Oliver Callan: Don’t let the Government off the hook on nursing homes

The Covid-19 crisis in nursing homes is a perfect storm of our usual healthcare controversies conspiring with the virus to cause maximum tragedy. The question is whether the caretaker Government and senior civil servants failed to act on advance warnings. Many of us were perhaps also complicit, too caught up in hero mythology and praising politicians to ask the tough questions or listen to those who did.

The phenomenon of a stressed and frightened populace suddenly showing deference to authority in a crisis has meant that unpopular leaders became acceptable again overnight. We believed Leo Varadkar, Simon Harris and the National Public Health Emergency Team when they said we were all going to protect our most vulnerable, the old and sick. However, the fine language and promises did not match actions as nursing homes began to raise alarm.

We know the Government and public health officials had been warned about a lack of guidelines as well as staff and PPE shortages in care homes back in March. On April 2nd, Fianna Fáil’s Stephen Donnelly reiterated all of these problems and warned that the Government was spending vast sums on preparing hospitals to treat the sick, but not investing in preventing those in care homes from getting sick in the first place. The Government was perhaps blinded by trying to fix a historic shortage of intensive care beds rather than work on prevention. It would be another 15 days before Simon Harris would appoint crisis teams to nursing homes, and only when the contagion grabbed national attention. In the meantime testing of nursing home residents and staff was scaled back by the HSE.

From the start, the Government spent a great deal of time on communications, talking up hospital readiness for the surge. The Taoiseach received much praise for these speeches and media appearances. Leo Varadkar hailed a historic deal with private hospitals, but declined to publish details. Last week he confirmed €115 million per month was “an accurate estimate” of the open bill. This compares to a €72 million fund for over 500 nursing homes, a package that is subject to controversial conditions.

Coronavirus: ‘If it was today we wouldn’t be lifting restrictions’, Holohan warns

---

Inmates with Covid-19 symptoms kept in 24-hour lock-up

---

Reopening of shops may require temperature checks for customers

---

Shops warned off price promotions when they reopen

---

There’s been a clear lag in the State’s response to infections in care homes. When Nursing Homes Ireland announced in early March it was restricting visitors, they were criticised by Dr Tony Holohan. When they asked for a meeting with the Minister, it took until the end of March to secure one. It’s been pointed out that in the meantime, Mr Harris was available for an astonishing number of interviews and social media activity, much of it good messages on social distancing, but some of it excessive. The delay in meeting the nursing homes’ body and a failure to heed their concerns seem like glaring missteps now.

The Government had told us we were faring better than other countries, but in fact we are about the same or slightly worse. As deaths in care homes rise, we have trailed countries with similar or bigger populations. Despite having Europe’s youngest population, we have hundreds more deaths than Austria, Denmark, Norway, Finland, Poland, Hungary, Slovakia and Croatia, although there are disputes in every country about data. The UK says 15 per cent of its care homes have infections. In Ireland, it’s at least 35 per cent of nursing homes, where the true death toll won’t be known for some time.

We recognise now the trademark failures from previous health controversies. Not heeding early warnings, erroneously reported test results, a software failure on contract tracing and the focus of politicians on PR over real action. We’ve even seen the Irish crisis-as-usual results; hiring expensive consultants to shore up the testing job that countless managers are already paid to do. Spin, just like with homelessness, that virus deaths in nursing homes were inevitable, an international norm.

The outbreak in care homes was exacerbated by the housing crisis, which placed low-paid workers in cramped quarters together. Rental pressures created petri dishes for the coronavirus to threaten the old and sick in homes where there was no nationwide system to adequately prevent and tackle infection.

Older people have for too long been regarded as a sort of foreign species in our society rather than a valued group in a life stage we should all aspire to reach. Is it fear of our own mortality that turns many of us away from thoughts of the elderly? We pour tax money into already profitable sports that celebrate youth and leave the unglamorous services that provide for the old and dying to volunteers and fund-raisers.

Last October, the amazing Mayo Hospice opened after raising every penny of its 9.2 million euro cost through private donations and fundraising. This, in a county that spends millions preparing its men’s team for the GAA championship. What has gone wrong with our priorities?

There’s been a divide in attitudes to Ireland’s response to Covid-19. A tug-of-war between blindly loyal cheerleaders and harsh inquisitors. We can find the right balance. We can be both supporters of the common cause led by public health officials, as well as subjecting its figures to the full rigours of accountability. We owe it to our old people, who are not others, not “underlying conditions”, but who are simply, us.

Oliver Callan is a writer and satirist