Calls for continued vigilance in nursing homes at this time 

The Minister for Mental Health and Older People, Mary Butler T.D. welcomes the acceleration of the country’s COVID-19 vaccination programme. The vaccination programme, which commenced in nursing homes in the past week will be further accelerated to deliver the first dose of vaccinations to all nursing home residents and staff over the coming two weeks.

Welcoming the development, Minister Butler said:

I want to commend the HSE and everybody involved in the roll out of the vaccination programme, particularly the 65 vaccination teams that have been established to administer the vaccine to some of the most vulnerable members of our society in the coming weeks. After many dark months, we can see light and real opportunity for hope in our battle against this deadly virus.

On the current epidemiological situation in relation to nursing homes, Minister Butler stated:

As the guidance and international evidence highlights, where community transmission is high, the risk to nursing homes increases. With new variants of COVID-19 identified in Ireland recently, we must maintain an even higher-level of vigilance in the coming weeks and ensure that all of the public health guidance is strictly followed. It is particularly important that nursing homes continue to fully apply the infection prevention and control guidance working with the State authorities as necessary.

The Health Protection Surveillance Centre (HPSC) has included an important note on the current surge in its COVID-19 Guidance on visits to Long Term Residential Care Facilities and in order to reduce the risk of COVID-19 being transmitted to vulnerable populations, it may be necessary to reduce the number of visitors to long-term residential care facilities at certain critical times.

Minister Butler noted: The last 10 months have been incredibly difficult for nursing home residents and their families. We have all witnessed the devastating impact that this virus can have on vulnerable residents. The virus poses a real threat at present and we must do everything we can to mitigate this, including by reducing contacts with nursing home residents as much as possible. Nursing home staff continue to respond to the ongoing challenges, often in circumstances where many of their colleagues are absent due to COVID-19. Staff must be able to maintain a priority focus on providing safe care to residents and on supporting the COVID-19 vaccine rollout over the coming weeks, which will provide long awaited, lifesaving protection to residents.

I understand that this remains a very difficult time for nursing home residents and their families. I ask for their understanding during this challenging period, to work with nursing homes in the context of visiting arrangements and to please support the dedicated staff to ensure a safe and effective roll out of the vaccine, as it offers hope for better days in the very near future. I also ask that all nursing homes redouble their efforts to have in place alternative and innovative communication measures for residents and families and to facilitate as much communication as possible.

Notes:

• The ‘Resilience and Recovery Plan for Living with COVID-19’ is a cross-government approach to managing the pandemic for the coming months and was published on 15^th September. Based on this framework, the HPSC have developed visitation guidance for long-term residential care facilities, which can be read here. This guidance is kept under ongoing review.

• COVID-19 is highly contagious and when it is circulating at high levels within the community, there is an increased risk that it will enter into nursing homes and other long-term residential care facilities. Those in these settings are often very vulnerable to this virus and its effects, as well as the settings themselves posing risks in terms of infection control and prevention.

• In order to reduce the risk of COVID-19 being transmitted to vulnerable populations, it may be necessary to reduce the number of visitors to long-term residential care facilities at certain critical times.

• The HSE’s Health Protection Surveillance Centre (HPSC) has included an important note on the current surge in its visiting guidance. The note outlines that the current surge in COVID-19 is a cause of profound concern to LTRCF (long-term residential care facilities) Residents, their families and friends and LTRCF service providers.  Vigilance to prevent introduction of COVID-19 into LTRCF and strict adherence to infection prevention and control practice is more than ever important at this time. Furthermore, in the current climate it may not be possible to support visiting in some LTRCFs because of constraints on staffing and outbreaks. Risk assessment needs to factor in very high community transmission rates.

• The HPSC’s important note further states that there is a need for clear communication on these issues with residents and families and in all circumstances the wishes of those residents who may feel safer not seeing visitors at any time should be respected.

• On the 19^th November, the European Centre for Disease Control published its latest risk assessment with regard to long-term care facilities. It highlights that “the probability of COVID-19 introduction into a long-term care facility depends on the level of COVID-19 circulation in the community, with a higher risk associated with higher incidence rates in the community.”

• This highlights the importance of supressing the level of the virus in the community as one of the primary measures for protecting nursing homes. As citizens, we all have a responsibility in this regard and our actions can directly impact the outcomes for nursing home residents.

• Recognising the difficult landscape that COVID-19 has presented for long-term residential care settings, a series of enhanced measures have been agreed by the NPHET to provide support to these settings and these are currently being implemented by the HSE, HIQA and service providers. They include measures to support facilities which have outbreaks of COVID-19, measures aimed at breaking the chain of transmission of the virus and support the provision of PPE and other protective measures. The measures include provision of PPE and staff accommodation free of charge, expert advice and support through the HSE COVID-19 Response Teams and HIQA, over €60m in additional financial support to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme and the serial testing programme for staff.

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