Covid surge and booster rollout
Catherine Murphy raised public anxiety about the latest Covid wave, hospital strain and the delayed delivery of promised beds, then asked about the third booster programme for older people. The Taoiseach pointed to the success of vaccination so far and said the booster rollout depends on NIAC advice, timing of second doses and HSE delivery through GPs and pharmacies.
People around the country are deeply concerned today. They are worried about the impact of the virus on their health, jobs, children's education and communities. They wonder if the small measure of normality that had returned in recent weeks is being snatched away and, if so, for how long. They are deeply concerned about the ability of our overburdened healthcare system to cope with the onslaught of cases. They wonder why, given the scale of the crisis in our hospitals, the HSE has yet to deliver the 350 hospital beds that were promised for ICUs.
The people are losing faith in the Government's ability to manage the response to the pandemic. They are concerned about the indecision and delay in the Government's response. Antigen testing has been promised for months but has yet to materialise. Ventilation has never been a priority, despite this being an airborne disease and ventilation being among the best weapons in the fight to suppress its transmission.
The roll-out of boosters has been painfully slow with little clarity on timelines for when the various cohorts will receive it. At the start of the crisis, Mike Ryan of the WHO gave some sage advice. He said, "speed trumps perfection" and "perfection is the enemy of the good when it comes to emergency management". That lesson seems to have been lost. Simple and effective measures, like antigen testing in schools, have not yet been rolled out. The overwhelming evidence that boosters would be required as part of the mitigation strategy has not been acted upon swiftly.
The Taoiseach and the Government have consistently highlighted personal responsibility and have said the onus is on people to limit their contacts and act responsibly, and that is certainly true. However, he has consistently downplayed the State's responsibility to manage the overarching response. Individuals cannot authorise antigen testing in schools, organise subsidies for antigen testing or institute a nationwide booster campaign. Individuals cannot mandate vaccination guidelines for workplaces or air purification systems in schools. Individuals cannot deliver additional hospital beds. Individuals cannot reintroduce the pandemic unemployment payment, PUP, for those who are likely to lose their jobs, even temporarily. All this work must be done by the Government. The Government has been sadly lacking and has taken its eye off the ball.
When will the booster campaign be scaled up? Will the Taoiseach give specific dates as to when each cohort will be dealt with? Why has it taken so long to roll out antigen testing, which is a no-brainer? The Taoiseach has failed to prioritise ventilation. When will he redress that? Will the PUP be reintroduced for people who lose their jobs?
Comment on this
I disagree with the Deputy's analysis of the country and the Government's performance in relation to Covid-19 since the onset of the pandemic. For instance, one key aspect has been the vaccination programme, which has been one of the most successful across the world in terms of speed, efficiency and effectiveness. About 90% of those over 12 years old are now fully vaccinated. That is no mean achievement and it is a tribute to the public, the robust debate within public media and those inside and outside officialdom who have offered opinions.
We reopened the economy substantively from March onwards, which has had a bounceback and has brought thousands of people back to work. That is a positive. We supported companies through the employment wage subsidy scheme, EWSS, the Covid restrictions support scheme, CRSS, the rates relief, and the variety of other supports we provided, including the warehousing of tax for businesses. This meant we kept thousands of businesses viable so that when we did reopen, they could start from a reasonable platform. That is something that should not be underestimated. If you talk to people, they will acknowledge that. The economic platform was very significant. We took a decision to borrow to underpin the economy in the midst of a once in 100 years event, which has borne fruit. That said, there has been a cost to the reopening. When the opportunities for socialisation are created, there will be opportunities for the virus to spread, particularly a transmissible variant of the virus that is the Delta variant. Therefore, there is a balance needed all the time and the Government has taken decisions in that regard.
On the booster programme, the national immunisation advisory committee, NIAC, provides public health advice, which I am sure the Deputy will accept and has accepted from the outset, on the utilisation of vaccines, especially with regard to the booster vaccination. There have been various timelines at which that advice has been given to the HSE on the booster campaign. The booster start date for residents of long-term care facilities aged 65 years and older, of whom there is an estimated cohort size of about 30,000, was 4 October. The end date for cohort eligibility is March 2022, because the five- to six-month interval of the application of that has to be factored in.
The booster programme for that group is expected to be substantially completed by the end of October. Residents of long-term care facilities under the age of 65, of whom there are approximately 18,000, are expected to have received a booster vaccine by early to mid-December. The programme for the cohort comprising healthcare workers aged under 60 years, including those working in long-term care facilities, is expected to be completed by the end of December. There are approximately 305,000 in this cohort. There are approximately 161,000 people in the cohort aged 80 and older. Administration of a booster to this group will be substantially completed by mid-November. Some of these will not be eligible until March 2022. We are looking at the end of November or early December for substantial completion in respect of the cohort aged 70 to 79. We are looking at the end of December for those aged 60 to 69. A booster vaccination campaign for the cohort aged 50 to 59 will now be operationalised. I just got that advice yesterday evening. I also got further advice regarding those who are at a very high risk, including four in seven of the immunocompromised and those with underlying conditions.
Comment on this
There is no doubt the vaccination programme was a real success, but we now know a third stage is required. People in their 70s are asking me when they are likely to even get notified of a date. Has the Government consulted the GPs on their ability to deliver this programme? The GPs are very busy at the moment as there are many things circulating in the community. Do they have the ability to do this? If not, can people be directed to vaccination centres? There is a real problem with people who got the AstraZeneca vaccine, particularly those in their 60s, because there was a 12-week gap between the first dose and the second. This means that some people did not receive their second vaccination until August.
We seem to be moving from wave to wave. The economy has been reopened but some of it has been closed down again. What is going to happen to the people who will be worried about losing their jobs this weekend? The pandemic unemployment payment is being reduced today. People will not be able to get on it again. That simply must be addressed. The likes of NIAC have been very slow to respond to issues, including the issue of healthcare workers. Some 1,800 such workers were out sick or were self-isolating. There needs to be greater speed in giving advice when all the evidence elsewhere shows that a booster programme needs to be delivered quickly.
Comment on this
In fairness, I just outlined the timelines the Deputy asked me for in respect of the booster programme. If you add it all up, including those four in seven and all people aged 50 to 59, there are now between 1.97 million and 2.2 million eligible under the NIAC advice. Those figures come from the HSE. There are timelines to consider with regard to when people got their second doses. That will be a key factor. It is not as simple as considering how the first and second doses, particularly the first, were administered and the original initiation of the primary vaccination programme. GPs, pharmacies and vaccination centres will be used for the booster vaccination programme.
With regard to antigen testing protocols, agreement between the Departments of Health and Education is very close. Again, the biggest issue arising during the presentation yesterday evening and our greatest concern is non-Covid respiratory illness, especially in paediatric medicine. The most dominant issue in healthcare as regards admissions to hospital among children has been respiratory syncytial virus, RSV, and other non-Covid illnesses. I am always surprised there has not as much focus on that in public debate. It is a very significant issue for parents of children.