Fine Gael have received some praise for their handling of the coronavirus crisis. But as Eoghan Ó Ceannabháin lays out the facts, the truth behind the grandstanding makes for uncomfortable reading.
Leo Varadkar and Simon Harris are in the National Virus Reference Laboratory in UCD. They’re wearing lab coats and protective glasses. They’re talking to the experts, who are presumably briefing them about the latest on Covid-19. There are many photographs.
Now Varadkar is in his office. He is at his desk, where his funny Mr. Taoiseach mug is placed in front of him – just conspicuous enough to be noticed by somebody and remarked upon. His tweet tells us he has been speaking to Chinese Premier Li. Essential medical supplies are on the way.
Now Varadkar and Harris are standing in the convention centre in City West, visiting the site of a proposed “StepDown Covid-19” facility. This will be used for patients who need to self-isolate, the tweet tells us.
Everyone is smiling. Varadkar is doing a power stance. They are doing a great job.
Or so goes the narrative. From the beginning of this crisis, a show of national unity has been put on, the leadership of Varadkar and Harris praised at every turn, and anyone who questions the line from the government and the HSE bureaucracy condemned as undermining the national effort.
But scratch the surface and a different reality begins to emerge.
The Starting Point
We cannot allow ourselves to forget the state in which we entered this health crisis. The 26 counties had one of the lowest numbers of hospital beds in Europe. The same was true of the Intensive Care Unit beds that are so crucial to tackling Covid-19; we had 5.2 ICUs per 100,000, far below the European average of 11.5.
Irish hospitals were already operating at the edge of their limits and the constant appeals by health professionals to increase capacity were steadfastly ignored by Fine Gael. Indeed, at the beginning of this year Dr. Brendan McCann of University Hospital Waterford (UHW) stated that two people were dying every week in UHW simply because of the trolley crisis.
He said staff were being “exploited cynically by leaders who understand that it is cheaper to herd patients like cattle” into an Emergency Department “bursting at the seams” than “admit them anywhere else that might give them some dignity”. McCann estimated the death toll from the trolley crisis in UHW was over 100 a year – in just one hospital.
It is not as though this pandemic has come out of the blue. Infectious diseases are becoming more and more prevalent, with viruses like Zika, H1N1, SARS and MERS giving ample signals that something of a greater magnitude could be on its way. And experts warned it could come soon – whether this year, next year, or in a few years’ time.
Covid-19 was made known to the WHO on 31 December 2019. The gravity of the danger has been clear for months. Yet, alarmingly, it appears that moves to procure additional medical equipment, additional capacity in our hospitals and PPE for health workers only began to be taken when the first cases were being announced in Ireland in March.
There were alarm bells in early March over the issue of contact tracing. Professor McConkey from the Department of International Health and Tropical Medicine at RCSI called for aggressive contact tracing of people who had come into contact with Covid-19 and said that 5,000 workers would be required to carry this out. At this point, there were 60 people doing this job. Simon Coveney told the media that they were planning to increase this to 1,000 in the coming weeks.
On March 23rd, Varadkar reassured us that we were following the “South Korea model” for dealing with Covid-19 – based on mass testing, with results produced within 1-2 days, followed by contact tracing of anyone who may have encountered the virus and shutdowns of any areas where clusters may appear. Given that South Korea has been one of the most effective countries in containing the virus, it certainly sounded good that we were to follow suit.
Just two days after Varadkar’s claim, the HSE announced that it was changing the criteria for testing: now two symptoms were required, with priority given to healthcare workers and vulnerable groups. At this point, 40,000 people had been waiting for tests, many of them for a week or longer. A substantial amount of them were suddenly told that they were no longer to be tested.
It is important to note the manner in which Fine Gael, at this stage, twisted the narrative to make it seem like they were still following the expert advice. They stressed that they were following WHO guidelines on testing, which state that where there are capacity issues vulnerable people and health workers must be prioritised.
This much is true, but an incredibly servile media barely questioned them over why there were capacity issues and what could be done to resolve them. WHO guidelines also state that where there are capacity issues, states should look at any potential capacity in the private sector and repurpose any labs or other private facilities that could be used to carry out testing.
The reality is that the acting government has completely failed to implement the South Korean model. Initially, they were slow to set up testing facilities like the drive-through centres commonly used in South Korea. Since then, there have been several delays due to lack of materials, with various labs asking for donations of reagent used in the testing.
One of the major stumbling blocks appears to be due to intellectual property rights. Dr. Cillian de Gascun of the National Virus Research Laboratory said at the end last month that the “extraction material to actually extract the viral RNA […] is proprietary, unfortunately.”
Fine Gael’s unwillingness to challenge private profiteers has slowed down testing. Thermofischer Scientific who have plants in Cork and Blanchardstown are the major producers of Trizol and Trizol LS, one of the most popular reagents. Another company which produces reagent, Roche, has a base in Clarecastle, Co. Clare. Rather than taking these companies under public control, and issuing the reagent where it was needed, the acting government stalled.
More recently, a German company made a formula for a reagent available to the public, and a lab in UCC have produced their own chemical formula that can be used to analyse tests. Rather than the state mass producing for the sake of public need, Fine Gael have responded by handing over the formula to pharmaceutical giant, Eli Lilly, to undertake the production for the sake of profits – lining the coffers of a massive corporation.
The government has now made a deal with GMI to supply enough reagent for 900,000 tests. This is further evidence that mass testing could have been carried out much quicker if the government had properly investigated the capabilities of private industry as recommended by the WHO. But Fine Gael have kowtowed to the private sector, slavishly avoiding any inconvenience to them.
The government is still claiming that lots of tests have been carried out, but this is misleading to the point of being more or less false. We do not have the results for these tests because of the shortage of reagent. To get around this, almost 30,000 tests have been sent to Germany, adding further delays. The current delay of 7-14 days for results makes the data increasingly less useful.
With testing, time is of the essence. This is particularly important with regard to an exit strategy for loosening movement restrictions without experiencing a second wave of the disease. The WHO states that for an exit strategy we must have the capacity to turn around all tests in 24-48 hours, so that outbreaks can be spotted quickly, cases isolated, and lockdowns introduced in specific areas where required.
Ireland had some of the lowest ICU per capita numbers in Europe – 255 in the public sector and approximately 50 in the private sector. People Before Profit have repeatedly asked the HSE, as far back as February 20, what their projections were for ICU use and how they planned to increase capacity. No answers have been given beyond vague outlines. It is therefore impossible to say what kind of surge capacity has been put in place or may be in place in the near future. However, reports are now coming that some hospitals in Dublin are already approaching ICU capacity.
While HSE reports state that the transmission rate has reduced considerably – meaning that the public is playing an important part in social distancing and slowing the spread of the disease – there is still a major danger of community spread happening in certain settings. Already, many clusters have appeared in nursing homes as well as up to 70 confirmed cases of medics in Cavan General Hospital.
The Private Hospital Con
On 24 March the government announced that the state would be operating a single tier health service to deal with Covid-19. Health Minister Simon Harris told us that there could be “no public versus private in a pandemic”. The praise for Fine Gael rolled in from all corners.
When the dust had settled, it emerged that what had actually been agreed was a Public-Private Partnership deal – the details of which are yet to be disclosed.
However we may be quite certain of some of the people who will benefit from this deal. Tax dodging billionaire Denis O’Brien will profit from the use of The Beacon hospital. Alongside him will be Larry Goodman, who owns Blackrock Clinic. Goodman’s workers in ABP Meats in Lurgan walked off the job over safety concerns only two weeks before this deal was being arranged. It is bitterly ironic that Goodman profits from endangering his workers in Lurgan while simultaneously profiting from the public need for healthcare in Blackrock.
Along with the Irish billionaires, a number of global investment funds stand to profit. Among these are Infravia Partners, who run the Mater Private, and US company UMPC who are based in Waterford.
To top it off, there are the Catholic institutions like the St Vincent’s HealthCare group and the Bon Secours. The Bon Secours never paid any redress for the Tuam babies scandal. Now they profit from our healthcare crisis.
By contrast, it appears that many nurses are still waiting for new contracts that reflect the pay rises they won during last years’ strike. And having promised to pay student nurses, it appears that Harris has done another swindle – student nurses can work as healthcare assistants when not on placement, but this was always the case. The placements themselves remain unpaid, as are the placements of student radiographers who protested this week in demand of paid work.
Nursing Homes – The Next Scandal?
There was never any doubt about the potential for nursing homes to be major hotspots for Covid-19. Having so many vulnerable people in close proximity would present a challenge anywhere, but Fine Gael have presided over a steady privatisation of nursing homes, as well as underfunding and short staffing.
Germany has been somewhat successful in containing the spread of Covid-19 in nursing homes by banning visits early on, and regularly testing care workers and residents. Results are delivered in 1-2 days, patients are quickly brought to ICU if necessary and there are regular follow-ups to monitor the situation.
By contrast, Bríd Smith TD asked Chief Medical Officer Tony Holohan at a HSE briefing in early March whether care workers would be tested and was dismissed with: “We don’t do that”. On 10 March, they said that visitor restrictions to nursing homes were unnecessary. On 19 March Nursing Homes Ireland wrote to Harris to request a meeting. When this did not happen, on 25 March, NHI issued a press release publicly asking for a meeting. Finally, on 30 March they met and the following day recommendations were put forward.
It appears during this time that there has not been rigorous testing of care workers or nursing home patients. The Journal.ie reported one 89-year-old man who passed away on 9 April had been waiting 15 days for test results. Despite the high percentage of deaths coming from nursing homes and the many clusters identified, there still seems to be little concrete action to address the dangers.
True to form, Harris announced a €72 million bailout of private nursing homes last week, with funding allocated on a per patient basis. But there seem to be very few conditions attached to this and very little detail as to how it will address issues of testing, low staffing levels and lack of PPE.
The Direct Provision Powder Keg
The Direct Provision (DP) system was being described as the modern-day version of the Magdalene Laundries even before this crisis. Approximately 7,000 asylum seekers are confined to almost 40 different centres, which are run by a dozen or so private companies. The misery of the system is well documented – people who have fled war and persecution are left to languish in the system for years with little income support, largely prevented from working, and isolated from wider society.
The manner in which asylum seekers are packed together makes the situation particularly dangerous with regard to Covid-19. It is virtually impossible to socially distance in a crowded DP centre, but the government initially advised those in direct provision distance “as much as possible”.
Subsequently they announced that self-isolation units would be put in place for asylum seekers who might become ill. As pointed out in a letter by 600 medical professionals, waiting for asylum seekers to become ill before allowing them to self-isolate is essentially closing the door after the horse has bolted. The virus could easily spread before a person might be able to self-isolate. The units themselves were also described as inadequate in the letter.
The government simply refuses to act to challenge private profiteers. It is difficult to find a conclusive figure, but it is certain that there are tens of thousands of empty homes in Ireland at present. Those in direct provision and the further 10,000 people in emergency accommodation could be provided with adequate housing that would allow them to safely distance themselves from others.
Doing so would involve taking on vulture funds and speculators who have hoarded property, as well as ending the lucrative business that is the direct provision system. Because once people are moved into empty houses that have been there all the time, it becomes extremely difficult after the fact to move them back into temporary accommodation.
Ventilators, Hoods & The PPE Debacle
The past few weeks has seen a global scramble for medical equipment. There is a worldwide shortage of PPE. Equipment destined for one country has been requisitioned by another on a number of occasions. Medical companies have jacked up their prices. The free market has proved utterly incapable of providing what is required.
Fine Gael’s devotion to the market means we are uncertain of where we stand with regard to medical equipment. At time of writing, Dublin-based company Narooma are withholding 350 ventilators and are taking the HSE to court because they say a bill of €7.3 million has not been paid. 1,000 CPAP hoods ordered from Ortega Systems were requisitioned by the Italian government two weeks ago.
It is completely understandable why Italy would hold onto this equipment given the depth of their crisis. However, the frequency with which this kind of thing is happening makes the call for the audit and requisition of all private capacity here even more necessary. Private factories should be instructed to retool in order to produce whatever is necessary, as was done by many countries during World War II. We could also provide medical equipment at cost to other countries, cutting out the price gouging.
The PPE scandal is the most obvious example of this failure. Approximately 25% of Covid-19 cases are healthcare workers. This compares poorly to even some of the worst affected countries like Italy and Spain, where between 10-15% of cases are healthcare workers. There is always a danger that a virus like this could spread in hospitals even if every precaution possible is taken. However, leaving healthcare staff without adequate PPE dramatically increases this risk.
In early March, HSE CEO Paul Reid insisted they had adequate stores of PPE. Like other reassurances and grandstanding announcements, this again proved to be untrue. There is a consistent pattern of all levels of government failing miserably on their promises.
Deliveries of PPE have been late or have not arrived at all. Having spent €200 million on an order of PPE from China and made much of the Aer Lingus planes flying over and back to collect it, it transpired that 20% of the order was unusable and a further 15% only “acceptable if the preferred product is not available”. With regard to masks – one of the most essential pieces of PPE for hospital staff – 3 out of 4 delivered were unsuitable for use.
It also appears that the early advice from the government which told the public not to wear masks was incorrect, and quite possibly based on resourcing issues rather than scientific evidence. Papers in BMJ and Nature, two of the most established international scientific journals, show that masks significantly reduce the spread of Covid-19 through droplets and aerosols. George Gao of the Chinese Centre for Disease Control has said that the decision not to have the general public wear masks is “a big mistake”.
Given the shortages, health workers should be prioritised, of course. However, it seems in this case that rather than ramp up production of masks for the general public, many European governments have decided to tell the public that they are not necessary.
With the Covid-19 crisis predicted to go on for many months, the continued reliance on the market and global supply chains is indefensible. In early April it was reported that Tipperary schools were coming together to make masks for local healthcare workers using 3D printers. If schools can do it, why can’t the state? The capacity of private factories to produce PPE here urgently needs to be assessed and put to work to mass produce the appropriate equipment for health workers and those working with vulnerable populations in particular.
All In This Together
Beyond the glaring issues with testing, capacity, private health and equipment, Fine Gael have tried to construct a narrative that we are all “in this together”, that we have a unified national approach and that they, at the head of it all, are showing true leadership.
Yet despite the plaudits Varadkar received after introducing the kinds of social protections that he would have balked at a year ago, workers and the newly unemployed are still struggling massively, people are still falling through the cracks, and Fine Gael have made no major moves to challenge the ultra-wealthy and make them pay their share.
The rent freeze that was deemed unconstitutional last year was introduced, along with a ban on evictions. However, rents are already far too high and a rent amnesty is what is required now. And with an eviction ban that lasts only 3 months, there is nothing to stop landlords from turfing people out on the 4th month when they cannot pay out the accumulated debt.
With regard to benefit payments, the €203 a week payment initially proposed for those out of work was brought up to €350 soon after – tantamount to an admission that the initial payment was not enough to survive on. However, the wage subsidy scheme that provides 70% of wages for those still tied to their companies but with reduced hours or no hours at all leaves many people earning significantly less than €350. There have also been reports of employers using the crisis as a smash and grab – threatening employees with the sack if they do not take a voluntary pay cut.
Far from challenging this and protecting workers, Varadkar recently channelled his spirit of old, raising the spectre of “people who asked their employers to lay them off because they would be better off on the €350 payment than maybe, working 20 hours a week for €11.”
We’re all in this together, but watch out for the welfare cheats who are once again cheating us all. In the same week, Fine Gael changed the laws so that tax exiles who ‘accidentally’ might have had to pay tax as a result of being stuck in Ireland, instead, get off scot free.
Moreover, when workers have come forward because they feel adequate safety measures are not being observed, Fine Gael have been largely silent. They have had nothing to say about Go Ahead workers who have been complaining about unsafe working conditions – with some being suspended as a result. People forget at this point that it took a massive furore on social media before Varadkar eventually ordered pubs to be closed. The same was true of construction sites, where the government supported the Construction Industry Federation before #shutthesites went viral on social media and this position became untenable.
Now, much of the discussion around “flattening the curve” has had to do with whether or not people are following social distancing protocol. There is no question that most people are – a point that Varadkar and Harris themselves have made on a number of occasions. The transmission rate of the disease has dropped dramatically, precisely because people are largely taking the measures very seriously.
Much of the government’s strategy is to praise the vast majority of people who are following the guidelines, but to draw attention to the rare cases where people are being irresponsible. It seems quite contradictory that Varadkar would one day say that distancing measures are working, and the next introduce new draconian powers for the Gardaí to stop, question and detain people, as well as punishments of fines up to €2,500 and up to 6 months in prison. This is in marked contrast with the lack of oversight of businesses who may be putting their workers in danger.
It is important that physical distancing protocol is followed, and it seems that this is largely the case. But if the virus continues to spread, the spotlight must be put back onto government inaction – why have they not taken action on nursing homes? Why is there still not adequate PPE for health and care workers? Why are so many non-essential businesses still forcing their employees come to work unnecessarily?
A Dangerous Game
Behind the spin and the grandstanding, Fine Gael are playing a dangerous game. Testing has been chaotic. A disaster is playing out in some nursing homes. The public are playing a huge part in following social distancing protocol, but with hospital and ICU capacity so low to begin with, we are still in perilous waters. With the ESRI predicting unemployment levels to reach 18%, Fine Gael still refuse to take meaningful action and provide an amnesty on rents, mortgages and bills. The assault on workers by many employers is provoking widespread anger.
In several of their grandiose speeches, Varadkar and Co. haven’t been able to help themselves; in an attempt to frighten us, they’ve raised the spectre of the “massive bill” that we will be paying for years to come. They appear to be overestimating a boost in popularity that still only leaves them at 34% in recent polls, much as they appear to have forgotten just how deeply unpopular they were only a few months ago. Now they are lining up a government deal with Fianna Fáil and a motley assortment of mudguards.
Far from rowing in behind the government as they try to spin their mismanagement and support of corporate power to the public, it is imperative that the socialist left hold them to account. We must challenge the prevailing narrative and expose their failings, because lives are at stake.
And finally, the proof is in the pudding. The evidence of the past weeks has shown that not only are political elites incapable of dealing with this crisis but that the same is true of the system as a whole. It is a question of life versus profits, capitalism versus people. Only by taking on the market can we have a humane solution to this pandemic, and to do that we need to expose the myth that “we are all in this together”.
They – Fine Gael, Fianna Fáil, the private corporations, the billionaires and the landlords – are all in this together.
We – working people and all who are struggling – must also be in this together in confronting them.