theirishtimes--2020-10-07--HSE early support to nursing homes ‘reactive and piecemeal’ – State watchdog

The HSE ’ s early response to nursing homes battling large Covid-19 outbreaks at the peak of the pandemic in April was “ reactive and piecemeal ” , a senior inspector at the State ’ s health watchdog said .
Internal correspondence between Health Information and Quality Authority ( Hiqa ) officials , who inspect and regulate care facilities , raised concerns about the HSE ’ s initial response to the Covid-19 crisis at the time .
Mary Dunnion , chief inspector of social services , highlighted the deteriorating situation in one nursing home in an April 3rd email to @ @ @ @ @ @ @ Dunnion said while the HSE had assisted the home , the support had been “ reactive and piecemeal and has not been informed by a strategic recognition of the deteriorating situation ” .
The home would have “ benefited from a more strategic co-ordinated approach ” from the HSE on issues such as supply of personal protective equipment ( PPE ) , testing for staff and residents , and infection control advice , she said .
The healthcare system was struggling to deal with the divide between State-run homes and private operators , @ @ @ @ @ @ @ of the homes in the State are run by private or voluntary providers .
The criticism emerges as a Co Laois nursing home confirmed on Tuesday that it was dealing with 31 Covid-19 cases in one of the biggest virus outbreaks in a care facility since coronavirus infections started rising again during the summer .
The privately run Kilminchy Lodge Nursing Home in Portlaoise said it was managing 21 cases of the Covid-19 disease among residents and a further 10 cases among staff .
The State ’ s chief medical officer , Dr @ @ @ @ @ @ @ cases in nursing homes in a letter on Sunday seeking stronger public measures to suppress the virus .
He said that at least 45 further coronavirus cases had been confirmed among nursing home residents in seven new outbreaks reported over the past week with 31 outbreaks still open .
The issues highlighted by Hiqa in the internal April correspondence , released under the Freedom of Information Act , forecast problems that later exacerbated large outbreaks in many nursing homes and led to significant numbers of deaths among residents in April and May .
@ @ @ @ @ @ @ that care homes required a “ consistent supply ” of PPE and prioritised staff testing , and that “ staff unnecessarily off work ” was adding pressure .
In another email , Dr Conor Teljeur , Hiqa ’ s chief scientist , raised concerns internally that “ at least one ” nursing home may have been under-reporting Covid-19 cases “ quite substantially ” .
The home later clarified that it had been under pressure dealing with an outbreak that caused an administrative backlog notifying Hiqa of Covid-19 deaths .

Kilminchy Lodge Nursing Home in Portlaoise, Co Laois confirmed on Tuesday it was dealing with 31 Covid-19 cases. Photograph: Google Street View
The HSE’s early response to nursing homes battling large Covid-19 outbreaks at the peak of the pandemic in April was “reactive and piecemeal”, a senior inspector at the State’s health watchdog said.
Internal correspondence between Health Information and Quality Authority (Hiqa) officials, who inspect and regulate care facilities, raised concerns about the HSE’s initial response to the Covid-19 crisis at the time.
Mary Dunnion, chief inspector of social services, highlighted the deteriorating situation in one nursing home in an April 3rd email to Hiqa chief executive Phelim Quinn.
Hospital Report
Ms Dunnion said while the HSE had assisted the home, the support had been “reactive and piecemeal and has not been informed by a strategic recognition of the deteriorating situation”.
READ MORE
The home would have “benefited from a more strategic co-ordinated approach” from the HSE on issues such as supply of personal protective equipment (PPE), testing for staff and residents, and infection control advice, she said.
The healthcare system was struggling to deal with the divide between State-run homes and private operators, she said. About 80 per cent of the homes in the State are run by private or voluntary providers.
Outbreak
The criticism emerges as a Co Laois nursing home confirmed on Tuesday that it was dealing with 31 Covid-19 cases in one of the biggest virus outbreaks in a care facility since coronavirus infections started rising again during the summer.
The privately run Kilminchy Lodge Nursing Home in Portlaoise said it was managing 21 cases of the Covid-19 disease among residents and a further 10 cases among staff.
The State's chief medical officer, Dr Tony Holohan, warned about increasing Covid-19 cases in nursing homes in a letter on Sunday seeking stronger public measures to suppress the virus.
He said that at least 45 further coronavirus cases had been confirmed among nursing home residents in seven new outbreaks reported over the past week with 31 outbreaks still open.
The issues highlighted by Hiqa in the internal April correspondence, released under the Freedom of Information Act, forecast problems that later exacerbated large outbreaks in many nursing homes and led to significant numbers of deaths among residents in April and May.
Ms Dunnion told Hiqa chief Phelim Quinn that care homes required a “consistent supply” of PPE and prioritised staff testing, and that “staff unnecessarily off work” was adding pressure.
In another email, Dr Conor Teljeur, Hiqa's chief scientist, raised concerns internally that "at least one" nursing home may have been under-reporting Covid-19 cases "quite substantially".
The home later clarified that it had been under pressure dealing with an outbreak that caused an administrative backlog notifying Hiqa of Covid-19 deaths.
In a statement, the HSE said it had supported private nursing homes experiencing outbreaks with both PPE and specialist consultants on-site.
“The provision of PPE was also prioritised for sites that experienced outbreaks. This was the case even prior to the State securing a consistent supply of PPE in a very challenging international market,” it said.
“The utilisation of Covid-19 testing at that time was assigned based on availability as per nationally issued protocols,” it said.


theirishtimes--2020-10-07--Super checkpoints will cause major traffic congestion, Harris warns

More than 2,500 Garda members are set to be deployed as part of a policing surge across the Republic in response to all parts of the State being upgraded to Level 3 Covid-19 restrictions , with major traffic congestion anticipated due to the impact of so-called super checkpoints .
Gardaí have said they believe traffic congestion , especially on the approaches to Dublin and within the city and county , will be very heavy .
They were hopeful the delays would prove so long it would discourage people leaving their home county and encourage them to work from home .
@ @ @ @ @ @ @ static checkpoints would be established on motorways and other main arterial routes across the country , as well as thousands of mobile checkpoints erected for short periods before moving elsewhere .
Speaking at Garda Headquarters , Phoenix Park , Dublin , on Tuesday , Mr Harris said it was only fair to warn people that travelling around the country would “ feel very different from tomorrow ” .
He said checkpoints would see traffic funnelled into one lane on motorways and other arterial routes nationwide .
This would mean it “ would be @ @ @ @ @ @ @ on the roads for the duration of Operation Fanacht over the next three weeks .
“ You only have to look what happens on any motorway when it goes from two or three lanes into one .
It ’ s inevitable there will be delays , ” Mr Harris said , adding he felt obliged to warn people in advance .
While Tánaiste Leo Varadkar suggested on Monday that new enforcement powers were being prepared for the Garda , Minister for Justice Helen McEntee said on Tuesday no new enforcement measures were planned @ @ @ @ @ @ @ did not believe new powers were required .
Gardaí would focus on “ educating ” people about the measures they were now being asked to comply with under Level 3 .
Meanwhile , as the National Public Health Emergency Team ( Nphet ) announced a further 432 new Covid-19 cases on Tuesday and one additional death , Mr Varadkar warned that a short and sharp lockdown may still happen despite the Government turning down Nphet ’ s advice to move to Level 5 .
Sources present at a meeting of the Fine Gael @ @ @ @ @ @ @ Varadkar warned a circuit-breaker lockdown may be on the horizon .
He also said there had been a “ breakdown ” in communication over the weekend between Government and Nphet .
“ The chain of command broke down , but he did not elaborate on why , ” one TD present said .

Drew Harris at Garda Headquarters: The Garda Commissioner said travelling around the country would ‘feel very different’ as Level 3 restrictions come into force countrywide. Photograph: Colin Keegan, Collins Dublin
More than 2,500 Garda members are set to be deployed as part of a policing surge across the Republic in response to all parts of the State being upgraded to Level 3 Covid-19 restrictions, with major traffic congestion anticipated due to the impact of so-called super checkpoints.
Gardaí have said they believe traffic congestion, especially on the approaches to Dublin and within the city and county, will be very heavy. They were hopeful the delays would prove so long it would discourage people leaving their home county and encourage them to work from home.
Garda Commissioner Drew Harris said 132 permanent static checkpoints would be established on motorways and other main arterial routes across the country, as well as thousands of mobile checkpoints erected for short periods before moving elsewhere.
Hospital Report
Speaking at Garda Headquarters, Phoenix Park, Dublin, on Tuesday, Mr Harris said it was only fair to warn people that travelling around the country would “feel very different from tomorrow”.
READ MORE
He said checkpoints would see traffic funnelled into one lane on motorways and other arterial routes nationwide. This would mean it “would be very difficult” for anyone making journeys on the roads for the duration of Operation Fanacht over the next three weeks.
“You only have to look what happens on any motorway when it goes from two or three lanes into one. It’s inevitable there will be delays,” Mr Harris said, adding he felt obliged to warn people in advance.
Enforcement powers
While Tánaiste Leo Varadkar suggested on Monday that new enforcement powers were being prepared for the Garda, Minister for Justice Helen McEntee said on Tuesday no new enforcement measures were planned at present.
Mr Harris said he did not believe new powers were required. Gardaí would focus on “educating” people about the measures they were now being asked to comply with under Level 3.
Meanwhile, as the National Public Health Emergency Team (Nphet) announced a further 432 new Covid-19 cases on Tuesday and one additional death, Mr Varadkar warned that a short and sharp lockdown may still happen despite the Government turning down Nphet’s advice to move to Level 5.
Sources present at a meeting of the Fine Gael parliamentary party on Tuesday night said Mr Varadkar warned a circuit-breaker lockdown may be on the horizon. He also said there had been a “breakdown” in communication over the weekend between Government and Nphet.
“The chain of command broke down, but he did not elaborate on why,” one TD present said.


theirishtimes--2020-10-07--DPP to consider charges against protest organisers

The Director of Public Prosecutions ( DPP ) is to consider charges against organisers of two protests which took place near the height of the coronavirus pandemic .
One of the events being considered for prosecution is a Black Lives Matter protest which took place on June 6th following the death of George Floyd at the hands of police in Minnesota in the United States and was attended by up to 5,000 people .
The other is a gathering of about 100 people outside the Four Courts on April 21st in support of journalist turned far-right activist Gemma O ’ @ @ @ @ @ @ @ challenge to the coronavirus restrictions .
Investigations into both matters have concluded .
Gardaí have already sent a file on the Black Lives Matter protest to the DPP while a file on the Four Courts demonstration is due to be sent shortly , a Garda spokesman confirmed .
To date , no one has been charged with organising events in contravention of the coronavirus emergency legislation introduced at the start of the pandemic in March .
This is despite several high-profile public demonstrations and gatherings , including , most recently , three large @ @ @ @ @ @ @ It will be up to the DPP whether the organisers of the Four Courts and Black Lives Matter protests will face charges .
It is understood gardaí faced difficulties definitively identifying the organisers of both protests , which , according to one Garda source , will make criminal charges unlikely .
Much of the organising for both events took place over social media which “ makes it complicated ” to identify who the original organisers were , they said .
The Health Act , 1947 and its associated statutory instruments make it a @ @ @ @ @ @ @ the pandemic .
Organisers face a €2,500 fine or up to six months in prison .
While there are some exceptions , protests and demonstrations are not among them .
Investigations into other events , such as the Oireachtas Golf Society Dinner in Clifden on August 19th are still ongoing .
Other ongoing investigations include a rave held in Oliver Bond flats in Dublin on September 19th and three large Dublin events demonstrating against coronavirus restrictions in August and September .
This includes a demonstration organised by anti-lockdown group Health Freedom Ireland and @ @ @ @ @ @ @ was attended by several thousand people and saw violence from far-right elements in attendance .
The same groups organised a much smaller event last Saturday which involved several hundred protesters staging a sit-in on Grafton Street .
Gardaí said the protesters dispersed “ without incident ” and that an investigation has been launched .
The policing of protests has attracted some criticism from monitoring groups .
The Irish Council for Civil Liberties has said protest should be permitted if they comply with social distancing rules .
The Policing Authority said the policing response @ @ @ @ @ @ @ and “ unfair ” .
It was speaking in May after Garda dispersed a group of Debenhams protesters while allowing the Four Courts protest to continue .
However , the authority later praised the Garda approach which it noted is to “ avoid escalation , arrests and physical contact ” and encourage attendees to comply with coronavirus regulations .
While no one has yet been charged with organising a public event , at least one person has been prosecuted for holding a house party in breach in the regulations .
Last month , @ @ @ @ @ @ @ of The Glebe , Kells , Co Meath , were fined €1,000 for hosting 30 people at a party .

The Director of Public Prosecutions (DPP) is to consider charges against organisers of two protests which took place near the height of the coronavirus pandemic.
One of the events being considered for prosecution is a Black Lives Matter protest which took place on June 6th following the death of George Floyd at the hands of police in Minnesota in the United States and was attended by up to 5,000 people.
The other is a gathering of about 100 people outside the Four Courts on April 21st in support of journalist turned far-right activist Gemma O’Doherty who was bringing a High Court challenge to the coronavirus restrictions.
Hospital Report
Investigations into both matters have concluded. Gardaí have already sent a file on the Black Lives Matter protest to the DPP while a file on the Four Courts demonstration is due to be sent shortly, a Garda spokesman confirmed.
READ MORE
High-profile demonstrations
To date, no one has been charged with organising events in contravention of the coronavirus emergency legislation introduced at the start of the pandemic in March. This is despite several high-profile public demonstrations and gatherings, including, most recently, three large anti-mask demonstrations in Dublin city centre.
It will be up to the DPP whether the organisers of the Four Courts and Black Lives Matter protests will face charges. It is understood gardaí faced difficulties definitively identifying the organisers of both protests, which, according to one Garda source, will make criminal charges unlikely.
Much of the organising for both events took place over social media which “makes it complicated” to identify who the original organisers were, they said.
The Health Act, 1947 and its associated statutory instruments make it a criminal offence to organise large events during the pandemic. Organisers face a €2,500 fine or up to six months in prison. While there are some exceptions, protests and demonstrations are not among them.
Investigations into other events, such as the Oireachtas Golf Society Dinner in Clifden on August 19th are still ongoing.
Other ongoing investigations include a rave held in Oliver Bond flats in Dublin on September 19th and three large Dublin events demonstrating against coronavirus restrictions in August and September.
This includes a demonstration organised by anti-lockdown group Health Freedom Ireland and the Yellow Vests on August 22nd which was attended by several thousand people and saw violence from far-right elements in attendance.
The same groups organised a much smaller event last Saturday which involved several hundred protesters staging a sit-in on Grafton Street. Gardaí said the protesters dispersed “without incident” and that an investigation has been launched.
Criticism
The policing of protests has attracted some criticism from monitoring groups. The Irish Council for Civil Liberties has said protest should be permitted if they comply with social distancing rules.
The Policing Authority said the policing response could be seen as “inconsistent” and “unfair”. It was speaking in May after Garda dispersed a group of Debenhams protesters while allowing the Four Courts protest to continue.
However, the authority later praised the Garda approach which it noted is to “avoid escalation, arrests and physical contact” and encourage attendees to comply with coronavirus regulations.
While no one has yet been charged with organising a public event, at least one person has been prosecuted for holding a house party in breach in the regulations. Last month, Juztyna Orkwiszewski and her husband Krsystof Orkwiszewski of The Glebe, Kells, Co Meath, were fined €1,000 for hosting 30 people at a party.


theirishtimes--2020-10-07--What we can do to bend the curve of Covid-19 infections?

Regardless of whether you think the country should be on Level 3 or Level 5 restrictions , there is much we can do to bend the curve of Covid-19 infections .
As the experience of other countries shows , there is nothing inevitable about the rate of transmission once countries implement well-resourced and thought-through strategies .
And while the graph line of case numbers may not always be your friend , the more important metrics of ICU admissions and deaths look more favourable than during the first surge .
The worst thing that could happen in the aftermath of the @ @ @ @ @ @ @ be for an air of fatalism to take root .
At this stage , we know what works to limit transmission on an individual level , and have a fair idea on a societal level ; the challenge is to implement them in a dynamic , joined-up fashion .
The move to Level 3 , while not as drastic as the change sought by Nphet , marks a considerable upping of restrictions for most of the country .
Building on this , we initially face two main tasks : cutting community transmission and @ @ @ @ @ @ @ in cases .
One in four cases currently involve community transmission , meaning the origin is unknown .
High levels of community transmission have been an issue in Ireland through this pandemic .
The solution lies in better testing and tracing .
We are now doing plenty of testing , with one of the highest rates in Europe , but is it happening fast enough and in the right locations ?
More pop-up testing in the vicinity of outbreaks would be good , as would alternative faster tests .
Ireland has been slow @ @ @ @ @ @ @ caution might have been justified earlier in the pandemic , but not any more as techniques improve and costs fall .
Contact tracing needs to be better resourced and focused more on investigating the causes of clusters .
It isn ’ t just about tracking down possible cases ; we need to do more to identify the locales where outbreaks occur .
To be fair to public health doctors , many are doing this work within available time and resources but it might be productive to do more to publicise outcomes , even @ @ @ @ @ @ @ The second priority is to ensure hospitals are not overwhelmed .
At present , there are just over 20 Covid-19 patients in ICU and just under 40 free ICU beds .
At least another 20 or so beds can be brought on stream as surge capacity and 12 new beds are due by the end of the year .
The numbers suggest it may be tight .
There was no shortage of ventilators during the first surge and there is unlikely to be this time either .
The ban on visiting care homes @ @ @ @ @ @ @ people , but the root of this problem lies elsewhere .
Over the past fortnight , there have been 325 cases among healthcare workers and 150 cases acquired in a healthcare facility .
Alarm bells should be ringing over these figures .
Anyone who has had to self-isolate will know how hard it is .
Countries that are successfully controlling the virus tend to have good quarantine facilities .
Could we be doing more to break the inevitability of intra-family transmission by giving people the option of living alone for the two weeks @ @ @ @ @ @ @ Fallon last week aptly summarised the drivers of infection as “ proximity , congregation and alcohol ” .
Is it not time we tackled the “ elephant in the room ” – the unfettered sale of alcohol in off-licences right through this pandemic ?

Is it time to tackle the ‘elephant in the room’ that is the unfettered sale of alcohol right through this pandemic? Photograph: iStock
Regardless of whether you think the country should be on Level 3 or Level 5 restrictions, there is much we can do to bend the curve of Covid-19 infections.
As the experience of other countries shows, there is nothing inevitable about the rate of transmission once countries implement well-resourced and thought-through strategies. And while the graph line of case numbers may not always be your friend, the more important metrics of ICU admissions and deaths look more favourable than during the first surge.
The worst thing that could happen in the aftermath of the disagreement between the Government and Nphet would be for an air of fatalism to take root.
Hospital Report
At this stage, we know what works to limit transmission on an individual level, and have a fair idea on a societal level; the challenge is to implement them in a dynamic, joined-up fashion.
READ MORE
The move to Level 3, while not as drastic as the change sought by Nphet, marks a considerable upping of restrictions for most of the country.
Building on this, we initially face two main tasks: cutting community transmission and ensuring hospitals can deal with a rise in cases.
One in four cases currently involve community transmission, meaning the origin is unknown. High levels of community transmission have been an issue in Ireland through this pandemic. The solution lies in better testing and tracing.
We are now doing plenty of testing, with one of the highest rates in Europe, but is it happening fast enough and in the right locations? More pop-up testing in the vicinity of outbreaks would be good, as would alternative faster tests.
Ireland has been slow to adopt new testing technologies. Such caution might have been justified earlier in the pandemic, but not any more as techniques improve and costs fall.
Contact tracing needs to be better resourced and focused more on investigating the causes of clusters. It isn’t just about tracking down possible cases; we need to do more to identify the locales where outbreaks occur.
To be fair to public health doctors, many are doing this work within available time and resources but it might be productive to do more to publicise outcomes, even to identify the location of outbreaks.
ICU beds
The second priority is to ensure hospitals are not overwhelmed. At present, there are just over 20 Covid-19 patients in ICU and just under 40 free ICU beds. At least another 20 or so beds can be brought on stream as surge capacity and 12 new beds are due by the end of the year. The numbers suggest it may be tight. There was no shortage of ventilators during the first surge and there is unlikely to be this time either.
The ban on visiting care homes may help stem the rise among older people, but the root of this problem lies elsewhere. Over the past fortnight, there have been 325 cases among healthcare workers and 150 cases acquired in a healthcare facility. Alarm bells should be ringing over these figures.
Anyone who has had to self-isolate will know how hard it is. Countries that are successfully controlling the virus tend to have good quarantine facilities. Could we be doing more to break the inevitability of intra-family transmission by giving people the option of living alone for the two weeks ?
Finally, public health doctor Una Fallon last week aptly summarised the drivers of infection as "proximity, congregation and alcohol". Is it not time we tackled the "elephant in the room" – the unfettered sale of alcohol in off-licences right through this pandemic?


theirishtimes--2020-10-07--Cost of providing State residential care for children rises by €40m

The cost of the provision of residential care for children by the child and family agency Tusla has increased by more than €40 million over recent years , a new review has found .
The report , published on Tuesday by the Department of Public Expenditure , maintains that approximately 87 per cent of this increase is associated with the use of private sector services .
Tusla is responsible for the delivery of residential care services for children and young people in the care of the State .
The review says while the number of placements has increased in recent @ @ @ @ @ @ @ on private residential care provision as distinct from facilities owned by Tusla or those provided by voluntary organisations .
“ Tusla have increasingly sourced both ‘ mainstream ’ and specialised placements through private services .
There has also been a transition toward smaller numbers of children per residential care setting ( such as single and dual occupancy services.
” The review says residential care is a demand-led service .
However it says that the provision of residential care has been a “ significant cost pressure for Tusla in recent years .
It warns @ @ @ @ @ @ @ could push costs higher this year .
The review says total costs of providing residential care increased from €152 million in 2016 to €192 million in 2019 .
“ Children placed in residential care require a high level of supervision and professional caregiving .
The number of children in a centre ( which is a domestic house ) is generally between two and six .
Staff must work through the night in ‘ live night ’ shifts i.e .
one staff member is awake at all times to ensure the safety of the @ @ @ @ @ @ @ with a young person ’ s social worker and other professionals to prepare a young person for a successful return home , transition to an agreed placement of choice or to independent/supported living.
” “ Residential care has been a significant cost pressure for Tusla in recent years .
Costs have increased year on year since 2016 .
In 2019 , a supplementary estimate of €15 million for Tusla was primarily driven by residential care costs .
Tusla have estimated a full year private residential care overspend of €26.1million for 2020 .
This @ @ @ @ @ @ @ the Children ’ s Residential Services budget and €9m overspend on private residential care by the Tusla ‘ Regions ’ .
While Covid-19 costs are included in this projected overspend , Tusla have signalled that the impact of Covid-19 will lead to additional costs over and above this projected overspend.
” The review says the increased costs experienced over recent years were driven by a rise in the numbers of children and young people in residential care and higher costs involved .
It says placements rose by 12 per cent , from 470 @ @ @ @ @ @ @ 2017 and the end of the first quarter in 2020 .
“ In September 2018 , private contract rates increased in order to comply with the European Working Time Directive , which led to additional staffing requirements .
According to Tusla , this increase arose primarily from a requirement to fund additional staffing .
The basic private ‘ mainstream ’ placement rate increased from €5,000 to €6,000 per week , while the basic ‘ enhanced ’ rate ( private only ) increased from €6,000 to €6,800 per week .
Dual occupancies were set @ @ @ @ @ @ @ per child per week ” , the review says .

Tusla is responsible for the delivery of residential care services for children and young people in the care of the State. .Photograph: Alan Betson
The cost of the provision of residential care for children by the child and family agency Tusla has increased by more than €40 million over recent years, a new review has found.
The report, published on Tuesday by the Department of Public Expenditure, maintains that approximately 87 per cent of this increase is associated with the use of private sector services.
Tusla is responsible for the delivery of residential care services for children and young people in the care of the State.
The review says while the number of placements has increased in recent years, there is a growing reliance on private residential care provision as distinct from facilities owned by Tusla or those provided by voluntary organisations.
READ MORE
“Tusla have increasingly sourced both ‘mainstream’ and specialised placements through private services. There has also been a transition toward smaller numbers of children per residential care setting (such as single and dual occupancy services.”
The review says residential care is a demand-led service. However it says that the provision of residential care has been a “significant cost pressure for Tusla in recent years.
It warns that the impact of the Covid-19 pandemic could push costs higher this year.
The review says total costs of providing residential care increased from €152 million in 2016 to €192 million in 2019.
“Children placed in residential care require a high level of supervision and professional caregiving. The number of children in a centre (which is a domestic house) is generally between two and six. Staff must work through the night in ‘live night’ shifts i.e. one staff member is awake at all times to ensure the safety of the children. Residential care may include working with a young person’s social worker and other professionals to prepare a young person for a successful return home, transition to an agreed placement of choice or to independent/supported living.”
“Residential care has been a significant cost pressure for Tusla in recent years. Costs have increased year on year since 2016. In 2019, a supplementary estimate of €15 million for Tusla was primarily driven by residential care costs. Tusla have estimated a full year private residential care overspend of €26.1million for 2020. This comprises €17.1million overspend for private care within the Children’s Residential Services budget and €9m overspend on private residential care by the Tusla ‘Regions’. While Covid-19 costs are included in this projected overspend, Tusla have signalled that the impact of Covid-19 will lead to additional costs over and above this projected overspend.”
The review says the increased costs experienced over recent years were driven by a rise in the numbers of children and young people in residential care and higher costs involved.
It says placements rose by 12 per cent, from 470 to 525, between the end of 2017 and the end of the first quarter in 2020.
“In September 2018, private contract rates increased in order to comply with the European Working Time Directive , which led to additional staffing requirements. According to Tusla, this increase arose primarily from a requirement to fund additional staffing. The basic private ‘mainstream’ placement rate increased from €5,000 to €6,000 per week, while the basic ‘enhanced’ rate (private only) increased from €6,000 to €6,800 per week. Dual occupancies were set at €8,500 and single occupancies at €13,500 per child per week”, the review says.


theirishtimes--2020-10-06--UCD and NUIG to stay teaching online until after Christmas

UCD and NUIG have decided to continue to operate all teaching and learning activities online for the remainder of the first semester , following the Taoiseach ’ s announcement on Monday night that the country would move to Level 3 restrictions for the next three weeks .
UCD management initially moved the university to Level 4 on September 18th , with all classes to be delivered online for three weeks of Dublin ’ s Level 3 restrictions .
Staff and students were informed in September that activities scheduled to take place on campus , including practical and laboratory classes , @ @ @ @ @ @ @ fieldwork would “ recommence as soon as possible ” .
However , UCD President Professor Deeks issued a bulletin to university staff on Tuesday to say the current level of restriction on academic activities would now be retained “ at least until the end of the current trimester ” in order to “ provide students , faculty and staff with some certainty in what to expect ” until December .
Staff were informed that “ where work can be done effectively from home , it should continue to be done from home.
” @ @ @ @ @ @ @ Irish higher education institutions , were advised in September to operate online where possible for at least two weeks .
However , NUI Galway announced its decision today to move all teaching and learning online until after Christmas .
Face-to-face teaching will be limited to essential activities , such as lab work and research .
Students who wished to “ return home to continue their studies remotely ” were informed the University will “ refund the cost of campus accommodation , less facilities charges , for the remainder of the semester ” .
@ @ @ @ @ @ @ UCD have called for the same response from UCD management to refund students who wish to return home this semester .
Students living on campus in UCD are not allowed to have any visitors due to the university operating under Level 4 restrictions .
Some students have also called on the UCD Students ’ Union to ask the university to partially refund their student centre contribution fees in response to the news , as access to on-site facilities remain closed or restricted .

UCD and NUIG have decided to continue to operate all teaching and learning activities online for the remainder of the first semester. File photograph: Frank Miller/The Irish Times.
UCD and NUIG have decided to continue to operate all teaching and learning activities online for the remainder of the first semester, following the Taoiseach’s announcement on Monday night that the country would move to Level 3 restrictions for the next three weeks.
UCD management initially moved the university to Level 4 on September 18th, with all classes to be delivered online for three weeks of Dublin’s Level 3 restrictions.
Staff and students were informed in September that activities scheduled to take place on campus, including practical and laboratory classes, clinical teaching, studio classes and outdoor fieldwork would “recommence as soon as possible”.
However, UCD President Professor Deeks issued a bulletin to university staff on Tuesday to say the current level of restriction on academic activities would now be retained “at least until the end of the current trimester” in order to “provide students, faculty and staff with some certainty in what to expect” until December. Staff were informed that “where work can be done effectively from home, it should continue to be done from home.”
READ MORE
NUIG, as well as all other Irish higher education institutions, were advised in September to operate online where possible for at least two weeks. However, NUI Galway announced its decision today to move all teaching and learning online until after Christmas. Face-to-face teaching will be limited to essential activities, such as lab work and research. Students who wished to “return home to continue their studies remotely” were informed the University will “refund the cost of campus accommodation, less facilities charges, for the remainder of the semester”.
Some students living in campus accommodation at UCD have called for the same response from UCD management to refund students who wish to return home this semester. Students living on campus in UCD are not allowed to have any visitors due to the university operating under Level 4 restrictions.
Some students have also called on the UCD Students’ Union to ask the university to partially refund their student centre contribution fees in response to the news, as access to on-site facilities remain closed or restricted.


theirishtimes--2020-10-06--Coronavirus: Two-thirds of public want tougher restrictions

Almost two out of every three people think the Government should impose more restrictions to curb Covid-19 , according to a new opinion poll .
The 63 per cent of people calling for more restrictions marks a significant rise in this sentiment over the previous week , when 54 per cent were of this view .
Back in early June , just 20 per cent of the population favoured the imposition of more restrictions .
Conversely , the proportion of people opposed to more restrictions fell to 23 per cent , from a high of 66 per cent in June @ @ @ @ @ @ @ Monday by Amarach Research for the Department of Health .
For the first time in the pandemic , more people think Ireland is trying to return to normal “ a bit too quickly ” than at “ about the right pace ” ( 35 per cent against 34 per cent ) .
Eighteen per cent think this is happening “ much too quickly ” .
On Monday - as the Government was extending Level 3 restrictions to the entire country - 44 per cent of people felt its response to the coronavirus pandemic @ @ @ @ @ @ @ it was insufficient .
In the spring , over 80 per cent of people approved of the extent of the Government response .
Levels of worry have risen to rates not seen since early April , and specific worries about the economy and prolonged restrictions are at the highest levels seen in the pandemic .
Levels of anger are at their highest levels in the pandemic , while fear is also reported to be increasing .
The findings were released on Tuesday as chief medical officer Dr Tony Holohan called for a “ @ @ @ @ @ @ @ coronavirus over the coming weeks .
Some 432 further cases were confirmed on Tuesday and one further death was reported to the National Public Health Emergency Team ( Nphet ) , bringing the total number of coronavirus-related deaths to 1,811 .
The total number of virus cases now stands at 38,973 .
Of the cases notified on Tuesday , 111 in Dublin , 51 in Donegal , 41 in Cork , 32 in Clare and the remaining 197 are located across 20 counties .
The new cases in Donegal , the worst-affected county @ @ @ @ @ @ @ is now close to 300 cases per 100,000 people in the past fortnight .
Almost half of Tuesday ’ s are associated with outbreaks or are close contacts of a confirmed case , while 60 cases involve community transmission .
Some 62 per cent of cases are under 45 years of age .
“ Every one of us has the power to interrupt the spread of this virus and now is a vital time to use it , ” Dr Holohan said .
Acting chief medical officer Dr Ronan Glynn urged anyone with @ @ @ @ @ @ @ fever , shortness of breath , loss of sense of taste or smell – not to go to work or to try to interact with others and to contact a GP .
The incidence of the virus rose yesterday in 21 counties , was unchanged in two and fell in just three counties ( Kilkenny , Waterford and Roscommon ) , according to the latest data from the Health Protection Surveillance Centre ( HPSC ) .
Case numbers increased by 37 per cent in Limerick , 30 per cent in Offaly and 16 @ @ @ @ @ @ @ previous day .
Over 95 per cent of people who died with the virus had an underlying condition , according to the latest HPSC update .
Among those admitted to ICU , people with underlying conditions accounted for 87.8 per cent .
Some 31.8 per cent of those diagnosed with the disease in the community had an underlying condition , as did 67.8 per cent of those hospitalised .
According to the Department of Health , there were 150 coronavirus patients in hospital on Tuesday morning , the same as the previous day @ @ @ @ @ @ @ , up one .
The HSE said it had 33 free critical care beds across the system on Monday evening .
Meanwhile , staff at two large Irish hospitals are to be tested as part of a study looking at rates of previous coronavirus infections in healthcare workers .
Over the next two weeks , the staff at St James ’ s Hospital in Dublin and University Hospital Galway will be invited to have a blood test to determine the presence of virus antibodies .
The study will be repeated in six months @ @ @ @ @ @ @ study will help the health service better understand this new infection , including the risk factors relevant to healthcare workers , for example the areas they work in and the type of patient exposure they have , as well as factors such as their sex , age and living arrangements , ” said HSE national clinical director for health protection Dr Lorraine Doherty .
The study will also be used to estimate the level of immunity to the virus among healthcare workers , and those still at risk of contracting it .

Almost two out of every three people think the Government should impose more restrictions to curb Covid-19, according to a new opinion poll.
The 63 per cent of people calling for more restrictions marks a significant rise in this sentiment over the previous week, when 54 per cent were of this view.
Back in early June, just 20 per cent of the population favoured the imposition of more restrictions.
Hospital Report
Conversely, the proportion of people opposed to more restrictions fell to 23 per cent, from a high of 66 per cent in June, according to the poll conducted on Monday by Amarach Research for the Department of Health.
READ MORE
For the first time in the pandemic, more people think Ireland is trying to return to normal “a bit too quickly” than at “about the right pace” (35 per cent against 34 per cent). Eighteen per cent think this is happening “much too quickly”.
On Monday - as the Government was extending Level 3 restrictions to the entire country - 44 per cent of people felt its response to the coronavirus pandemic was appropriate and 44 per cent said it was insufficient. In the spring, over 80 per cent of people approved of the extent of the Government response.
Levels of worry have risen to rates not seen since early April, and specific worries about the economy and prolonged restrictions are at the highest levels seen in the pandemic.
Levels of anger are at their highest levels in the pandemic, while fear is also reported to be increasing.
The findings were released on Tuesday as chief medical officer Dr Tony Holohan called for a “broad societal effort” to curb the coronavirus over the coming weeks.
Some 432 further cases were confirmed on Tuesday and one further death was reported to the National Public Health Emergency Team (Nphet), bringing the total number of coronavirus-related deaths to 1,811. The total number of virus cases now stands at 38,973.
Of the cases notified on Tuesday, 111 in Dublin, 51 in Donegal, 41 in Cork, 32 in Clare and the remaining 197 are located across 20 counties.
The new cases in Donegal, the worst-affected county in the Republic, means its incidence is now close to 300 cases per 100,000 people in the past fortnight.
Almost half of Tuesday’s are associated with outbreaks or are close contacts of a confirmed case, while 60 cases involve community transmission.
Spread
Some 62 per cent of cases are under 45 years of age.
“Every one of us has the power to interrupt the spread of this virus and now is a vital time to use it,” Dr Holohan said.
Acting chief medical officer Dr Ronan Glynn urged anyone with a relevant symptom – a cough, fever, shortness of breath, loss of sense of taste or smell – not to go to work or to try to interact with others and to contact a GP.
The incidence of the virus rose yesterday in 21 counties, was unchanged in two and fell in just three counties (Kilkenny, Waterford and Roscommon), according to the latest data from the Health Protection Surveillance Centre (HPSC).
Case numbers increased by 37 per cent in Limerick, 30 per cent in Offaly and 16 per cent in Monaghan compared to the previous day.
Over 95 per cent of people who died with the virus had an underlying condition, according to the latest HPSC update. Among those admitted to ICU, people with underlying conditions accounted for 87.8 per cent. Some 31.8 per cent of those diagnosed with the disease in the community had an underlying condition, as did 67.8 per cent of those hospitalised.
Critical care beds
According to the Department of Health, there were 150 coronavirus patients in hospital on Tuesday morning, the same as the previous day. This included 24 patients in ICU, up one.
The HSE said it had 33 free critical care beds across the system on Monday evening. Meanwhile, staff at two large Irish hospitals are to be tested as part of a study looking at rates of previous coronavirus infections in healthcare workers.
Over the next two weeks, the staff at St James’s Hospital in Dublin and University Hospital Galway will be invited to have a blood test to determine the presence of virus antibodies. The study will be repeated in six months and the data compared.
“The study will help the health service better understand this new infection, including the risk factors relevant to healthcare workers, for example the areas they work in and the type of patient exposure they have, as well as factors such as their sex, age and living arrangements,” said HSE national clinical director for health protection Dr Lorraine Doherty.
The study will also be used to estimate the level of immunity to the virus among healthcare workers, and those still at risk of contracting it.


theirishtimes--2020-10-06--State may need ‘fallback’ deal with UK post-Brexit for cross-Border policing

The Government may need to negotiate a “ fallback ” bilateral agreement with the United Kingdom on data sharing to protect cross-Border policing post-Brexit , Minister for Justice Helen McEntee has said .
Ms McEntee told the Oireachtas justice committee that one of the biggest concerns after the UK ’ s exit from the European Union comes into effect on January 1st was the continued co-operation and sharing of intelligence between the Garda Siochána and the Police Service of Northern Ireland .
The Minister said data sharing between the police forces is covered by EU and Irish law but in @ @ @ @ @ @ @ , the “ fallback option ” was to create and retain records of all data transferred under a bilateral agreement between the UK and Ireland .
“ It is not the direction that we want to go .
Obviously we would prefer that there was an agreement on an EU-wide basis but that is something that we would have to look at given the huge level of co-operation that has happened between the Garda and the PSNI , ” she said .
Ms McEntee said that it was “ very concerning ” that @ @ @ @ @ @ @ go ” to reach a deal between the EU and UK .
She was discussing the Brexit Omnibus Bill that the Government intends to enact before the end of the year to be ready for the possibility of a no-deal scenario .
Ms McEntee said that if no trade deal is agreed between the EU and the UK , the Government will need to fall back on legal conventions on extradition , immigration and family law that “ won ’ t enable us to work as seamlessly as we currently have ” with @ @ @ @ @ @ @ Brexit means change and we have always said that even with an agreement in place but certainly without an agreement particularly when it comes to the area of law , particularly if we are falling back on conventions that maybe don ’ t allow us to work with the same ease as we do now , ” she said .
Ms McEntee also said that the State would “ find ourselves in a very challenging situation ” if the UK were to breach international law and an international agreement , in the Brexit @ @ @ @ @ @ @ Market Bill to remove checks between Northern Ireland and Britain .
She said that the Northern Ireland protocol with the withdrawal agreement requires additional checks on the Irish Sea “ to ensure the integrity of the [ EU ] single market.
” “ It ’ s unfortunately not legislation that I ’ m working on within our department but it ’ s something that we would have to look at , ” said the Minister .

Minister for Justice Helen McEntee said that it was “very concerning” that there was “still a way to go” to reach a deal between the EU and UK. Photograph: Alan Betson
The Government may need to negotiate a "fallback" bilateral agreement with the United Kingdom on data sharing to protect cross-Border policing post-Brexit, Minister for Justice Helen McEntee has said.
Ms McEntee told the Oireachtas justice committee that one of the biggest concerns after the UK's exit from the European Union comes into effect on January 1st was the continued co-operation and sharing of intelligence between the Garda Siochána and the Police Service of Northern Ireland.
The Minister said data sharing between the police forces is covered by EU and Irish law but in the absence of a post-Brexit EU-UK deal, the "fallback option" was to create and retain records of all data transferred under a bilateral agreement between the UK and Ireland.
Co-operation
“It is not the direction that we want to go. Obviously we would prefer that there was an agreement on an EU-wide basis but that is something that we would have to look at given the huge level of co-operation that has happened between the Garda and the PSNI,” she said.
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Ms McEntee said that it was “very concerning” that there was “still a way to go” to reach a deal between the EU and UK. She was discussing the Brexit Omnibus Bill that the Government intends to enact before the end of the year to be ready for the possibility of a no-deal scenario.
Ms McEntee said that if no trade deal is agreed between the EU and the UK, the Government will need to fall back on legal conventions on extradition, immigration and family law that “won’t enable us to work as seamlessly as we currently have” with the UK under EU arrangements.
“Brexit means change and we have always said that even with an agreement in place but certainly without an agreement particularly when it comes to the area of law, particularly if we are falling back on conventions that maybe don’t allow us to work with the same ease as we do now,” she said.
Ms McEntee also said that the State would “find ourselves in a very challenging situation” if the UK were to breach international law and an international agreement, in the Brexit withdrawal deal, by implementing the Internal Market Bill to remove checks between Northern Ireland and Britain.
She said that the Northern Ireland protocol with the withdrawal agreement requires additional checks on the Irish Sea “to ensure the integrity of the [EU] single market.”
“It’s unfortunately not legislation that I’m working on within our department but it’s something that we would have to look at,” said the Minister.


theirishtimes--2020-10-06--Bono was ‘beaten up by Orangemen’ as a kid - if you can believe Bon Jovi

In his early childhood , Bono was subjected to threats of violence from Orangemen marauding through his Dublin neighbourhood - at least if you believe a brief history of rock legends according to Jon Bon Jovi .
The singer from the eponymous New Jersey band paints a rather colourful , if entirely fanciful , portrait of his Irish peer .
But then , growing up in a quiet north Dublin suburb just wouldn ’ t be very rock and roll , would it ?
In an interview on the US-based Armchair Expert podcast , Bon Jovi briefly discusses topical song @ @ @ @ @ @ @ humble upbringing , devoid of the kind of lingering sectarian threat that overhung the U2 front man .
“ Bono is probably right at my age , he ’ s a couple of months older I think .
His upbringing was obviously very different than mine , ” he said .
“ I never had the Orangemen walking through my neighbourhood saying , you know , get the Catholic kid and beat him up .
“ You know I didn ’ t have any of that kind of turmoil in suburban New Jersey @ @ @ @ @ @ @ upbringing with two hard working parents .
So of course you ’ re writing the happy anthemic song.
” Bon Jovi appears to be referring to members of the Orange Order who celebrate the 17th century king William of Orange and his efforts to secure the Protestant ascendancy in Ireland .
The celebratory marching season between April and August , peaking on July 12th , sees Orangemen march in locations across Northern Ireland to commemorate William ’ s victory .
Some way south of the Border , however , Bono - or Paul @ @ @ @ @ @ @ north Dublin ( Ballymun is also known to claim him ) .
His father was Catholic but his mother was Protestant .
Bono went to the multidenominational Mount Temple secondary school and , according to reports , attended Protestant Church of Ireland services growing up .

Jon Bon Jovi photographed at the RDS in Dublin in 2011. Photograph: Brenda Fitzsimons / The Irish Times
In his early childhood, Bono was subjected to threats of violence from Orangemen marauding through his Dublin neighbourhood - at least if you believe a brief history of rock legends according to Jon Bon Jovi.
The singer from the eponymous New Jersey band paints a rather colourful, if entirely fanciful, portrait of his Irish peer. But then, growing up in a quiet north Dublin suburb just wouldn't be very rock and roll, would it?
In an interview on the US-based Armchair Expert podcast, Bon Jovi briefly discusses topical song writing in the context of his comparatively humble upbringing, devoid of the kind of lingering sectarian threat that overhung the U2 front man.
“Bono is probably right at my age, he’s a couple of months older I think. His upbringing was obviously very different than mine,” he said.
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“I never had the Orangemen walking through my neighbourhood saying, you know, get the Catholic kid and beat him up.
“You know I didn’t have any of that kind of turmoil in suburban New Jersey when you had a wonderful middle class upbringing with two hard working parents. So of course you’re writing the happy anthemic song.”
Bon Jovi appears to be referring to members of the Orange Order who celebrate the 17th century king William of Orange and his efforts to secure the Protestant ascendancy in Ireland.
The celebratory marching season between April and August, peaking on July 12th, sees Orangemen march in locations across Northern Ireland to commemorate William's victory.
Some way south of the Border, however, Bono - or Paul Hewson - grew up in Finglas, north Dublin (Ballymun is also known to claim him). His father was Catholic but his mother was Protestant.
Bono went to the multidenominational Mount Temple secondary school and, according to reports, attended Protestant Church of Ireland services growing up.


theirishtimes--2020-10-06--Increase in Covid-19 deaths in Northern Ireland ‘almost inevitable’

The North ’ s chief scientific and medical officers have warned of an increase in the number of coronavirus deaths if the public doesn ’ t adhere to the regulations to limit the spread of the pandemic .
On a day when 669 new cases and one more death were recorded in Northern Ireland the north ’ s chief scientific officer Prof Ian Young predicted a rise in deaths appeared almost inevitable .
“ We are in the lag period , I think , between the increase in hospital admissions and , unfortunately , the increase in deaths , ” @ @ @ @ @ @ @ So , it is almost inevitable that as hospital admissions increase , as patients in ICU increase , which we are seeing now , unfortunately and sadly the number of deaths will increase as well , ” he said .
“ We don ’ t want to wait for that .
We want everybody to change their behaviours now so that we minimise the extent to which that will happen.
” The North ’ s chief medical officer Dr Michael McBride in a joint Zoom press conference with Prof Young , supported that @ @ @ @ @ @ @ t do what we all need to do at this present moment in time after the next couple of weeks it is inevitable we will see more deaths , ” he said .
They issued their warnings as the North ’ s Department of Health reported 669 new cases of the virus in its daily bulletin issued on Tuesday afternoon , taking the total to 15,359 .
One more coronavirus death was recorded , bringing the total to 585 since the beginning of the pandemic in Northern Ireland .
In the past seven @ @ @ @ @ @ @ the North .
Over that period there were 962 cases in the Belfast City Council area and 876 cases in Derry and Strabane where more stringent coronavirus conditions apply .
Currently , there are 67 patients being treated for the virus in Northern Ireland hospitals , with 13 of them in intensive care units and eight on ventilators .
Northern Executive Ministers indicated over recent days that in the coming period a “ circuit breaker ” may be introduced in Northern Ireland – an increase in restrictions across the North over a possible @ @ @ @ @ @ @ limit the spread of the virus .
The scientific and medical officers also indicated that such a “ circuit breaker ” was inevitable .
Prof Young said that the virus circulated more widely in winter .
“ It is increasingly likely and more likely than not that further restrictions will be required over the winter to get us through to spring , ” agreed Dr McBride .
It will be for the Northern Executive , based on the advice from Dr McBride and Prof Young , to decide on additional restrictions .
Deputy @ @ @ @ @ @ @ she wanted to “ avoid additional restrictions ” but “ unfortunately it appears they are going to be necessary ” .

The North’s chief scientific and medical officers have warned of an increase in the number of coronavirus deaths if the public doesn’t adhere to the regulations to limit the spread of the pandemic.
On a day when 669 new cases and one more death were recorded in Northern Ireland the north's chief scientific officer Prof Ian Young predicted a rise in deaths appeared almost inevitable.
“We are in the lag period, I think, between the increase in hospital admissions and, unfortunately, the increase in deaths,” said Prof Young on Tuesday.
“So, it is almost inevitable that as hospital admissions increase, as patients in ICU increase, which we are seeing now, unfortunately and sadly the number of deaths will increase as well,” he said.
READ MORE
‘Circuit breaker’
“We don’t want to wait for that. We want everybody to change their behaviours now so that we minimise the extent to which that will happen.”
The North’s chief medical officer Dr Michael McBride in a joint Zoom press conference with Prof Young, supported that analysis.
“If we don’t do what we all need to do at this present moment in time after the next couple of weeks it is inevitable we will see more deaths,” he said.
They issued their warnings as the North's Department of Health reported 669 new cases of the virus in its daily bulletin issued on Tuesday afternoon, taking the total to 15,359.
One more coronavirus death was recorded, bringing the total to 585 since the beginning of the pandemic in Northern Ireland.
In the past seven days there were 4,005 virus cases in the North. Over that period there were 962 cases in the Belfast City Council area and 876 cases in Derry and Strabane where more stringent coronavirus conditions apply.
Currently, there are 67 patients being treated for the virus in Northern Ireland hospitals, with 13 of them in intensive care units and eight on ventilators.
Northern Executive Ministers indicated over recent days that in the coming period a “circuit breaker” may be introduced in Northern Ireland – an increase in restrictions across the North over a possible two- or three-week period to try to limit the spread of the virus.
Restrictions
The scientific and medical officers also indicated that such a “circuit breaker” was inevitable. Prof Young said that the virus circulated more widely in winter.
“It is increasingly likely and more likely than not that further restrictions will be required over the winter to get us through to spring,” agreed Dr McBride.
It will be for the Northern Executive, based on the advice from Dr McBride and Prof Young, to decide on additional restrictions. Deputy First Minister Michelle O’Neill said she wanted to “avoid additional restrictions” but “ unfortunately it appears they are going to be necessary”.


theirishtimes--2020-10-06--Woulfe-Clarke meeting over golf dinner deferred on ‘medical grounds’

Recently appointed Supreme Court judge , Mr Justice Séamus Woulfe , has sought a postponement on medical grounds of a key meeting to deal with the outcome of the Golfgate inquiry with the Chief Justice , Mr Frank Clarke .
A meeting between the two had been due to take place on Monday , but was postponed until Friday by Mr Justice Clarke , following a request for a delay by Mr Justice Woulfe .
In a statement on Tuesday night , however , a spokesman for the Chief Justice said the Chief Justice “ has received a request for @ @ @ @ @ @ @ .
The Chief Justice had agreed a delay until Tuesday of next week , the spokesman said .
“ The Chief Justice has emphasised to Mr Justice Woulfe the urgency of bringing this process forward.
” The informal resolution process included a meeting between Mr Justice Woulfe and three of his judicial peers , which took place on Friday , as reported by The Irish Times on Saturday .
The judges ’ delegation , including Ms Justice Iseult O ’ Malley , Mr Justice Donal O ’ Donnell and an ex-officio member , @ @ @ @ @ @ @ , Mr Justice George Birmingham .
However , the Friday meeting did not go well , with Mr Woulfe said to have been very surprised by the negative views that they had expressed , according to sources .
Throughout , members of the Supreme Court have refused to comment , though many continue to be furious with Mr Justice Woulfe for the negative publicity he has brought upon the court .
It is understood that the former attorney general has faced calls to make some form of public apology , or to face @ @ @ @ @ @ @ Chief Justice .
It is not clear that this can happen without his consent , however .
But if an agreed resolution can not be found , then , according to one source , the collegiate Supreme Court faces “ a very difficult situation ” .
Mr Justice Woulfe , who was appointed to the State ’ s highest court in July , had been listed to begin his Supreme Court career on Tuesday , but this was changed , and he is currently not listed to hear any cases .
In her @ @ @ @ @ @ @ former attorney general had not been “ sufficiently vigilant ” about his position as a newly appointed judge when he accepted the invitation to the Oireachtas Golf Society dinner .
However , she went further than some had expected by expressly stating that she believed it would be “ unjust and disproportionate ” if Mr Justice Woulfe was to face a resignation call now .
His attendance at the Clifden gathering “ did nothing involving impropriety such as would justify calls for his resignation ” , she said , adding that it was @ @ @ @ @ @ @ with the issue “ by way of informal resolution ” .
Ms Justice Denham was asked to compile her report in the absence of a complaints procedure for judges .
The Judicial Council ’ s Conduct Committee was set up in July , but , so far , has engaged only in preliminary preparatory work .
Ms Justice Denham said she assumed her report was “ in place of any potential action before the Judicial Conduct Committee ” and that it would not be “ fair , or in accordance with due process @ @ @ @ @ @ @ taken ” .
Mr Justice Woulfe had good grounds for accepting assurances that the Clifden dinner did obey the Covid-19 rules , she said , adding that evidence had been produced to show that that was so .

Recently appointed Supreme Court judge, Mr Justice Séamus Woulfe, has sought a postponement on medical grounds of a key meeting to deal with the outcome of the Golfgate inquiry with the Chief Justice, Mr Frank Clarke.
A meeting between the two had been due to take place on Monday, but was postponed until Friday by Mr Justice Clarke, following a request for a delay by Mr Justice Woulfe.
In a statement on Tuesday night, however, a spokesman for the Chief Justice said the Chief Justice “has received a request for a further postponement on medical grounds”.
The Chief Justice had agreed a delay until Tuesday of next week, the spokesman said.
READ MORE
“The Chief Justice has emphasised to Mr Justice Woulfe the urgency of bringing this process forward.”
The informal resolution process included a meeting between Mr Justice Woulfe and three of his judicial peers, which took place on Friday, as reported by The Irish Times on Saturday.
The judges’ delegation, including Ms Justice Iseult O’Malley, Mr Justice Donal O’Donnell and an ex-officio member, the President of the Court of Appeal, Mr Justice George Birmingham.
However, the Friday meeting did not go well, with Mr Woulfe said to have been very surprised by the negative views that they had expressed, according to sources.
Throughout, members of the Supreme Court have refused to comment, though many continue to be furious with Mr Justice Woulfe for the negative publicity he has brought upon the court.
It is understood that the former attorney general has faced calls to make some form of public apology, or to face “a dressing down” from the Chief Justice.
It is not clear that this can happen without his consent, however. But if an agreed resolution cannot be found, then, according to one source, the collegiate Supreme Court faces “a very difficult situation”.
Mr Justice Woulfe, who was appointed to the State’s highest court in July, had been listed to begin his Supreme Court career on Tuesday, but this was changed, and he is currently not listed to hear any cases.
Report
In her report, Ms Justice Denham said the former attorney general had not been “sufficiently vigilant” about his position as a newly appointed judge when he accepted the invitation to the Oireachtas Golf Society dinner.
However, she went further than some had expected by expressly stating that she believed it would be “unjust and disproportionate” if Mr Justice Woulfe was to face a resignation call now.
His attendance at the Clifden gathering “did nothing involving impropriety such as would justify calls for his resignation”, she said, adding that it was open to the Chief Justice to deal with the issue “by way of informal resolution”.
Ms Justice Denham was asked to compile her report in the absence of a complaints procedure for judges. The Judicial Council’s Conduct Committee was set up in July, but, so far, has engaged only in preliminary preparatory work.
Ms Justice Denham said she assumed her report was “in place of any potential action before the Judicial Conduct Committee” and that it would not be “ fair, or in accordance with due process, for any further action to be taken”.
Mr Justice Woulfe had good grounds for accepting assurances that the Clifden dinner did obey the Covid-19 rules, she said, adding that evidence had been produced to show that that was so.


theirishtimes--2020-10-06--Income data for thousands of students receiving grants is ‘incomplete’

Insufficient data is being collected to determine the full income of thousands of students who are in receipt of third level grants , according to a new spending review .
A report by the Department of Public Expenditure shows the State is spending about €360 million per year to a total of 77,000 students in further and higher education .
About half of all 18 and 19 year olds in higher and further education receive some form of grant aid .
The gross median household income for students in this age category is just over €62,000 .
The review notes @ @ @ @ @ @ @ non-recurring sources of income such as overtime payments and excludes the value of any assets , which is assessed as means in many other government supports .
“ As a result the data on the income of Susi recipients is somewhat incomplete , ” the review states .
“ Analysis of other sources of income excluded from the income assessment , as well as asset value , would allow for a more comprehensive profile of the income of Susi recipients.
” The review also notes there are sharp differences in the proportion of @ @ @ @ @ @ @ The RCSI , UCD and Trinity College have the lowest proportion of students on Susi grants with between 5 and 25 per cent entitled to grant assistance .
By contrast , Letterkenny IT , Sligo IT and Limerick IT had the highest proportion with between 60 and 65 per cent in receipt of grants .
Over half of students at institutes of technology receive Susi grants compared to about one third of students studying in universities .
Susi grants are paid to about 77,000 students in further and higher education who meet the @ @ @ @ @ @ @ income of a Susi recipient is just under €49,000 .
A detailed breakdown of the figures show that half of all 18 and 19 year olds in higher and further education receive a grant .
This gross median household income for these students is just over €62,000 .
A sliding scale of grants are available , ranging from the highest rate of support - which covers college fees and living expenses - to the lowest which partly covers college fees .
About a third of these students who receive the highest rate of @ @ @ @ @ @ @ no income from employment/self-employment .
Susi recipients reflect the gender breakdown of the wider higher and further education population , with more female than male recipients .
Counties such as Cavan , Donegal , Longford , Mayo , Monaghan and Wexford received the highest proportion of students on the higher level of support .
The report says there is limited data in relation to the economic occupation and education of Susi recipients ’ parents , as well as information on the academic and labour market outcomes of Susi recipients , including drop-out rates @ @ @ @ @ @ @ there is a lack of data available of the field of study of Post-Leaving Cert and postgraduate recipients .
“ This data would allow for a fuller exploration in relation to issues of social mobility such as whether Susi grants are supporting students from lower educated backgrounds to pursue higher/further education , ” it states .
The largest share of grant recipients are studying honours bachelor degrees at third level .
However , a higher proportion of Susi recipients are studying ordinary bachelor degrees when compared to the overall student population .
The @ @ @ @ @ @ @ of grant recipients are arts and humanities , business , admin and law , health and welfare , and natural sciences .

The RCSI, UCD and Trinity College have the lowest proportion of students on Susi grants with between 5 and 25 per cent entitled to grant assistance. Photograph: Alan Betson/The Irish Times
Insufficient data is being collected to determine the full income of thousands of students who are in receipt of third level grants, according to a new spending review.
A report by the Department of Public Expenditure shows the State is spending about €360 million per year to a total of 77,000 students in further and higher education.
About half of all 18 and 19 year olds in higher and further education receive some form of grant aid.
The gross median household income for students in this age category is just over €62,000.
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The review notes that the Susi income assessment process excludes non-recurring sources of income such as overtime payments and excludes the value of any assets, which is assessed as means in many other government supports.
“As a result the data on the income of Susi recipients is somewhat incomplete,” the review states.
“Analysis of other sources of income excluded from the income assessment, as well as asset value, would allow for a more comprehensive profile of the income of Susi recipients.”
The review also notes there are sharp differences in the proportion of grant-holders enrolled in third level colleges.
The RCSI, UCD and Trinity College have the lowest proportion of students on Susi grants with between 5 and 25 per cent entitled to grant assistance.
By contrast, Letterkenny IT, Sligo IT and Limerick IT had the highest proportion with between 60 and 65 per cent in receipt of grants.
Over half of students at institutes of technology receive Susi grants compared to about one third of students studying in universities.
Susi grants are paid to about 77,000 students in further and higher education who meet the eligibility criteria.
The gross median household income of a Susi recipient is just under €49,000.
A detailed breakdown of the figures show that half of all 18 and 19 year olds in higher and further education receive a grant.
This gross median household income for these students is just over €62,000.
A sliding scale of grants are available, ranging from the highest rate of support - which covers college fees and living expenses - to the lowest which partly covers college fees.
About a third of these students who receive the highest rate of support are households in which there is no income from employment/self-employment.
Susi recipients reflect the gender breakdown of the wider higher and further education population, with more female than male recipients.
Counties such as Cavan, Donegal, Longford, Mayo, Monaghan and Wexford received the highest proportion of students on the higher level of support.
The report says there is limited data in relation to the economic occupation and education of Susi recipients’ parents, as well as information on the academic and labour market outcomes of Susi recipients, including drop-out rates and future earnings.
It also says there is a lack of data available of the field of study of Post-Leaving Cert and postgraduate recipients.
“This data would allow for a fuller exploration in relation to issues of social mobility such as whether Susi grants are supporting students from lower educated backgrounds to pursue higher/further education,” it states.
The largest share of grant recipients are studying honours bachelor degrees at third level.
However, a higher proportion of Susi recipients are studying ordinary bachelor degrees when compared to the overall student population.
The fields of study with the highest share of grant recipients are arts and humanities, business, admin and law, health and welfare, and natural sciences.


theirishtimes--2020-10-06--New organisation to represent medical and dental consultants

A new organisation to represent medical and dental consultants in Ireland has been announced .
The Medical and Dental Consultants Association will seek to represent members working both in private hospitals and in the public system .
The establishment of the association stems from unhappiness among medical specialists particularly over the State ’ s takeover of the country ’ s private hospitals ahead of an expected surge of Covid-19 patients last spring .
The association said on Tuesday that it hoped to have 300 - 500 members in the near future .
It is planning to meet with private hospitals @ @ @ @ @ @ @ Minister for Health Stephen Donnelly .
There are already two organisations representing medical specialists , the Irish Hospital Consultants Association and the Irish Medical Organisation .
The new association said in a note on its website that it began as “ a loose group of like-minded doctors in April 2020 ” .
“ The Private Hospitals Association ( PHA ) , at the time of the anticipated Covid pandemic , signed up unilaterally to a HSE government contract without full-time private practice consultants being meaningfully involved in the decision-making process .
Likewise , @ @ @ @ @ @ @ , in our opinion , robustly involved on behalf of full-time private practice doctors .
“ While generally initially welcomed , as a means of addressing urgent bed capacity issues in the public hospitals , it became immediately apparent that consultants were unexpectedly placed under enormous state pressure to sign up to a public- only ( type ) A contract preventing maintenance of continuity of patient care .
This had particular relevance for those patients normally seen in the outpatient office setting .
Access to inpatient care was hindered by temporary withdrawal of @ @ @ @ @ @ @ declined to sign , opting to provide pro bono care to the highest medical and ethical standards.
” The association said its main objectives would be to “ represent the professional character and professional interests of medical and dental consultants and to provide them with all relevant services to the development of a caring and effective health service , putting the patients at the centre of its activities ” .
It said it would aim to “ promote , and protect by all lawful means , the rights and interests of medical and @ @ @ @ @ @ @ insurance bodies , private hospitals and relevant State entities and key stakeholders on behalf of members ” .

The Medical and Dental Consultants Association will seek to represent members working both in private hospitals and in the public system. Photograph: Thinkstock.
A new organisation to represent medical and dental consultants in Ireland has been announced.
The Medical and Dental Consultants Association will seek to represent members working both in private hospitals and in the public system.
The establishment of the association stems from unhappiness among medical specialists particularly over the State’s takeover of the country’s private hospitals ahead of an expected surge of Covid-19 patients last spring.
The association said on Tuesday that it hoped to have 300 - 500 members in the near future.
READ MORE
It is planning to meet with private hospitals and will seek a meeting with the Minister for Health Stephen Donnelly.
There are already two organisations representing medical specialists, the Irish Hospital Consultants Association and the Irish Medical Organisation.
The new association said in a note on its website that it began as “a loose group of like-minded doctors in April 2020”.
"The Private Hospitals Association (PHA), at the time of the anticipated Covid pandemic, signed up unilaterally to a HSE government contract without full-time private practice consultants being meaningfully involved in the decision-making process. Likewise, the medical representative associations did not become, in our opinion, robustly involved on behalf of full-time private practice doctors.
“While generally initially welcomed, as a means of addressing urgent bed capacity issues in the public hospitals, it became immediately apparent that consultants were unexpectedly placed under enormous state pressure to sign up to a public- only(type ) A contract preventing maintenance of continuity of patient care. This had particular relevance for those patients normally seen in the outpatient office setting. Access to inpatient care was hindered by temporary withdrawal of State indemnity. Doctors in many cases declined to sign, opting to provide pro bono care to the highest medical and ethical standards.”
The association said its main objectives would be to “ represent the professional character and professional interests of medical and dental consultants and to provide them with all relevant services to the development of a caring and effective health service, putting the patients at the centre of its activities”.
It said it would aim to “promote, and protect by all lawful means, the rights and interests of medical and dental consultants and to negotiate with relevant insurance bodies, private hospitals and relevant State entities and key stakeholders on behalf of members”.


theirishtimes--2020-10-06--Students resurrect old uniforms to mark school’s 175th anniversary

School uniforms are designed so everyone is dressed the same in class - so heads turned recently when students at one Dublin secondary school arrived into class in the historic garb of past pupils from the 1890s to the 1960s .
The old uniforms from the archives of Wesley College in Ballinteer were resurrected to add a bit of fun to the school ’ s 175th anniversary celebrations .
And , to add further drama , the students took on the persona of some of these past pupils .
The characters included Florence Forsyth – one of the first girls @ @ @ @ @ @ @ boarding school in 1912 ( it became co-educational in 1911 ) .
A talented singer , Forsyth set up the Pembroke School of Singing and worked in 2RN , the forerunner of Radio Éireann .
Another character re-enacted was that of , Eileen McKew , a diligent academic student who went on to become the first female Registrar of Sir Patrick Dun ’ s Hospital in 1939 .
No one was quite brave enough to take on the role of the school ’ s most famous past pupil , playwright , George Bernard @ @ @ @ @ @ @ wool swimming costume of prize-winning swimmer , Reginald Arthur Dench , who met his wife-to-be Eleanora Olive Jones at Wesley College and they later became the parents of actress , Dame Judi Dench .
The students seemed to enjoy stepping back in time .
Daisy Forte who dressed in 1920s white tennis dress and blazer says that she realised how lucky students are now .
“ In the 1920s , girls couldn ’ t take the same subjects as boys and had to study elocution , painting/drawing and domestic science instead .
They @ @ @ @ @ @ @ dining room either , ” she said .
Ruby Meira , who wore a gingham dress , blazer and a beret which was the summer uniform of the 1960s says she loved wearing the beret .
“ I wanted to be a student from the 1960s because this was the first generation of teenagers and a time when boys and girls became friends rather than being fascinated or scared of each other.
” The school was then on the corner of St Stephen ’ s Green and Harcourt St and the berets – @ @ @ @ @ @ @ wear - were thrown in the nearby Grand Canal as a rite of passage into the senior cycle .
The current school , designed by architects , Scott , Tallon , Walker , was built on a 50 acre farm in Ballinteer in the 1960s .
Raheem Olatunde wore a suit with short pantaloon trousers , a waistcoat and woven tie and took on the persona of Harry Brown , a final year boarder from 1895 .
“ The boys had to get up at 6.30am and do one hour ’ s study @ @ @ @ @ @ @ ’ d be sleeping in class if I did that .
Also there were no girls in Wesley at that time and I find that strange as a lot of my friends in school are girls , ” says Olatunde .
Other historic uniforms included a homemade pleated pinafore from the 1950s , a white smock and chef ’ s hat for the girls ’ domestic science class in 1925 .
The boys ’ uniform from the 1940s was a double-breasted blazer with baggy grey flannel trousers , a narrow school tie and @ @ @ @ @ @ @ enjoyed wearing .
Wesley College principal , Christopher Woods is only sorry one of the students didn ’ t choose to take on the persona of former student , Sir Robert Hart who was responsible for financial reforms in 19th century China .
“ He was the only western named by Empress Dowager Cixi among the 50 most important people in China at that time , ” says Woods .
Maybe a student will enact this crucial character in Sino-Irish relations for the 200th anniversary celebrations .
And , regarding the debate on @ @ @ @ @ @ @ trousers as part of their uniform – the Wesley girls seem nonplussed .
“ We can wear trousers if we want but they aren ’ t that comfortable so most girls prefer to wear skirts , ” said Forte .

School uniforms are designed so everyone is dressed the same in class - so heads turned recently when students at one Dublin secondary school arrived into class in the historic garb of past pupils from the 1890s to the 1960s.
The old uniforms from the archives of Wesley College in Ballinteer were resurrected to add a bit of fun to the school’s 175th anniversary celebrations.
And, to add further drama, the students took on the persona of some of these past pupils.
Wesley College students Chris Bailey, Charlotte Dougherty, Grace Harbison, Amy Stratford, Craig Mackay, Ruby Meira, Raheem Olatunde, Bosola Ojewale and Daisy Forte-O’Hanlon in historic school uniforms to celebrate the 175th anniversary of their school. Photograph: Alan Betson / The Irish Times
The characters included Florence Forsyth – one of the first girls to enrol at the Methodist day and boarding school in 1912 (it became co-educational in 1911).
READ MORE
A talented singer, Forsyth set up the Pembroke School of Singing and worked in 2RN, the forerunner of Radio Éireann.
Renacted
Another character re-enacted was that of, Eileen McKew, a diligent academic student who went on to become the first female Registrar of Sir Patrick Dun’s Hospital in 1939.
No one was quite brave enough to take on the role of the school’s most famous past pupil, playwright, George Bernard Shaw but one student dressed in the wool swimming costume of prize-winning swimmer, Reginald Arthur Dench, who met his wife-to-be Eleanora Olive Jones at Wesley College and they later became the parents of actress, Dame Judi Dench.
The students seemed to enjoy stepping back in time. Daisy Forte who dressed in 1920s white tennis dress and blazer says that she realised how lucky students are now.
“In the 1920s, girls couldn’t take the same subjects as boys and had to study elocution, painting/drawing and domestic science instead. They couldn’t eat in the same dining room either,” she said.
Ruby Meira, who wore a gingham dress, blazer and a beret which was the summer uniform of the 1960s says she loved wearing the beret.
The school was then on the corner of St Stephen's Green and Harcourt St and the berets – which only the junior students had to wear - were thrown in the nearby Grand Canal as a rite of passage into the senior cycle.
“I wanted to be a student from the 1960s because this was the first generation of teenagers and a time when boys and girls became friends rather than being fascinated or scared of each other.”
The school was then on the corner of St Stephen’s Green and Harcourt St and the berets – which only the junior students had to wear - were thrown in the nearby Grand Canal as a rite of passage into the senior cycle.
The current school, designed by architects, Scott, Tallon, Walker, was built on a 50 acre farm in Ballinteer in the 1960s.
Raheem Olatunde wore a suit with short pantaloon trousers, a waistcoat and woven tie and took on the persona of Harry Brown, a final year boarder from 1895.
“The boys had to get up at 6.30am and do one hour’s study before school started at 9am. I’d be sleeping in class if I did that. Also there were no girls in Wesley at that time and I find that strange as a lot of my friends in school are girls,” says Olatunde.
Pinafore
Other historic uniforms included a homemade pleated pinafore from the 1950s, a white smock and chef’s hat for the girls’ domestic science class in 1925.
The boys’ uniform from the 1940s was a double-breasted blazer with baggy grey flannel trousers, a narrow school tie and braces – which Bosola Ojewale says he enjoyed wearing.
Wesley College principal, Christopher Woods is only sorry one of the students didn’t choose to take on the persona of former student, Sir Robert Hart who was responsible for financial reforms in 19th century China.
“He was the only western named by Empress Dowager Cixi among the 50 most important people in China at that time,” says Woods.
Maybe a student will enact this crucial character in Sino-Irish relations for the 200th anniversary celebrations.
And, regarding the debate on whether girls should be allowed to wear trousers as part of their uniform – the Wesley girls seem nonplussed.
“We can wear trousers if we want but they aren’t that comfortable so most girls prefer to wear skirts,” said Forte.


theirishtimes--2020-10-06--Critical care staff concerned over capacity to cope with Covid surge

There is a growing concern among hospital staff over the system ’ s capacity to cope with a surge of coronavirus patients during the winter season , a senior intensive care nurse has said .
John Gilmore , an intensive care nurse and assistant professor of nursing at University College Dublin , said the “ biggest concern is we ’ re going into a busy winter.
” The intensive care system had been “ chronically under resourced ” for years , and already was under pressure at present , he said .
“ ICU ’ s are busy , extremely @ @ @ @ @ @ @ are tired , staff are stressed , ” he said .
During the first wave of the coronavirus pandemic Dr Gilmore worked in St Vincent ’ s Hospital intensive care unit .
“ The challenge is a busy system is already swelled , and adding Covid into that , ” he said .
“ We were able to do it in March because we cancelled many elective procedures .
The flu isn ’ t elective , road traffic accidents aren ’ t elective , those all go up in winter .
There is @ @ @ @ @ @ @ care community , ” he said .
The National Public Health Emergency Team ( Nphet ) on Sunday recommended the Government introduce a national lockdown for four weeks , to halt the concerning increase in Covid-19 cases .
The team cited concerns over low ICU capacity and a steady increase in coronavirus hospitalisations in recent weeks .
The Government rejected the recommendation and instead placed the country on Level 3 of its Living with Covid-19 plan , rather than Level 5 .
There were 147 confirmed Covid-19 patients in hospitals as of 8pm @ @ @ @ @ @ @ HSE operations report .
There were 243 patients in intensive care units , including 23 coronavirus patients , eight of whom were on ventilators .
This left 39 critical care beds vacant currently , according to the report .
“ I think we do need to listen to what they ( Nphet ) are saying … I know the Government have to make decisions , ” Dr Gilmore said .
It would not be easy to quickly ramp up ICU capacity within a number of weeks in response to a surge of Covid-19 @ @ @ @ @ @ @ “ For every single ICU bed you need 6.5 registered nurses , who have specialist training , that ’ s not got over a two week induction period , ” he said .
“ I would worry if our capacity was stretched we would end up doubling up , ” he said .
Dr Michael Power , critical care consultant at Beaumont Hospital , said during normal winter seasons intensive care units came under strain .
The country was again seeing “ slowly growing , but steadily growing Covid hospitalisations , ” he @ @ @ @ @ @ @ s decision to opt for lower Level 3 restrictions against Nphet ’ s advice , Dr Power said there had to be a “ balance , ” which took “ livelihoods into account ” as well as public health , he said .
Dr Jack Lambert , professor of medicine and infectious diseases at the Mater Hospital , said the current process between Nphet and Government was “ flawed.
” He called for different groups to have more input into the decision-making process , including frontline organisations , scientists , restaurateurs and travel @ @ @ @ @ @ @ up - I work in a hospital , and I don ’ t want to see people dead .
But there are ways to solve this problem without going back into a massive lockdown .
We need to come up with solutions quickly , ” he said .

There is a growing concern among hospital staff over the system’s capacity to cope with a surge of coronavirus patients during the winter season. Photograph: Alan Betson/The Irish Times
There is a growing concern among hospital staff over the system’s capacity to cope with a surge of coronavirus patients during the winter season, a senior intensive care nurse has said.
John Gilmore, an intensive care nurse and assistant professor of nursing at University College Dublin, said the "biggest concern is we're going into a busy winter."
The intensive care system had been “chronically under resourced” for years, and already was under pressure at present, he said. “ICU’s are busy, extremely busy with extremely sick patients … Staff are tired, staff are stressed,” he said.
During the first wave of the coronavirus pandemic Dr Gilmore worked in St Vincent’s Hospital intensive care unit. “The challenge is a busy system is already swelled, and adding Covid into that,” he said.
READ MORE
“We were able to do it in March because we cancelled many elective procedures. The flu isn’t elective, road traffic accidents aren’t elective, those all go up in winter. There is a lot of concern in the critical care community,” he said.
The National Public Health Emergency Team (Nphet) on Sunday recommended the Government introduce a national lockdown for four weeks, to halt the concerning increase in Covid-19 cases. The team cited concerns over low ICU capacity and a steady increase in coronavirus hospitalisations in recent weeks.
The Government rejected the recommendation and instead placed the country on Level 3 of its Living with Covid-19 plan, rather than Level 5.
There were 147 confirmed Covid-19 patients in hospitals as of 8pm on Monday, according to a daily HSE operations report.
There were 243 patients in intensive care units, including 23 coronavirus patients, eight of whom were on ventilators. This left 39 critical care beds vacant currently, according to the report.
“I think we do need to listen to what they (Nphet) are saying … I know the Government have to make decisions,” Dr Gilmore said.
It would not be easy to quickly ramp up ICU capacity within a number of weeks in response to a surge of Covid-19 cases in hospitals, he said. “For every single ICU bed you need 6.5 registered nurses, who have specialist training, that’s not got over a two week induction period,” he said.
“I would worry if our capacity was stretched we would end up doubling up,” he said.
Balance
Dr Michael Power, critical care consultant at Beaumont Hospital, said during normal winter seasons intensive care units came under strain. The country was again seeing "slowly growing, but steadily growing Covid hospitalisations," he said.
Commenting on the Government’s decision to opt for lower Level 3 restrictions against Nphet’s advice, Dr Power said there had to be a “balance,” which took “livelihoods into account” as well as public health, he said.
Dr Jack Lambert, professor of medicine and infectious diseases at the Mater Hospital, said the current process between Nphet and Government was "flawed." He called for different groups to have more input into the decision-making process, including frontline organisations, scientists, restaurateurs and travel representatives.
“The numbers are going up - I work in a hospital, and I don’t want to see people dead. But there are ways to solve this problem without going back into a massive lockdown. We need to come up with solutions quickly,” he said.