Devastating impact of pandemic hits home for Covid-19 survivor

Neil Michael meets Margot McAuliffe, who believes a hospital move saved her life
Devastating impact of pandemic hits home for Covid-19 survivor

Ballynoe resident Margot McAuliffe, currently being treated for the after-effects of Covid.

Margot McAuliffe is lucky to be alive.

The 87-year-old was one of the residents of Ballynoe Nursing Home in Cork who caught Covid-19 earlier this year.

She survived, but many others died during what would be one of the country’s deadliest outbreaks.

Exactly how many died after contracting the virus in the Upper Glanmire home is not clear, but the Irish Examiner has been told at least 21 people passed away after contracting it.

Ballynoe, like many other nursing homes, had managed to avoid Covid-19 during the first two waves and throughout the start of the third wave in November 2020.

But by the end of January 2021, and following the departure of key staff including the respected director of nursing, it swept through the home, striking down staff as well as residents.

Mother-of-three Margot, who is convinced she would have died if she hadn’t been taken to the Mercy Hospital in late February, is still very upset about the events of the past few months.

Perhaps the starkest period was when she came out of hospital at the beginning of March.

Up to that point, she had — like other residents — been largely confined to her room for her own safety.

She had also given an interview to the Irish Examiner just hours before being rushed to hospital. 

At the time, she told of how nobody was as surprised that she contracted the virus as she was herself.

This was because, bored with listening to fellow residents “discussing bowel movements in the day room”, she had retreated to her own room.

And since the pandemic, she had hardly left it, yet a Covid-19 test she took on January 29 turned out to be positive.

Margot says she only found out she had the virus by accident when, she says, a member of staff mentioned it in passing.

Although Ballynoe did not comment on how or when she was told, it insists her family was told in a timely manner.

After nearly four weeks of fighting the virus, she was rushed to hospital.

A lonelier place

Ballynoe Nursing Home.
Ballynoe Nursing Home.

Fast forward to today, and she says the home is now a lonelier place for her, in much the same way she believes any nursing home would be.

Indeed, she has tried to leave, but can’t get a place in another home.

Margot, who is virtually blind and has restricted mobility, now only recognises one member of staff.

In addition — and it’s something that still clearly rankles her — she no longer lives in the room on the first floor that was her home since that day back in March 2011 when she first went to live in Ballynoe.

“I asked the staff how everybody was when I left the hospital and returned here,” she said.

I asked about people I was friendly with in here and every name I mentioned, I was told they had died.”

She pauses, momentarily overcome with a wave of emotion.

“I asked about this person, that person and then somebody else,” she continues, her voice now trembling. “But I was told they had all gone.”

She reels off a list of names of people she used to know in the home, and sounds anguished as she repeats that “all of them are gone”.

They include Jimmy Lee, the 81-year-old who died on February 3.

A popular and much-loved resident of the home in Upper Glanmire, he had devoted a lot of his time at the home tending to its gardens.

She said: “He was an exceptional gentleman. He had no intention of dying and he used to do the garden, and we were great pals.

“He would talk you to death, and he was sure he was going to be better and run around again.

I asked: ‘How is Jimmy Lee?’, and I was told by a carer: ‘Oh, he’s dead’.

“It’s the same response she gave to everyone I asked about, ‘she’s dead, and she’s dead’, I was told. 

"Eventually, I found out that everyone was gone.” 

She believes she would also be dead if she hadn’t been taken to hospital.

“I was so desperately ill,” she said. 

“My girls [daughters Ruth and Claire] were brought in to see me.

I really think they thought I was going to kick the bucket and this was my last visit, but I wasn’t told that, naturally — but I just put two and two together.

“I have not been myself properly since I came out. But when I did come out, I asked [a former member of staff] how many people had died here?

“And she said: ‘I won’t tell you, you would only worry’, but of course I have since found out that it was 27 — but not all with Covid.”

Since the deaths at the home, there have been repeated calls for an inquiry, not just into what happened in Ballynoe, but in homes across the country, especially where there were multiple deaths.

So far, every call for an inquiry has hit a brick wall, and the Government instead insists it is up to Hiqa to act.

The health watchdog has no plans to mount any form of investigation at this stage, however.

Even if it did, it would probably need to make sure any investigation it carries out would be different to the inspection work it has already completed.

Two reports, in particular, have already looked at the issue of Covid-19 outbreaks in nursing homes — the Oireachtas special committee on Covid-19 response in October 2020, and the Covid-19 Nursing Homes Expert Panel Report, published last August.

Both of them covered extensive ground.

The special committee, for example, held 67 public sessions over 30 days of hearings, and received 275 written submissions.

For its part, the expert panel held 13 meetings with key stakeholder groups comprising of a total of 43 representatives.

The panel also met with key staff and residents of three nursing homes.

In addition, the country’s 573 registered nursing homes were also all invited by Hiqa to make written submissions, but just 53 nursing home submissions were received.

A further 60 submissions came from members of the public.

The third wave

Despite the collective recommendations of the two reports, which covered the first two waves, they appear to have had little or no impact on what would happen in the third wave.

As is now known, more died in nursing homes in the third wave than the previous waves combined — and that happened with the benefit of two fairly exhaustive reports.

The special committee’s first recommendation was that there should be a public inquiry established to “investigate and report on all circumstances relating to each individual death” from Covid-19 in nursing homes.

It said draft terms of reference should be presented for consideration by the Joint Committee on Health by the end of 2020.

That inquiry should, it said, have to look at the circumstances that lead to the spread of the virus to, and within, nursing homes.

While the special committee chairman talked of the risks of lives being lost in vain, the expert panel talked of the importance of its work being “forward-looking to protect the at-risk population in nursing homes into the near future”.

This was regardless of “whether or not a surge of Covid-19 occurs or if the infection remains in the community and continues to be a risk to those especially vulnerable to it”.

The panel said its work was “guided by the principles of in-action and after-action reviews” where “lessons learned in real-time are acted upon”.

This is not simply to identify those lessons learned, but to seek to apply these insights in a tighter timescale in order to improve the outcome of the ongoing response,” it stated.

But the surge did happen, and despite the recommendations of both reports, the death toll in the third wave ended up higher than the first two waves put together.

No investigation

The subsequent lack of a commitment by any arm of the State to investigate what happened, and why, has left many of the relatives of those who have died feeling frustrated and angry.

In Ballynoe’s case, 13 families have now banded together and are suing the home for negligence — something the home denies.

The families are represented by law firm PA Duffy, which is also representing relatives of those who died in around 15 other homes around the country.

A variety of just some of their allegations appeared in the Irish Examiner earlier this year.

Families and residents alike have claimed there were consistently delays in them being told that either they or their loved ones had Covid-19.

A number said they found out “by accident”, for example, where a staff member casually dropped it into the conversation, not realising they had not been told.

CareChoice, which runs the home, has admitted that “at times” its communications and interactions with families were not of its “usual standard” and they have acknowledged “the hurt this has caused”.

One family maintains that they were told by Ballynoe staff to come in and say goodbye to a loved one, only to arrive after their loved one had already died.

CareChoice told the Irish Examiner earlier this year that “unfortunately, this is something that can occur in end-of-life situations”.

In another case, a resident was left in their bed where they died alone while their family remained outside. 

The family realised from outside the window that they had died, and had to notify the nursing home staff by contacting the front desk

CareChoice later confirmed “a resident sadly passed away during a family visit”.

It is not always the case that a staff member will be present, and that is what occurred on this occasion,” it stated.

More than 2,000 deaths

A little more than 2,000 nursing home residents have died after contracting Covid-19 during the pandemic.

But, as the Irish Examiner reported in April, just more than 1,000 died during the third wave alone.

The highest proportion — 190 — died in the Cork and Kerry Community Health Organisation area.

The next-highest death toll was in the Wicklow, Dun Laoghaire, Dublin South East CHO area.

A total of 134 died there between November 22, 2020, and midnight on April 14, this year.

The statistics, which were obtained from the Health Protection Surveillance Centre’s (HPSC) Computerised Infectious Disease Reporting System (CIDR), state that 973 died as a result of an outbreak in a home or other similar institution.

It also says a further 83 residents died in the public, private, or other nursing homes or community hospital long-stay units not linked to a Covid-19 outbreak in the third wave of the pandemic.

The fact that so many died in the third wave led to renewed calls for a national inquiry into Covid-19 deaths in nursing homes, but those calls fell on deaf ears.

Lessons learned

Margot McAuliffe believes there needs to be an investigation into what happened.

While reluctant to suggest anybody in particular did anything wrong as far as she can tell, she says the fact that so many people died in such a short space of time needs to be looked at.

“We can’t, as a country, learn from what happened if we don’t know why it happened,” she said.

“I don’t think it is enough to just put it down to Covid, because Ballynoe managed to keep the virus out for the first two waves.

So something happened, and it will be important to see what can be learned.”

In light of the number of people who died in the third wave, and after the Oireachtas published the final report of the Oireachtas special committee on Covid-19 response, the foreword from special committee chairman, Independent TD Michael McNamara, in October 2020 now seems more apocryphal than he could ever have imagined.

All that has been done and said, and examined and analysed, will be for nothing unless the State learns from it, embraces change, and acts quickly as it sees challenges coming,” he said.

“The many sacrifices will have been in vain, as will the too-many heartbreaking deaths, the unnatural funerals loved ones have had to endure, the incomplete mourning and grieving and unanswered questions for families.”

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