Dáil Éireann Debate, Wednesday - 27 May 2020
535. Deputy Peter Fitzpatrick asked the Minister for Health if he has been briefed on the matter of hospital discharges into nursing homes (details supplied); if his attention has been drawn to specific evidence that Covid-19 was likely introduced into some nursing homes in this way; and if he will make a statement on the matter. [7363/20]
Amharc ar fhreagraThe HSE through the Health Protection Surveillance Centre has developed an extensive body of guidance and support tools to assist staff in long-term residential care facilities (LTRC), including nursing homes, in their management of COVID-19 cases, including in relation to decisions on transfer of residents, to hospitals, where appropriate.
The current relevant guidelines are the: “Interim Public Health and Infection Prevention Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities and Similar Units ” (version 4, 4 May 2020).
On the 10th March, the HSE issued preliminary guidance on the transfer of hospitalised patients from an acute hospital to a residential care facility in the context of the global COVID-19 epidemic.
The guidance, based on the best available information at the time, set out the various procedures to be followed, including:
- Patients with COVID-19 should not be transferred to an LTRC until they had two consecutive tests indicating virus not detected;
- Patients who were symptomatic and were contacts of a confirmed COVID-19 case should only transfer if the persons had a test indicating virus not detected and it was possible for that person to be isolated for the relevant incubation period;
- Patients who were asymptomatic and were contacts of a confirmed COVID-19 case should only transfer if it was possible for that person to be isolated for the relevant incubation period;
- Transfers from hospitals with no evidence of spread of COVID-19 should proceed as normal, except patients with respiratory tract infection meeting the then criteria for COVID-19 testing – in those cases testing should be carried out and the result should be virus not-detected before transfer.
COVID-19 emerged first in China in December last and was first confirmed in Europe in January and since has spread widely and rapidly around the globe, disregarding borders, time zones, age and race. As a new virus, the world has been learning as the situation with the virus has evolved and new evidence becomes available.
The very infectious nature of the COVID-19 virus makes it difficult to prevent and control in residential care settings - an experience replicated internationally. Interrupting transmission of the COVID-19 virus is the main goal of public health measures and it is clear from our experience that the scale of effect of interruption of transmission is influenced by a number of factors. The most important way to protect our older population, whether living at home or in a LTRC setting, has been to reduce the amount of disease present in our community. If we can keep the rate of disease low this means that we protect both the staff and residents in LTRC. The transmission of the virus, particularly in respect of LTRCs is multifactorial and its introduction into any setting could be the result of a number of factors, including it being introduced unknowingly by asymptomatic residents or staff. This is why the substantial package of published guidance continues to evolve and be updated in line with new national and international evidence and guidance. Regular research is undertaken of national and international literature to ensure that the best available information and evidence is considered in this rapidly evolving environment.
