The HSE needs to trust the society it is trying to protect
ON Friday evening, the National Public Health Emergency Team announced a census of mortality across all long-term residential care facilities.
That is to be welcomed. This newspaper repeatedly asked questions of the Department of Health about the rate of Covid19-related deaths in nursing homes. After two weeks of ignoring these questions, it was finally revealed that rate of deaths in nursing homes was 54%, higher than in any other country, and it since has risen to 60%. Subsequently, this paper asked – again without receiving an answer – if the Department of Health had confidence that numbers of Covid-19 deaths being announced daily fully accounted for all deaths from the virus.
After two weeks without receiving an answer, Friday evening’s announcement of the census give an inadvertant response to that question. The Department of Health does not have full confidence that the figures announced each day account for all the Covid-19 related deaths in Ireland.
This in itself is understandable, or at least it was at the outset. In the midst of an unprecedented crisis, with difficulties and backlogs around testing, it is fathomable that the Department and the HSE could not be sure all deaths were being accurately accounted for. When dealing with a particularly vulnerable cohort, those in nursing homes, it may not always be immediately apparent if a death is related to the virus, when underlying conditions were very likely present. Also, it seems that the elderly are less likely to develop the extreme symptoms more pronounced in a younger cohort, so we accept there are multiple factors at work.
That said, there were pointers. The deaths on cruise ships were mostly among the advanced in years and it was a red flag that should have been noted. Why ask couples in their seventies to cocoon, but leave those in their eighties, nineties and even centenarians so vulnerable in clusters? That seems naïve to say the least.
What is even less understandable is the lack of transparency from those managing this health crisis. The general public has been asked to make what hopefully will be a once-in-a-lifetime sacrifice, to literally furlough its own liberty and freedom of movement in order to save the life of the entire community. With a few boorish exceptions, we all have bought into that and find ourselves living daily lives in a vastly different, and sometimes scary, new way.
A basic price of our acquiescence is honesty. We have shown we can listen to tough messages and not only understand but implement them. We are living through the greatest period of non-partisanship our country has ever known, and perhaps ever will.
Insisting on repeatedly trying to control the flow of information that, absolutely inevitably, will make its way into the public domain, is not just stupid - it’s counterproductive.
We need to have confidence in those managing this crisis. If they presented their figures all along with caveats relating to delays in testing and uncertainties around the recording of deaths in long-term residential care, people would understand. But it would seem that trusting the public is against HSE policy.
It has become clear that nursing homes are the battleground in this crisis. Giving the public an honest portrait of the situation can only encourage those making an effort to isolate. Obfuscation can only erode public confidence and fuel resentment and suspicion. This is not the first time we have made this point in this crisis. Let us hope, albeit naively, that it will be the last time.