on passenger locator forms we are leaving ourselves exposed. The system must be improved and there are options such as mandatory testing, rapid antigen testing and investment in the passenger locator form follow-up. I encourage the Minister to improve on those areas.

There has been a very clear failure of communication between business and the Government regarding what should come after level 5. I do not believe anyone would dispute that. For weeks, businesses have been calling for clarity regarding Christmas trading. The public were looking for information on the public health measures that would be in place for Christmas and how things will look after 1 December. Today, the Tánaiste tweeted that we are on our way out of level 5 but he did not tweet about what is coming after that so we have mothers and fathers who do not know what size turkey, nut roast or whatever they are having for Christmas to order because they do not know if their children will be home. We have workers who cannot arrange their lives over the festive period because they do not know if they will be working or what work will look like. We have businesses that do not know how many staff they will have to roster, the stock they will need to order, the additional health and safety protections that will be necessary or their opening and closing hours. Essentially, they have no idea what trading will look like.

I have been in touch with countless businesses and many reached out to me in advance of speaking in this debate to relay their concerns about having no clarity on what next week will bring. The Hamlet bar, in Balbriggan, Pottager Restaurant, in Skerries, the Manor Inn, in Swords, The Snug, in Skerries and Kealy's of Cloghran are a tiny fraction of the number of people who have reached out because businesses are desperate at this stage. In normal times, planning for Christmas takes place months in advance, therefore, it is completely unfair during a pandemic to leave businesses in the dark regarding the nature of Christmas trading.

The Government, along with the Tánaiste and Minister for Enterprise, Trade and Employment and the Minister for Health, should be sitting down with businesses - it should have been done before now - and with workers' representatives from the trade union movement, to give them an idea of what they can expect. That would have been the best way to ensure that businesses can plan to operate in a safe and secure manner which protects workers and customers because that is what they want to do. They want to protect their staff and their customers but they want to trade. Instead, it is being left to the last minute for families and businesses alike and because of that workers, small businesses and families will be left scrambling.

People know that Christmas will not be the same this year as last year. They are already across that and, for very many people, all they want is to get Christmas over with but for 2021 can we please have deeper engagement with businesses, workers and their representatives? I urge the Minister and his colleagues to be imaginative, think outside the box and consider measures that will stimulate the economy such as the voucher scheme introduced by my colleague, Conor Murphy, in the North. I ask him to be imaginative, plan ahead and allow us to get a good start on 2021 for workers, jobs and the general public.

I call Deputy Róisín Shortall.

I am sorry. I was expecting a Government representative to be called in light of the insistence of a change in the order a few months ago.

I am glad to have an opportunity to speak on this issue. I want to say at the outset that I do not for a moment underestimate the challenges involved in taking the kind of decisions that are required over the coming weeks. There is no doubt that there is a lot of pressure on, some of which I believe is coming internally from Government parties, and a lot of expectation. Clearly, the question of public health and safety must be paramount in this. I recognise the fact that it is very difficult to strike that balance to ensure that businesses have a fair opportunity to trade and that we are very mindful of the challenges ahead in terms of an upsurge in the virus. Undoubtedly, it is difficult to strike that balance between allowing some level of celebration and business to take place during December while also being mindful of the fact that the more we celebrate, the more chances there are that some time in the new year we will have to go into a third lockdown.

I am disappointed that no attempt has been made to involve Opposition parties. The right way of going about this would have been to take an all-party approach. I have said to the Taoiseach over many months that it is regrettable he did not take that on board. That would involve sharing the data with other parties and sharing the decision-making also. All of us were up for that. In fairness, across the board Opposition parties have been very responsible and reasonable. On those few occasions when there were briefings we asked to be included in the decision-making. There would have been very definite benefits in including, on a cross-party basis, all parties in respect of the public health messaging. That would have been powerful but I believe that has been a missed opportunity. It would have been all the better if we could have had a united approach. Many of us have been asking for that.

It is critical that the decisions that will be taken over the coming days are based on the data and on a proper risk assessment. If the Minister wants to bring people with him he has to explain the reason some businesses can open, others can open in limited ways or some not at all. It is very important that the science and the risk assessment is provided on the reason those decisions are being taken. That is how the Minister will keep people with him. Obviously, that rationale has to be shared across the board.

There needs to be certainty for business as soon as possible because a lead-in is required for restaurants in particular. If there is to be an opening for pubs that serve food and so on and for retail in general they need that certainty and, in the case of restaurants, they need a two-week lead-in period. I hope those decisions can be announced before the weekend.

With regard to retail, I am assuming that non-essential retail will be allowed open up fairly soon. In that case it is very important that the Government ensures there are extended opening hours for retail, not only for their own sake but from the point of view of reducing pressure and congregation and that the footfall can be smoothed out somewhat.

The footfall could be smoothed out somewhat so that we do not have a rush for the undoubtedly pent-up demand. We can spread that demand out over busy peak periods in order to reduce the danger of congregating.

I ask the Government to make an extra effort to make the messaging clear to people. We need to keep repeating the original, basic messages. That is essential. The Government needs to do two things. First, it needs to be clear about the role of ventilation. The Government and NPHET have recognised that ventilation plays a significant role in reducing the spread of the virus. At this time of year when it is cold outside, there is a tendency to close windows and doors to keep heat in. There is a definite tendency over the Christmas period for people to spend long hours together at home in enclosed areas. The Government has to concentrate on getting out the message of how important it is to have air circulation and ventilation to reduce the spread of the virus.

The second clear message the Government needs to get out to people relates to the dangers that could arise in this period, and for people to limit their contacts. We all want to be with family and extended family. If the Government gives clear messages to people about what they need to do to reduce the circles they mix in, that helps. Christmas is a time when there might be much pressure on extended family to visit, call, come for dinner and spend a long time doing so. Clear messaging would be helpful because, instinctively, the vast majority of people are quite nervous about what Christmas might bring, in the worst sense. We all want it to be as good as possible but there is a real danger involved. Clear messaging about that, about reducing the length of time involved in visits and about trying to meet family outdoors as much as possible will take a lot of pressure off extended families with regard to their relations and expectations.

I welcome what the Government has said about recruitment. Let us not have a strike by public health doctors after all they have done this year. Will the Government please sort out that issue and ensure that existing public health doctors are given the status they deserve, which is consultant status, like all of their colleagues?

I join in the thanks to so many, not just those on the front line but also the many people who are making sacrifices to keep others safe. I do not agree with my colleague, Deputy Shortall, when she says that decisions should be made by the whole Parliament. Parliament has a role of scrutiny but the Government has to make decisions. At a time like this, we need to recognise that difference in roles.

As we move from the emergency, which is the present phase, with a focus on public health with NPHET's criteria consciously being narrow, we must move to a different approach. We need different structures so that we can break out of those narrow silos in order to effectively manage the critical pathways we all now recognise, namely, testing and tracing, quarantine and effective enforcement, so that people take tests; how we keep vulnerable groups safe; how we manage health facilities and use the wide range of health facilities to the best effect; and vaccine planning and modelling the virus. We need to reach into the private sector too. We are renowned for the data management skills that abound across the private sector. We need to bring that capacity to bear on the challenges we face.

We need to more openly balance the genuine costs of some of the choices that we make following risk assessment against the benefits involved. We have been very blunt with the instruments we have adopted to date. We need to become more forensic and weigh those on both sides, particularly as the risks that we see from the virus are decreasing and as vaccines emerge.

We need to evolve a different relationship with the communities and sectors we are trying to keep safe. We need to provide more information and have a more principle-based approach to allowing sectors and communities to evolve systems that are seen to be safe, and manage that risk. The truth is that we need to use all of the valves that can reduce risk in different social situations to open up every dimension of life in a safe way, including, in my view, wet pubs. As Deputy Shortall stated, ventilation, temperature testing before people go inside, rapid testing in some sectors, strict protocols on containment and quarantine being applied in workplaces, tightening duration of stay, occupancy levels and distances and the size and make-up of pods are some of the many elements that we can manage to reduce the risk in different sectors rather than have blanket closures. I appeal for that to become a feature.

This is a time when we need to pull together. Hopefully, we can evolve that new relationship as we move on.

I am delighted to have the opportunity to speak. Any time I have made a contribution, I am reminded that our only precedent for this is Spanish flu. There was a third surge of the Spanish flu in March and April and it will be hard for the country to avoid that in this instance, despite people's best efforts. We need to be mindful of it. The Taoiseach was right in his determination to prioritise the reopening of schools. He and the Minister for Education often do not get the credit for that. Deputy Shortall mentioned the need for ventilation. I have visited a number of schools in my constituency and they are probably the most ventilated buildings in the country.

As I stated at our parliamentary party meeting some time ago, if schools were allowed to close on 18 December, since children circulate en masse in these school communities anyway, it would provide families with the opportunity to isolate for a period of up to a week or in excess of a week, with Christmas coming, and perhaps facilitate the opportunity to socialise with grandparents. Please bear that in mind, along with the fact that school communities are exhausted. I will focus on the level of stress involved in managing that environment. For anyone who might be watching this later, I cannot talk about other areas because of the limited time. School communities are at the point of exhaustion. Entire school communities worked right through the summer to get schools open. They put in a phenomenal effort. I have seen that first hand. The Minister has brought a degree of consistency and stability. He achieved in excess of 100,000 tests and his message in recent months has been consistent, which has been helpful.

We cannot forget those people who I describe as our brothers and sisters. I refer to those in the hospitality, travel, event management and transport sectors. We are asking them, in the lead-up to Christmas, to survive on Covid payments and one double payment. That must inform everything the Minister says. Wet pubs have not opened since March and pubs that serve food have not opened since September. We have had a surge in that time and the pubs are not responsible for it. I am not an advocate for publicans but I am looking at the potential for another surge. The choice that the Government has to make is whether it allows for people to socialise in a manner that is capable of being policed, observed and regulated or if it, through rules and regulations, drives socialisation and socialising underground into an unregulated, completely unpoliceable environment. If the latter happens, it will lead to a surge over Christmas. That is one of the biggest challenges the Government faces.

When we use the term "younger people", it clearly comes from those of us who are older.

I pay tribute to that generation who had least to lose from a health perspective from the virus and who made awe-inspiring sacrifices to protect their parents and grandparents, our health workers and all those on the front line and those who are vulnerable. They kept our shelves stacked throughout the period. When we finally see this virus in the rear-view mirror they will be some of the unsung heroes of this period.

Too many people have died from this virus and the Taoiseach is correct that it is very serious. It can and does kill. The lethal nature of the virus is nowhere near as serious as it once was. Taking average figures provided by the Central Statistics Office for April, 74 of 1,000 cases tragically led to deaths. In October, five of 1,000 cases tragically led to deaths. Of 1,000 cases in March, 192 led to hospitalisation. Of 1,000 cases in October, 50 led to hospitalisation. This virus is not as lethal as it once was, nor is it as lethal as we once feared. We all remember the horrific scenes from Bergamo and felt that pain at the time. Furthermore, thanks to the huge efforts of so many people, that has not and will not happen here. Despite this, the hammer of lockdown, designed to fight something far more deadly, is still being used now. The facts have changed and our strategy has not. That is not to criticise what we have done until this point. It is to say that now is an opportunity to recalibrate our approach as we look towards the next 12 months.

A question that is a separate question from whether lockdowns are still necessary, which I believe they are not, is whether lockdowns potentially do more harm than good. Cancer referral rates are dramatically down and reports of abuse in the home, be it of a child or a partner, are up. People are struggling with mental health. These are just the other health concerns that we have in society today. That is not to mention the societal or economic damage that is being done as a result of lockdowns. Covid is very serious but this is too narrow a lens to make these tremendous changes and interruptions to our citizens lives and how they go about living, week in and week out, and now month in month out, over the course of 2020.

There is an opportunity for the Government to make some changes. The first thing we should do is remove national lockdowns from the five-level strategy for the reasons I have given. I also favour the opening of structured environments because the Government has told us that these open structured environments are safer. I emphasise individual responsibility for people and businesses and we should penalise people accordingly. We should place rings of steel around vulnerable communities. We can do this. The health authorities, local authorities, charities in the homeless sector and the Department of Housing, Planning and Local Government did this earlier this year and do it still under the new Minister. It can be done for vulnerable communities. We should also keep the National Public Health Emergency Team, NPHET, but merge it into the National Emergency Co-ordination Group. That group is our best practice in this country and we are not using it. It is more inclusive and will lead to better decisions. We should move away from case numbers as a metric for major policy decisions because the correlation, as I have just outlined, is no longer there. We should re-establish the Special Committee on Covid-19 Response. Its Chairman, Deputy McNamara, did great work and we need that layer of accountability back in place.

It is not only Members but also businesses who are eagerly awaiting news of where we will emerge on the living with Covid-19 roadmap during the essential Christmas and new year period. Many commercial sectors are depending on having a good Christmas, especially retail and hospitality. It is a vital time of year and preparation must begin now if these sectors are to make a success of it.

The coming weeks are a time to cherish and one that allows families to spend time together. It is also an important time for religious services. As we enter the new year, many people embark on new fitness regimes and it is a critical sales period for gyms. Many sectors and ways of life have been heavily impacted by the current restrictions, which have taken an enormous toll to date.

I have emphasised the need for clarity when speaking on these issues in the past. This week, we need to provide optimism and hope for the self-employed and for those whose employment is effectively on hold. As parliamentarians, we need to bring balance to how this is approached to ensure this is a fair Christmas for businesses. Much media commentary indicates that an uneven playing field may emerge when the current restrictions are lifted. This must be avoided. Our communities are built on mutual respect and helping our neighbours in times of need. I passionately believe in the resolve of the Irish people to drive Covid-19 into the history books where it belongs. To do so, we must place trust in our communities to act responsibly, as the vast majority have done to date. We must trust our businesses to operate as intended and do our best to reopen as much of society as possible.

A consultant in perinatal psychiatry at the Rotunda Hospital, Dr. Richard Duffy, told the journal.ie that Covid-19 has had a major impact on the mental health of new mothers. He talked about women staying in hospital for four or five days with no visitors and how isolating this can be for them. These are women who would normally have had support circles at home. Families and friends would have been calling to see the new baby and lend support and help to the mother and partner. These women, and indeed their partners, are missing out on this emotional and physical support but also the reassurance that family and friends would give. They are alone in some of the most worrying weeks of a new parent’s life.

I was contacted by a constituent last week who was greatly concerned that her child who was born in March has yet to receive a developmental check from a public health nurse. The HSE confirmed that these services were shut in March and no date has been given for their reopening. Developmental checks are vital for babies and their mothers. They are a chance to discuss any concern a new mother might have and provide an additional net to prevent those with postnatal depression from falling through the cracks. Without them, there is a real fear for babies for whom serious developmental issues may have been missed. This is a very significant issue. There is fear that mothers will struggle alone because they do not know where to find help and there is fear for the welfare of babies and mothers. We need to see these vital developmental health checks return as soon as possible.

I welcome the opportunity to contribute to this debate. I pay tribute to all of the health workers for the work they have done over the past nine months, and to the teachers, caretakers, pupils and school secretaries in the education sector.

It is highly likely that this winter we will see the annual trolley crisis come to the fore. Unfortunately, it is also possible we will have the effect of a third wave of Covid. We must do everything we can over Christmas to ensure we do not allow the spread of the virus to increase. With that in mind, what plans does the Minister’s Department have in place to deal with the annual surge in admissions to hospitals which puts pressure on accident and emergency departments?

Capacity needs to be increased. I highlight the case of the Midland Regional Hospital in Portlaoise and Tullamore. Last winter, both hospitals operated at 100% capacity for much of the time, whereas the recommended maximum operational capacity is 85%. What work is being done to increase the capacity in our public hospitals? Will progress made in this area be long-term and additional? We recognise now that we need to expand capacity in our health services. This should not be seen as a temporary issue. We need long-term solutions.

On intensive care unit, ICU, capacity, prior to the pandemic Ireland had only six intensive care beds per 100,000 of our population. That is only half the European average. We are a long way behind. Tullamore hospital has four permanent ICU beds and Portlaoise hospital has two such beds. That is six beds for a population in excess of 160,000 people. I am raising this issue in a genuine way because we are skating on thin ice with ICU capacity. Temporary capacity can be put in and the hospital has done that when it has become overwhelmingly busy. These are matters in our health service which must be addressed regardless of whether we face a pandemic.

I welcome the Government’s announcement this week that the pandemic unemployment payment will be extended until the end of March. Workers and businesses in every constituency, including Laois-Offaly, require this certainty to allow them to plan for the future. This announcement is welcome news and provides some peace of mind for the next few months.

On the issue of rates, there was a guarantee given that the rates break would continue to the end of December. Unfortunately, businesses are coming out of this year in bad shape. Due to the ongoing nature of the pandemic, we need to see this break in rates extended to at least June of next year. I appeal to the Government to clarify that point tonight.

Child psychology services have been more or less suspended, as have child speech and language services and child occupational therapy. Parents of autistic children contact me day and night on this issue, as I am sure they contact every other Deputy in the House. We need to get those services back up and running. I appeal to the Minister to use his influence to address this issue.

Those who are trying to underestimate the threat of Covid-19, as Deputy Eoghan Murphy just did, need to explain why there are hospitals in this city turning patients away because they have had Covid outbreaks, irrespective of whether the patients are Covid patients or non-Covid patients. That is with infection rates at a relatively low level. If the rates rise, our hospitals will be overrun, and people who make irresponsible comments will have a lot to answer for.

In the insulting amount of time given to discuss the most important issue affecting this country, I am going to make just one point to the Minister. If he wants a Covid strategy that works, he should treat with respect, dignity and support the health workers who are on the front line fighting Covid-19. He is singularly failing to do that.

I will not go through in detail the long list of comments made to me, including those of the contact tracers and testers who do not get sick pay and who are on temporary contracts and the nursing staff who have had their pay cut in recent years because of the FEMPI legislation and who have been affected by understaffing and under-resourcing; I will just speak up for one particular group, the student nurses and midwives. Thousands of them have been working on the front line. The Minister was forced in March and April to accept they were working and should, therefore, be paid and then pulled the rug from under that payment leaving them working for nothing again on the front line.

I held an online meeting last night with student nurses and midwives. I will allude to some of the comments they made in the short time I have available. They were furious with the Minister over the €50 allowance for accommodation, which most or many of them do not get, and the miserable little travel allowance. They just laughed at the idea that the Minister is protecting their education. One individual said the student nurses are left to their own devices to do front-line work. Another said nurses are doing 12 and 13-hour shifts with no nurse beside them. Yet another said nurses are working in a red zone with Covid patients, covering for staff shortages and people who are sick. I was told student nurses are worried about their family members with underlying conditions. I was also told student nurses had to give up their jobs to do their placements and that this would not be tolerated if they were mostly men. They ask how it is that paramedics, gardaí, those who do military training and apprentices get paid while they are training and student nurses do not although they are actually working on the front line in hospitals.

I was told the €50 allowance would not even cover the cost of accommodation and that it would barely cover the cost of a cardboard box. I was also told student nurses and midwives need to pay for parking and that the parking charges for one week are more than they get. Some are paying fees of €3,000 and not getting paid, and mature students are paying €7,000 and not getting paid. The individuals I spoke to say student nurses and midwives fear speaking out and were warned not to speak to the media. I discovered mental health nurses are talking about the fact that their mental health is absolutely in bits because of the situation they are facing. I learned that student nurses are doing multiple academic assignments while filling in for sick staff and understaffed hospitals. They ask how they are even supposed to live or do their shopping. That is how the Minister is treating them. He should pay the student nurses, end the exploitation and treat healthcare workers with respect.

I wish to make three comments - one on schools, one on Christmas and one on workers' rights.

On schools, the mental health pressures on the students are mounting. The Minister was very quick to shoot down the suggestion made by the Teachers' Union of Ireland about finishing for Christmas on 18 December. She gave the very strong impression that the Government is not listening, not only to the teachers but also to the students. The Minister needs to see what is happening with mental health and she needs to learn how to read the room.

On the question of Christmas, the people of Ireland are wise enough to know there cannot be a fully normal Christmas this year. They should be able to have an enjoyable Christmas without having to fear lockdown again in January. Unfortunately, the Government's continuing failure to put in place a world-class testing and tracing system does increase the risk. The entire population of Liverpool was recently tested for Covid, and 2,000 asymptomatic people were identified and quarantined. Why are we not doing mass testing here in this country?

On workers' rights, if there was a trade union leadership worthy of the name, 2020 would have witnessed a general strike to defend workers' rights and to demand an Irish national health service. The year 2021 must be the year when we beat the virus and see a workers' fight-back for real change on these issues.

Like many, I feel trapped in a kind of doom loop of lockdowns. Figures come down but community transmission is nowhere near eliminated. The Government listens to the considerable amount of business lobbying and reopens too quickly, and then the number of cases rises again. The way the Government talks, it is like a third wave and third lockdown are inevitable. That would be a nightmare for people. It is completely avoidable if the Government invests in finding, testing, tracing, isolation and supports for people and adopts a strategy of eliminating community transition. From media reports, it seems the plan for next week is to reopen restaurants and then, later in the month, reopen inter-county travel. If that is accurate, it is a recipe for seeding the virus across Dublin for a couple of weeks and then spreading it right across the country. The focus at this time should be on ensuring people can spend time with their families at Christmas. That is what is central. There is public support for it. Despite all one hears in the media and all the business lobbying, there is broad public support for doing what is necessary. An opinion poll published just yesterday indicates that 84% of people believe the Government is either not doing enough or that the action is sufficient. Only 17% say it is too extreme. There is broad public support for doing what is necessary but private profit stands in the way time and again.

I am glad we are on track to exit level 5 next week and that we are preparing to reopen gyms. I ask the Minister to allow dance classes with social distancing during level 3 to boost physical and mental health.

If one lives on a county border, the opening up of one's county may not offer much hope of seeing one's family. It one lives in Lucan, one is more likely to have family in Leixlip than Lusk. If one lives in Rathcoole, one is more likely to have family in Kill than Killiney, but under county-wide restrictions, even though one may be less than 15 km from one's family, one will not get to see them under level 3. Level 3 is meant to be less restrictive than level 5; that is the point of the graduated levels system, but if one lives on the border of a county, it can end up being more restrictive. If, like me, one lives in Lucan, one can under level 3 travel 40 km north to Skerries and 40 km south to Dalkey but one may not travel 5 km to Leixlip. The Minister should extend the travel radius to allow for travel within 20 km of one's home because that is how to make level 3 the reward it should be for all the families who live close together but who have been separated since September.

Families separated by more than 20 km need to know they will be able to spend Christmas together, pull Christmas crackers and tell bad jokes, as they normally do, see their grandchildren, nieces or nephews open their gifts, and uphold just some of their family Christmas traditions. We realise it will not be a traditional Christmas for Ireland but it will be a Christmas that our country has never needed more - a time to come together and value the things that matter to us most as people, as sons and daughters and as parents and grandparents. If ever there were a Christmas that families needed to spend together, this Christmas would be it. Can the Minister tell people living in places such as Lucan and Clondalkin and who want to travel home to spend Christmas with their loved ones that they can plan to do so? This year, more than ever, we all need a little something to look forward to.

We are now in the final week of level 5 restrictions. The figures indicate these restrictions have significantly suppressed the spread of the virus. It has not been suppressed as much as we would have liked but the trajectory of the spread is downward. The hospital and wider healthcare systems have responded effectively to the autumn surge of cases. The various health agencies and healthcare personnel deserve our continued support and encouragement. The leadership shown by the Government and health agencies has been supported by widespread adherence to the guidelines by the public. The restrictions have imposed considerable economic, social and psychological burdens on many people. Lives and livelihoods have been turned upside down.

Many small businesses which survived the first lockdown in spring and early summer will struggle to survive the second hit. Every possible assistance must be made available to these businesses to help them keep going until Easter next year, by which time the roll-out of vaccines will be well under way.

We need to be guided by the evidence with regard to how we move out of level 5 restrictions and what regulations should remain in place. From the beginning of the first lockdown in March, supermarkets, food stores, butcher shops, pharmacies and off-licences have remained open. The evidence is fairly strong with regard to these outlets. They have not contributed in any significant way to the spread of the virus. The evidence suggests that the opening of general retail in an ordered and controlled way will not be a major contributory factor in the spread of the virus.

A big decision has to be made with regard to restaurants and public houses. Any reopening of the hospitality sector will need to be gradual, measured and have restricted opening hours, but we must give the sector the necessary support so that the businesses can survive.

Christmas can still be special for families and everyone. This is a time to watch out for and to be there for each other in different ways. If we follow basic sensible precautions we can get through Christmas and the new year without a large surge of cases in January.

I was a schoolteacher until February. As a former schoolteacher, I never doubted for a moment the capacity of schools to be able to withstand the ravages of Covid-19. Yet, in the back of my head I was concerned that the mass gatherings of children and parents at the school gate every morning would lead to a spread of Covid-19. Great credit is due to our country's schools for the work they have done to minimise the spread of the virus and how they have managed everything thus far in what has been the toughest of all academic years.

I wish to speak briefly about the hospitality sector. In the part of the country I come from, social isolation has been practised in pubs for many years. People sit apart on stools. They look down the counters at someone else. They do the crossword and there is little social interaction. This contrasts with the likes of the Berlin D2 bar in Dublin, with people pouring vodka down mouths and running across countertops. That kind of messing has done major damage to the rural model of pub. I hope that when level 5 restrictions are eased in a week or so pubs can be considered. We passed legislation in the House in the summer to allow An Garda Síochána to raid and sanction pubs and take the licence away if the pub is flouting the rules in place.

The choice at the moment will be between drinking in a safe controlled environment, where we can trust the publican and manager, versus people on street corners or, as we have seen in parts of Dublin, drinking at the corner of a pub with take-away pints. That it totally unrealistic and dangerous at this time.

Families deserve a Christmas. It is good for their mental health and the well-being of the family. I appeal to the Government to do everything possible to ensure a Christmas for families near and far, including for people flying in from abroad.

The mantra of "essential travel only" has to change. People should be allowed to travel if they travel with a polymerase chain reaction, PCR, test confirming the person is Covid-free at the point of departure and at the point of entry to the country. If the person is not carrying Covid, he should be able to go home to the family and spend time with them. Then he may go back to the UK, Dubai or wherever he lives and domicile for the rest of the year.

The issue of masses and religious worship needs to be provided for. Spiritual health is important for people. Many people have contacted my office. If we can have 24 people at a funeral, then we can have 24 at Sunday mass. We can have Irish dancing and outdoor events provided all of these activities are subject to social restrictions. There have to be caveats but a great deal can happen. I urge the Government to make the right decisions in the coming 24 or 48 hours.

It is clear to everyone in the House that the second lockdown has impacted our society, possibly more than the first. That is notwithstanding the participation of children in schools and the continuation of certain sectors of the economy. Thankfully, we have the hope of several vaccines for 2021. Without them, I believe the picture would be grim indeed.

We know the impact lockdown has had on domestic violence. We know, or are beginning to know, the impact on mental health. We thank every person in Ireland who has so faithfully changed his or her way of living to try to protect the most vulnerable from the virus.

I want to highlight two things in my contribution. The first is the real challenge felt by young people. They have been impacted more than we have given them credit for. There is no doubt that lockdown can be easier for people with longer life experience and those who may have a partner at home with whom to share the evenings, though there are many who, working at home all day with their partners and spending the evening with them as well, could be facing genuine challenges of a different kind. We need to acknowledge that as well. Anyway, young people need to be considered as an emerging vulnerable group in the planning for the vaccine distribution. They are suffering a peculiar isolation, whether living with or away from families. We need them to get back out, back to college, back to work and back to working in publicly facing businesses. This is going to be important for them later in life. I appeal for this to be seriously included in the thinking for vaccine planning.

The second issue relates to business supports. The range of supports provided this year for businesses by the Government are without precedent. Of course, this is in the context where their activities have had to be constrained by the Government and the Parliament to keep other people safe. We acknowledge that and thank them for it. Next year, 2021, needs to be a new vista for those businesses. They need to be able to open and they need time to plan for it.

I remain concerned about the events and exhibition sectors. They are unable to apply for the Covid restrictions support scheme. I hope they can be included in the fund for live events established by the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media, Deputy Catherine Martin. I hope other businesses that have been nearly closed will be supported as well. Bars, hotels and those in the hospitality sector as a whole have been affected similarly.

We have done remarkable work together. People are tired now. I wish to reiterate the comments of my colleagues earlier about the need for new planning and new ways of managing our collective behaviour while we wait for a longer-term solution.

Sadly, it was announced this evening that a further six people have passed away due to Covid-19, bringing the total loss of life to 2,028 people. Once again, I wish to offer my condolences to them and their families and loved ones throughout Ireland.

Since the pandemic emerged here in March, we knew this winter would be a challenge. The pandemic combined with the winter flu season could have overwhelmed our health service. This was spoken about many times in the Chamber. Thankfully, that is not the case today. The public have made great sacrifices. Credit is due to the efforts of hospital staff, teachers, retail workers, transport workers and all front-line workers involved in Covid-19. They are helping to keep the trend downward.

Ireland appears to be managing this second wave better than most of our EU counterparts. As we approach the end of level 5 restrictions, it is appropriate that Dáil Éireann considers the kind of Christmas we want for 2020. We were told that the objective of level 5 was to reduce the incidence of Covid to a manageable level to allow us a meaningful Christmas. We all know and accept that this Christmas will be like no other. People have lost their loved ones and the threat of the virus still hangs over us. Yet, there is hope. Three vaccines have been announced. They will be distributed early in the new year. It is clear that the sacrifices made by the people during level 3 and level 5 have worked and are working.

We must now move to allow some services to resume. Activities like sports are essential to support mental health and physical well-being. For many people, attending religious services is essential for spiritual well-being. Activities like meeting a friend for a coffee can be essential to emotional well-being. As we exit level 5 it is important that we relax restrictions on activities in a controlled manner. This should apply to gyms, churches, coffee shops, retail, restaurants and gastropubs. However, these businesses need certainty and the Government must confirm arrangements as soon as possible.

As the Taoiseach and the Minister of State, Deputy Rabbitte, will be aware, I have previously raised my concerns for the many business sectors, including hospitality, tourism, arts and retail. Businesses should reopen based on the size of the premises. That must be considered. We must balance the risk to the public and ensure that any reopening of the economy will be done against the backdrop of best public health advice.

I commend the small business owners throughout the country who are struggling during this pandemic. Small business owners are the backbone of rural Ireland in particular. They provide badly needed employment where larger companies believe it is not feasible to do so. They need to be supported and we need to ensure they survive this crisis. It is a matter of survival at this stage because it is a crisis.

I received an email from a gentleman at 10.30 p.m. on Sunday. The time it was sent will give an idea of how stressful the situation is and how it is weighing on the minds of people. He wrote to express his frustration about the lack of support for small business. He describes himself as the director of a small business in Kildare. He says he is the administrator, accountant, purchasing manager, salesperson, engineer, order picker and delivery person. The founder of this business was let go from a multinational in recent years. He started his business in 2019 and did not take a wage initially. He invested all his spare cash into the business. Then his business fell off a cliff when the virus arrived.

He did not qualify for Covid assistance because he was not taking a salary and was last employed in 2018. The Government introduced rates assistance for business but this business did not qualify for it. As a start-up business, the company was renting space from a logistics provider and did not pay rates. When the first lockdown was lifted, the director started paying himself a wage. When level 5 hit Kildare, he applied for the pandemic unemployment payment. He did not qualify because he was not fully unemployed since he was a director of the business. We need to reward our risk-takers rather than punish them. They need a lifeline and they need it fast. It is time to act now before it is too late.

Many businesses will not survive this if we do not do something.

It has already been said by many that our numbers are still too high. We have had the terrible news of six more deaths in the past 24 hours, which means there have been 2,028 deaths during this entire period. It is an absolute tragedy for a huge number of families. There is a severe impact on our lives and our economy. We all have to do what we can to bring the numbers down, particularly as we are looking at opening up. A major emphasis has to be on test, trace and isolate. We all welcome the fact that there has been an increase in the capacity for tracing. We need to maintain this under continuous review. We are talking about opening up and that is necessary but we need to talk about outbreaks and how we deal with them. That is done by chasing down this horrible virus.

We have had a huge issue in respect of nursing homes and we have all heard of particular outbreaks in the past while that have got us worried when we remember what happened in March, April and May. I welcome what I have been told by the HSE regarding its improved strategies and line management in dealing with all these issues. We need to ensure that this happens and that all the necessary supports are provided to ensure our elderly citizens are looked after properly at this time.

I want to raise the issue of public health protocols in congregated settings. In fairness to the Minister of State, she has already indicated to me that this is something that needs to be looked at. It was brought to my attention that there was an outbreak at St. John of God's in Drumcar in and around 14 October last. This was in a congregated setting. It was like a residential campus. There were three residents and approximately 14 staff. One resident became sick with Covid-19 but, on public health advice, all of those in the facility were not considered a close contact. In fairness, the staff drew attention to the fact it was very likely that an asymptomatic member of staff had brought Covid-19 in. That was their belief. Screen testing was not happening in this congregated setting and, even following the outbreak in question, full testing was not done. A number of staff did not feel particularly well over two periods. They went to their own doctors to get tested and approximately nine of them had Covid-19. This is something we need to look at.

I have also heard that in September or October there was an outbreak at the Crosslanes psychiatric unit in Drogheda. As a result of this outbreak, the provision of the many mental health services on offer there, which are very necessary, particularly at this time, was almost brought to a halt. We need to look at all these health settings and at other congregated settings from the point of view of screening. The question is whether the latter is done by using the PCR capacity that exists. We also have to look at the possibility of carrying out rapid antigen tests, possibly alongside PCR testing, which is still seen as the gold standard. This is what we have to do until we get to that almost promised land when we have a vaccine and can move to a more normal life.

I call Deputy Verona Murphy, sharing with Deputies Fitzpatrick and Tóibín.

Deputy Fitzpatrick is first.

I welcome the opportunity to speak. Covid continues to dominate the daily lives of everyone, not only here in Ireland but worldwide. I welcome the fact there are positive signs that a successful vaccine is not too far away. Everyone’s life has been affected and put on hold during the pandemic. Many people have paid the ultimate price.

We must learn from this pandemic. We must prepare ourselves for the future pandemic because there is no doubt we will be faced with this at some stage in the future. I suspect that life will not go back to normal as it was before. Rather, we will have to deal with a new normal. It is for this reason that we must plan now. The people cannot face another serious lockdown and the hardship to which it gives rise. We must make our public buildings, schools, hospitals, libraries, care homes and all other places where people can meet and congregate as safe as possible from viruses like Covid. How do we do this? We must examine that matter now and proposals must be put forward.

As I have stated on previous occasions, I support the efforts of this Government and the way it has handled the pandemic. It is not a time for playing petty political games like those we have seen in other jurisdictions, nor is it a time for scaremongering. When we compare the numbers of deaths and hospitalisations now with those in the first wave, what is encouraging is that it is clear progress has been made in the treatment of Covid.

The next challenge we face is the roll-out of a vaccine. I am pleased that the Government has appointed Dundalk man Professor Brian MacCraith to chair the vaccine task force, which will be vital in the context of getting the country back up and running. It is important that the public is made aware of all aspects of the roll-out of the vaccine. In order for this to be successful, we need the public to buy into it. I have full confidence in Professor MacCraith and his team to deliver. I agree with Professor MacCraith that urgency and certainty are the keys to a successful roll-out. We need the roll-out to happen quickly, with the most vulnerable and the front-line workers to be first in line.

I welcome the fact that a vaccine is now imminent, that hospital numbers and deaths have not reached the levels seen during the first wave and that we have a task force in place to develop a roll-out strategy. Society in general has made huge sacrifices during this past seven months and we must now do everything in our power to ensure that we, as elected representatives, make the right choices moving forward so that the lives of the people are brought back to normal.

I was one of the first Deputies to highlight the issue of contact tracing. I was concerned to hear the Minister for Health say that there were 231 contact tracers mid-September, at a time when we had 255 cases daily. At that time, I questioned the Tánaiste and he informed us that there were 400 contact tracers and that we would have to bring in the Army should we need any more. Last week, the previous Minister for Health, Deputy Harris, called for the Army to be brought in and to allow those in other essential services get back to their day jobs, such as providing vital speech therapy services and so on. I am glad we now have nigh on 700 contact tracers with the number of cases standing at 255 per day. I hope the Government understands that it is better to have a couple of thousand contact tracers than it is to have 350,000 people drawing the PUP because of the need to go to level 5 as a result of an ineffective testing and tracing system.

Lockdown restrictions should not be what we need to sort out our testing and tracing. I ask the Government to bear in mind that the purpose of these level 5 restrictions was to increase bed capacity, ICU capacity and ensure that testing and tracing capacity was put in place to keep us out of lockdown. Something the WHO totally disagrees with is the lockdown. While the advice of NPHET must be taken on board, we must have regard also for the many medical and science professionals who disagree with its view and request a balanced approach to other health services, whose needs are equally great. We must take their advice on board also. I will mention a few of those services: our mental health services are overwhelmed, our disability services are overwhelmed, our cancer screening services are non-existent. Failing to recognise their needs, will far outweigh the effects of Covid in the long run.

There is clear evidence that a new approach is required. That approach must encompass more than the element of medical opinion that we have followed to date. I wish the Government appreciated and had equal regard for people's general health as well as for their livelihoods. I hope this will be forthcoming without delay.

Ireland is the sixth most restricted country in the world and this is despite the fact that we have the second lowest level of Covid in Europe. This means that 97% of all the countries in the world have chosen strategies that are less restricted than Ireland. Ireland is a significant outlier in international terms and this has given rise to a massive human cost.

The WHO has stated that lockdowns should only be used when there is so much pressure on a health service that it will be overwhelmed. We have not been in such a situation in this wave.

When measured purely on the basis of Covid numbers, Ireland has done comparatively well. If all of life's other indicators are measured, though, Ireland has done shockingly poorly. As a result of the Government's decisions, there have been 150,000 missed cancer appointments, 200,000 women are on waiting lists for cancer screening and there are widespread diagnosis and treatment delays for stroke, heart disease and mental health. Today, 480 people were diagnosed with cancer, 24 people died from cancer and 27 people died from heart disease or strokes. Due to Government restrictions, these health areas have not had the necessary resources given to them.

Regarding mental health, it is a poor situation that we do not yet have the current suicide figures. These figures are generated from coroner's reports, which tend to be made six months to a year after a suicide has happened. When I tabled a parliamentary question to the Minister for Health, he admitted to me that suicide prevention organisations had advised him that there had been a recent increase in suicides. More than 500,000 Irish people are out of work, more than 3,000 SMEs have closed for good and there has been a 25% increase in child poverty, which is directly related to future mortality and morbidity rates. We in Aontú are not saying that there is no need for restrictions. There is a need, but the current restrictions are disproportionate and having a serious and negative effect on lives.

We called for the Government to focus on protecting the most vulnerable. More than half of those who have died from Covid were in nursing homes. Nursing homes were not properly protected. That was the first line on which the Government needed to focus. The second was ICU and ensuring that we had the necessary ICU capacity to deal with the pandemic. Precious little of the €18 billion announced in the previous budget went into the front line of ICU and extra hospital beds.

We asked the Government to focus on testing at airports, but there is still none. Let no one be fooled, in that Irish people in their tens of thousands will travel home for Christmas. People from other countries who are working in Ireland will travel to those countries for Christmas. If we do not get our testing to ensure that all of this can happen safely, we will suffer significantly in the new year.

I understand that Deputy Calleary is sharing time with colleagues.

With Deputies Cowen and O'Connor.

I welcome the opportunity to speak about Covid and I acknowledge the considerable effort made in recent weeks to reduce the numbers since the autumn. I commend the Government, but also health workers, the HSE, other public health bodies and NPHET, on their work. Covid has had a major economic cost, but as other Deputies have mentioned, there are considerable social and non-Covid health costs as well that we must focus on addressing early in the new year. We need a community-based mental health programme that will attract people who may not have accessed mental health services previously. We need to address screening delays. We need to consider other public services that have been delayed, for example, driver testing. Public services that required contacts between people during the first lockdown are showing significant delays and causing major difficulties.

We must start taking our public health services seriously. Public health has been the Cinderella of the Irish health services. Now is the chance to invest properly in it so that, as Deputy Fitzpatrick stated, we will be ready if another pandemic arises, but also if we are to deal with issues of obesity and the like that will have a significant impact on the nation's health.

Some issues must be addressed in the next few weeks. We need clarity and consistency in every part of the country about visits to nursing homes. The rules are different depending on the region and are causing people stress. Where access to maternity hospitals is concerned, particularly for fathers, the rules also differ from hospital to hospital. We need consistency.

We must focus on younger people, including teenagers, and get them back to their sporting activities, dance classes and singing classes, which help them. If young people can be in school in a structured and controlled environment, surely they can attend a dance or singing class in a structured and controlled environment. The responsibility is on the class organiser.

Inevitably, there will be a great deal of focus on the decisions taken in the coming days. I wish our colleagues in government well. They will take their decisions with safety in mind, but they need to consider all options. The largest source of Covid outbreaks are private houses. One dissuades people from visiting private houses by providing other options, for example, opening all pubs. Where proper controls are in place, the distinction between wet and dry pubs can be reviewed as a way of reducing the amount of activity in private houses.

There must be co-ordination on the island. There cannot be one law in Blacklion and another in Belcoo even though they are effectively the same town. Consistency must be brought not just to the Border, but to borders between counties. People are being told that they cannot travel between counties, but if they live a mile from a county border like I do, people going about their daily business will travel to Ballina from County Sligo, from Castlerea to Ballyhaunis and from Ballindine and Milltown. During the first lockdown, there was provision for business to be done across county borders by people who lived there. The same provision should be made for the coming weeks.

There needs to be clear information as soon as the announcement is made. We cannot be scrambling for information and trying to respond. There should be one spot where everyone can go to see the announcement.

I wish to signal a concern about all of the calls for 24-7 shopping and retail. We must think about the workers. The calls sound good, but retail workers have had a tough year. They are also on the front line and they, their arrangements and their families should be considered in the coming weeks.

On balance, our nation has responded well to the pandemic. We owe our relative success to our front-line workers and the Irish people. I recognise the leadership and decision-making - initially of the caretaker Government and then the new Government - that sought to protect the vulnerable primarily and assist the economy by means of many expensive but worthwhile interventions in a wide and varied number of sectors and services, be they business, cultural, sporting or community-based. We have become more accustomed to the basic defences against the virus, for example, good personal hygiene habits and etiquette, while commerce has improved its offerings with home working and online trading, to name but a few measures.

Many sectors have been trusted previously and we are led to believe they will be trusted again. These include hairdressers, barbers, non-essential services or retail offerings and so forth. They and their customers can and will live and trade, not in spite or fear of Covid, but with it. They will do this because they have to, and doing so is essential if they and we are to have a future.

We need to consider extending that trust, loyalty and understanding to other sectors that are willing to reciprocate by showing that they, too, can live and trade with Covid. Leadership is about affording trust and earning loyalty, through compromise if necessary. The trust afforded to children, staff and management in schools has been repaid by the bucketful. It has been the shining light in this dark pandemic, together with our far greater appreciation of our families, surroundings and communities.

The success of schools was based on consultation and planning. I would ask for, or even demand at this stage, an assurance that the Government is considering the possibilities that would allow the hospitality sector to reopen and discussing those not at, to or for the sector, but with it in order to agree new guidelines or, if necessary, new laws. The sector, its staff and their families want and expect a meaningful Christmas, too. By agreeing these protocols, the Government would give society a far greater ownership of the solutions. We will need the hospitality sector when we seek to repay the billions of euro that, thankfully, we have been able to dish out in recent months. Shut the sector out now and we shut out a large slice of the cake needed to repay that money. People in the sector know, understand and appreciate what the consequences will be for those who do not adhere to the guidelines and relevant laws - closure. That is justice in a democracy during a pandemic to which we have grown accustomed. If someone breaks the law, he or she suffers the consequences. God knows, I should know that.

If we are to have a meaningful Christmas that all of society can share and own, let us ensure that it ticks every box so that society buys into it, the economy is able for it , we have the spiritual and mental well-being to appreciate the offerings available to us, and can relish the opportunities presented by Christmas even at this dark time.

Many people will not forget 2020 for a very long time. It started out as a bright new decade, but was destroyed by this pandemic. I feel for what many business owners across the constituency of Cork East, whom I am paid to represent as a new Deputy in the House, have gone through throughout the year. I concur with some of the comments made by Deputy Cowen on the rounds of applause. Businesses in constituencies throughout the country cannot walk into a bank or Revenue and give them a round of applause. They need the support of the State in the upcoming months when we finally get through the worst part of this pandemic. I am sincerely hopeful that through the fantastic efforts made by scientists throughout the world we will have an effective vaccine in the very near future and I hope the Government can plan for that being put in place swiftly so society throughout Ireland can go back to normal as soon as possible.

However, I have to state that I have several concerns about our current strategy. It has been very difficult for many backbench Deputies who are supporting the Government throughout the past number of months to put ideas forward to NPHET and Ministers. I understand that Ministers who are working with NPHET are in a difficult position as they try to implement the best possible policy to protect our population from the spread of Covid.

I am concerned about the impact it is having on the hospitality sector and students in higher education. As I said, I am the youngest Deputy in the House. The stress and strain that has been put on students throughout the country has been enormous. In the next number of months I want the Government to state whether plans will be put in place to allow students about to enter and currently in university to plan to be able to return to college lectures and tutorials. An integrated learning system will be critical in the next six months if we are serious about allowing students a proper experience of university. So much has been taken away from them. They are in constant communication with me. A lot of them are hurting and are very angry and frustrated. They have been put in a position, through no fault of their own or the Government, of having to deal with what is in front of them. It is an enormous task for anybody, never mind somebody who is starting out in his or her life for the first time on his or her own, to have to deal with this problem and be stuck at home when he or she is supposed to be out enjoying life. I am quite conscious of that issue. It is critical. I know the Minister will do his best, as he always does, to feed that message back to the Government.

I also want to talk about the effects the pandemic is having on the hospitality sector. Over 20,000 jobs in County Cork depend on hospitality. NPHET is kidding itself if it is under the impression that people will not gather in each other's homes. That is reason enough to examine the possibility of allowing people to use the services that our hotels provide, including dining and accommodation, without having too much of the burden of restrictions over the Christmas period. I am working alongside many hoteliers in my constituency and I trust them, as I trust our restaurateurs and publicans, to do the right thing over the next number of months. The Government and NPHET should do the very same.

Deputy Carol Nolan is sharing time with Deputies Michael Healy-Rae, Richard O'Donoghue and Danny Healy-Rae.

I am happy to contribute to this debate. I want to acknowledge the extraordinary effort and role played by Irish people over the past seven months, including front-line staff in our hospitals, retail workers and principals and teachers in our schools who have done and continue to do a fantastic job every day.

The restrictions and lockdowns have had serious implications in terms of people's health. Cancer screening and treatment has been almost non-existent. I have had first-hand experience of trying to fight for people who have cancer to get them transferred to hospital for timely treatment. As I have said all along, I sincerely hope that the cure does not become worse than the disease. We need to be very careful about that because lives are being lost. We will, unfortunately, see the effects of this over the next number of months.

Businesses in my constituency of Laois-Offaly have also had to endure a severe and unwarranted series of extra lockdown measures that have cost the local economy dearly. Unfortunately, we have also seen the re-emergence of the cut-throat practices associated with vulture funds which are now running riot. I highlighted this issue last week when I noted that vulture funds are engaging in the forced sale of a significant number of farms. The picture that is emerging from around the country is horrendous. It is of deep concern to many farmers who are trying their level best to engage with lenders around debt management and repayment arrangements. As I understand it, personal insolvency practitioners have attempted to sound the alarm about the vicious and unsympathetic approach that is being adopted by various vulture funds. These vulture funds have to be reined in. There are also credible reports that the sale of some farms is being forced through without any prior notice being given. All of this demonstrates that while most people are trying to live with Covid, some organisations seek to thrive from the misery it has created.

I also want to point out that the denial of physical access to mass and religious services has been very upsetting. The treatment of Fr. Hughes, who was threatened with prosecution, was nothing short of scandalous and reminiscent of penal times.

By the end of January 98 beds will be ready for opening in University Hospital Limerick, 20 of which will be open this week. The emergency department had 52 patients on trolleys yesterday, with an additional ten trolleys in wards. The overcrowding in the accident and emergency department has been an issue for years and the department has been the worst in the country. It is currently finding it impossible to operate social distancing. The HIQA regulator has stated he will be unable to comply with restrictions due to the current overcrowding in the department. This is no reflection on the staff or nursing care in our hospitals. This type of investment means that in January 98 beds will have been opened and there will be 150 extra staff in hospital. I want that accountability from management. When I was elected I said this on my first day in the House. I am repeating now that I want accountability from management.

I thank the people of Ireland and Kerry for all of the great work they have done to try to control this virus and abide by the restrictive rules that have been placed upon us for several months. I call on the Government to give the hospitality sector a chance and trust it in the coming days. Many businesses opened for only a couple of weeks in September.

People all around us have been isolated in rural places. They have not met anybody or been to a local pub for almost six months. That is being reflected in the rate of depression and suicide in my neck of the woods in recent times. I call on the Government to trust publicans, who work in the most regulated sector and have been best placed to sell alcohol over the years. The same amount of alcohol, if not more, has been sold this year compared to any other year. It is unfair for Dr. Holohan to have said a couple of weeks ago that there will be no drinking in pubs this Christmas. He is not the Minister or Tánaiste.

There was a lot of praise in this debate for the people working in our healthcare service. As I have said on numerous occasions, I do not want them to be praised. I know they are not looking for praise. I want them to be paid. Wage agreements are in place for our nurses. Catering staff who have worked in our hospitals have not received a pay increase in 13 years. If I am wrong about that, I would like to be corrected and told that I am wrong. Unfortunately, I am correct. That situation is wrong.

The Government has made many mistakes in how it handled this crisis. I supported it in every way when it was doing something right. I will outline an example of absolute stupidity. When I and others came to the House and asked for marts to be opened so that farmers could go around a ring and bid for cattle, the answer was "No". Instead, they are sitting on the bonnets of motor cars staring into computers to look at animals.

That is a far more unsafe practice than if they were allowed around the rings, where the excellent mart managers would take care of them and ensure that social distancing would apply.

People have put their shoulders to the wheel, and I am deeply grateful to them for that, in trying to save and protect lives, which they have done. Nevertheless, the hospitality sector has been sold down the Swanee. I spoke to people earlier who told me they will not now open their pubs because of the way the Government has treated them. It is really unfair to pick on one sector of society. Despite the Government's best efforts, it has failed to produce any evidence of a link between people consuming alcohol in public houses and the spread of the virus. It tried to prove it but it failed.

I am sharing time. I will stick to my time, which will preclude me from saying many things. The Taoiseach spoke about how there was no handbook to guide the Government at the beginning of the pandemic, but common sense would have guided anybody at the time to protect the nursing homes, direct provision, those working in meat plants and so on. That is what common sense would dictate. At this point, common sense dictates that we look at those most needing our assistance, those who are saving the economy millions of euro, namely, carers, as the Minister of State knows better than I do. There is absolutely no respite and I do not see it at the top of anybody's list. I acknowledge that the Ministers of State, Deputies Rabbitte and Butler, have done their best in respect of day centres and respite, but it is simply not adequate to the need. It seems the Government is premising its solution on the basis that when somebody physically or mentally has a breakdown, the service will kick in to give respite. That is totally unacceptable. Any measure of our economy should be how we treasure those who save the State a fortune, and they are mostly women.

There are false arguments about NPHET all the time. There was the spin from the Tánaiste, which did very well, the spin from the Taoiseach, which did not do as well, the undermining of NPHET and all the false messages going out. There was the distinction between wet and dry pubs, which was absurd from day one and a waste of Garda time, with gardaí going in to see who was eating a substantial meal. There were the draconian measures we did not need, described as such by the Policing Authority. The Garda told the Government it did not need any more powers as it had plenty. The Policing Authority complimented the Garda and, more important, the vast majority of the people who were - I forget the exact words - surprisingly compliant. That is how we have reduced our numbers. It is worth remembering that all our actions were prefaced, in the first instance, on a very bad health system, where the panicked reaction suggested that the health system would be overwhelmed because we had run it down for so long. Then there was the daft arrangement with the private hospitals where we paid them to remain empty while people were going under at home, with no day centre and no respite. It is mind-boggling.

I will use my remaining time as a voice to say to Deputy Rabbitte, at some level as a woman and a female Minister of State, let us do something different here to provide respite. Let us not wait for the breakdown. Let us do it positively. Carers are doing us a marvellous service. I am ashamed and embarrassed. I recently got a response to a parliamentary question but did not have the courage to give it to the person affected to say there was no respite. This is somebody who is up day and night, although I will not go into the details. We do not need more anecdotes; we need action.

Everyone is affected by Covid-19, but some are badly affected. We can never forget about the grief of those who have lost a loved one, who never got a chance to say goodbye and, in some cases, could not attend a funeral. There has also been the everyday pain of people going to a window of a nursing home, just to try to be present. We need some regime, however strict, to allow at least some visits. I hate to say it but the budget let down family carers, worn out behind their own front doors. We need further support immediately. There are Covid survivors, often thought of as the lucky ones, who have been struck down by post-viral fatigue, while lives have been circumscribed, sometimes badly. We need, in parallel, to fund research and to try to find therapies and treatments for these people. There are young people over the age of 18 who are not working or in college and are pursuing online courses in bedrooms that have become virtual prisons. We need to find ways to allow their return to campus for blended learning, even on a staggered basis. Any business that, for the best public health reasons, will not be allowed to reopen needs a special package of supports immediately. Businesses, often one or two-person operations, that do not operate from a specific premises cannot access business supports because they are tied to premises. We need to look again at that group.

We should consider setting up a Dáil committee, similar to the Special Committee on Covid-19 Response, on the vaccination process from start to finish. I refer to the plans, the processes, the implementation of decisions taken by public health experts, the national and local approach, the follow-up and the follow-through, the collection of information, the staff, the buildings and their location, the transport, the sourcing of what I call the tools of the trade, the cost, the public information provision, the human factors and all the other logistics. All this and more will add up to probably the most important work the Government will undertake. A special Dáil committee would provide proper accountability, good co-operation and reassurance to people.

In regard to Christmas, people want simple, clear messages. To be honest, I do not want to hear about bringing home one's own plates or cutlery or putting grandpa near an open window. If Covid does not get him, the flu will. We need straightforward messages about the number of households in total that someone can meet up with at Christmas, the exact requirements for those travelling from abroad and the simple messages of washing hands, masking up and social distancing. Moreover, while there must be proper ventilation, mind grandpa.

I am sharing time. We know we will have to live with Covid-19 but we cannot live with lockdowns, which threaten our economy. We have to consider opening the country and deal with testing, tracing and outbreak management. We cannot afford another lockdown. I refer in particular to the move from level 5 to level 3. This would still mean that hotels could not accept visitors from outside their county, restaurants could serve only at a limited capacity and wet pubs could not open. We need to find a way of easing county travel restrictions and allowing indoor dining in the very safe environments of hotels and restaurants. These establishments have done all they can to protect their customers. Most especially in these vital weeks in the lead-up to Christmas, we must ensure we do all we can to protect lives and also to provide information for businesses, people working in the arts, gyms, sports clubs, hairdressers and barbers. Christmas will be four weeks away on Friday and everyone is wondering what will happen. I accept we are taking things day by day, but if we could get more information, it would be so important.

The lockdown has taken its toll in many ways, in particular on mental health and people who are waiting for hospital appointments. I have contacted the Minister of State about disability and respite services. She has given me her full support and I thank her for that. The imminent arrival of an effective, low-cost vaccine could be a game changer and we should ensure we have all we need to enable the most vulnerable people to get the vaccine. That is the number one issue. Everyone who wants the vaccine should be able to access it.

Another issue we need to discuss is the driver licence test backlog, which affects so many. This is not just a road safety issue but also a financial one.

Drivers who do not have their driving tests in hand due to delays may face up to €600 extra in insurance costs. I was contacted this week by a constituent who was due to sit his theory test last Friday. It was cancelled and rescheduled for some time in February, four months from now. He lives in a rural part of County Carlow without public transport. His situation is not unique. I am told that some 30,000 drivers could be impacted by the delays, as I am sure the Minister for Transport is aware. It is an issue that must be addressed. Each week, Deputies rise in the Chamber to point to cases where this is impacting people. Being certified is important for drivers not only because it saves them money but also because driving may be their means of accessing work. People who do not have a licence and do not have access to public transport cannot get to work. I have spoken to the Minister about this issue before. We need to find a solution for the people in that situation.

I want to raise the issue of home visits. With Christmas around the corner, people are asking me what will happen in this regard. There are vulnerable people who need to know that someone can come to see them, whether on Christmas Eve, Christmas Day or shortly thereafter. They do not want to be left alone at Christmas, which has always been associated with visitors and family time. I accept that we must be careful about visitor numbers and I am sure there will be restrictions in that regard. However, it is important that people are allowed to visit family members and also neighbours and friends, including older people, to ensure they do not feel alone. Christmas is a very special time for the people of Ireland. We love Christmas, it is part of our heritage and we enjoy celebrating it with family. This year, Christmas is more special than it ever was before. All of us in this House have a responsibility for our own actions and a duty of care to follow the guidelines, give people as much information as possible and help as many people as we can.

It is important to state that the people have been excellent throughout this time. As I have said before, this has been a really hard year and one we will never forget. Front-line workers and workers in all sectors have been very good. It is important that we make this Christmas special and see what we can do to be a bit more lenient and allow people to do a little extra. I acknowledge the importance of keeping people safe and working within the NPHET guidelines. We do not want to go into another lockdown after Christmas. However, it is also important that we do what we can for people at Christmas.

I thank the Minister of State for listening to the points we have raised. Covid has changed all our lives. I was speaking to a friend recently who has a family member who contracted the virus. Life is precious and we have to make the best of it and make sure we do the best we can for everyone.

I thank Deputies for their contributions to the debate. I have a script to hand but I always choose, in responding to debates, to address the issues raised by the Deputies who are still in the Chamber. That is how I operate.

Lest I forget, there is one point I would like to make before responding to the points raised. As we move to level 3 and open up the economy, if that is what happens, businesses might consider setting aside an hour or two for older people and people who are vulnerable to do their shopping. It might be for two hours on a Sunday morning, for example, in the weeks leading up to Christmas. It would be a very kind and thoughtful thing to do.

I am not part of the team that meets with NPHET and, as such, anything I say does not carry as much weight as statements by the Minister for Health. The last time I was in the House for a debate on the Covid situation, we discussed the number of people who were deployed to contact and tracing, an issue that was raised again by a number of Deputies this evening. At the end of September, there were 866 people involved in swabbing and contact tracing. Today, there are 1,700 staff involved in that effort. It is important to note the breakdown of that figure. In regard to contact tracing, 530 staff have been newly recruited to that work and another 70 will start next week. We currently have 1,000 people involved in swabbing, which includes 440 newly recruited personnel. The recruitment drive that happened is showing results.

I will deal now with an issue that was raised which relates to my brief of disability services, namely, the situation of family carers. The hurt, frustration and anxiety they have been enduring since March is unimaginable for any of us unless we are in their shoes. As Deputy Connolly pointed out, many have had no access to respite. I am working on that issue. We have designated day services for persons with disabilities as an essential service and we intend to do the same for respite care. I am just waiting on the go-ahead to ensure those services, as opposed to being deemed emergency care, will be opened up in the same way that they were in the past. I acknowledge and pay tribute to family carers. When we talk about front-line workers in various services, we must include family carers in that bracket.

Deputy Ó Murchú queried whether swabbing was taking place in a particular organisation in his constituency. I probably read the same article the Deputy did and I cannot answer his question this evening. In regard to the facility in Drumcar, it is important that I take this opportunity to pay my sympathies to the family of the person who died there due to Covid. I do so in the same way that I would pass my sympathies to anybody who has lost a loved one. I will look at the issue of whether people living in residential settings - not just nursing homes but also day houses and respite houses - have the protection of a programme of continual swabbing. There seems to have been a gap in this regard and it is something I am examining.

My colleague, Deputy Calleary, referred to the importance, as we begin to open up our society again, of focusing on activities for young people. As a former spokesperson for children and youth affairs, I agree that we must look at how we can enable children to access dance classes, sports and so on. We need to allow them to reintegrate back into their communities and move on with their lives. The Deputy's point about the importance of social interaction for well-being is very valid. I have two young children who are taught in pods in their school. We should be thinking about using pods on the sports field. In fact, we are doing that one night a week in our local GAA club.

Deputy Cowen referred to the need for trust. As we go forward into whatever level we move to next - it looks like it will be level 3 - we must ensure that people have trust in our business community, cultural community, sporting community and communities at large. That is necessary if we are to ensure that some normality will be returned.

Finally, it would be wrong of me not to mention borders in the context of whatever restrictions may apply in the future. I live in Portumna, which is on the border with County Tipperary. A move to level 3 would mean that I could not go across the bridge and that people in Portland could not come into Portumna to shop. We need to look at the wider question of how we can allow communities to live.

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