A staff member in St Mary's Hospital nursing home in Dublin's Phoenix Park raised serious concerns over access to personal protective equipment (PPE) with senior management more than a month ago, internal correspondence shows.
St Mary's is one of the worst hit nursing homes in the country with 24 confirmed coronavirus deaths. The home is run by the Health Service Executive, has 150 beds and a separate 48 bed step-down hospital.
Last Saturday The Irish Times published an extensive investigation on the coronavirus outbreak in the Dublin care home.
On Wednesday a staff member made a whistleblower’s report, known as a protected disclosure, alleging shortcomings in the facility’s response to Covid-19.
It is understood the healthcare worker attempted to flag concerns with nursing home management.
In an April 4th email to senior management, seen by The Irish Times and sent at onset of the outbreak in the home, the staff member expressed concerns over the criteria for when healthcare workers should wear PPE, and that the process of identifying suspected coronavirus patients was “unclear”.
The email stated the worker was “gravely concerned” about the lack of gear for front-line workers, over fears staff would transmit the virus from one resident to others.
The staff member also queried the practice that protective equipment should not be worn if a patient presented with one symptom only of coronavirus.
“If someone has one symptom, and we are not using PPE, there is an obvious risk that if the person does actually have Covid-19 we as front-line workers will get Covid-19 and will be carriers, transmitting it to other residents,” said the staff member.
The email also expressed fears that suspected coronavirus patients were being moved between wards.
In response senior management sent the staff member the Health Protection Surveillance Centre guidelines on the use of PPE and insisted the clinical criteria for identifying suspected coronavirus cases was clear.
The staff member’s 35-page protected disclosure noted concerns “fell on deaf ears” and they faced “alienation and disapproval” for highlighting the issues.
The protected disclosure was sent to HSE chief executive Paul Reid and Minister for Health Simon Harris. The staff member called for a statutory inquiry to be set up, or failing that an independent external inquiry.
The nursing home had its first confirmed coronavirus case on March 28th and the first death from the virus on April 2nd. Over the course of last month Covid-19 spread rapidly throughout the care home to nearly every ward, with almost half of residents contracting the virus.
Adjusting guidelines
In a March 26th email, St Mary’s staff had been instructed on the “prudent” rationing of protective equipment. “The unnecessary use of PPE will deplete stocks which will be needed as the number of people with the virus increases,” the email stated.
All staff were reminded that HSE guidelines did not recommend the use of face masks when treating confirmed or suspected Covid-19 cases “in situations other than close contact”.
However, following the nursing home outbreak all staff are now required to wear face masks.
A HSE spokeswoman has previously said the use of protective equipment and testing in the home had followed National Public Health Emergency Team guidelines.
In response to the outbreak the home had put in place infection control measures, with the assistance of consultants from the Mater hospital. The HSE spokeswoman said the facility had “adequate” supply of protective equipment.
