The stark reality of life on the frontlines was laid bare by nurses and doctors today, as unions told the Oireachtas health committee their members are exhausted and do not feel safe at work despite the vaccine rollout being under way.
They also warned of how this affects patients, with one union describing a “tsunami of missed care” ahead as much non-Covid care has been set aside for almost a year.
The Irish Nurses and Midwives Organisation raised serious questions about how safety at work has been recorded during the pandemic, noting until November the Health Safety Authority was not involved in this area.
INMO general secretary Phil Ní Sheaghdha said more detailed data was kept by the Health Surveillance Protection Centre, saying:
Ms Ní Sheaghdha quoted from research carried out by the HSPC, which found “the number of female cases is disproportionately high, 76.9% among healthcare worker Covid cases compared to non-healthcare worker cases (49.6%), most likely due to some specialities — nursing — being female-dominated".
Other research shows Irish healthcare workers have an infection rate of about 12% compared to 10% globally, so while the situation has improved here since April, it remains extremely worrying.
Ms Ní Sheaghdha criticised the vaccine roll-out, saying the initial doses for healthcare workers were not sent out in an organised manner, and did not focus on the known hot-spots for Covid-19 transmission.
"The rollout commenced in a haphazard manner, not focused on the locations or workplaces with the highest infections or geographically bordering areas with high community infection.
“Put simply, the initial distribution seemed to be based on the HSE's administrative areas, rather than by where the virus was most prevalent," she said.
Ms Ní Sheaghdha said childcare has become a critical issue, with nurses paying for extra care or sharing the load with partners who are also working in healthcare.
Anthony Owens, director of industrial relations, consultant and non consultant hospital doctors, with the Irish Medical Organisation, called for urgent completion of the vaccine roll-out for all healthcare workers.
He focused attention on the low number of public health specialists in Ireland, just 60 compared to 180 in Scotland and New Zealand where the population is of a similar size.
These doctors do not have the same pay as their colleagues in other specialties who have a consultant contract.
"It beggars belief, and should be a cause of considerable shame, that these doctors, our frontline in this battle, had to ballot for industrial action, in a pandemic, to have their long-running grievances considered in a serious fashion," he said.
Waiting lists for patients have now stretched past 800,000, and Mr Owens said one clear reason for this is the shortage of consultants.
"No concrete measures have been taken to address the two-tier pay disparity among hospital consultants," Mr Owens said.
The Irish Hospital Consultants Association (IHCA) estimates the shortage as close to 2,000 when public health and mental health are taken into account.
IHCA vice-president Professor Robert Landers said one in five consultants roles are not filled on a permanent basis.
He said: “The vacancies and the shortage of consultants have resulted in excessive workloads being carried by understaffed medical and surgical teams to the detriment of patients.”
Prof Landers said a crucial issue is the impact this has had on non-Covid care.
He said a survey of IHCA members last week found that 54% feel “moderate or high staff absentee levels that are having an adverse impact on service delivery”. This would include staff on Covid-leave.
In line with the infrastructural problems highlighted by the nurses’ union, Prof Landers said: “Our members also expressed concerns about lack of regular testing and screening of staff, poor ventilation in crowded areas and clinical areas.”
He added also that poor security and incursions from visitors not wearing PPE have caused distress.