Health service would be in ‘serious trouble’ without asymptomatic close-contact staff working

The health service would be in “serious trouble” without the derogation measures allowing asymptomatic, vaccinated staff who are close contacts to return to work, chief clinical officer of the Health Service Executive (HSE) has said, as the positivity rate in the community stands at 60 per cent.

The scale of disruption being experienced by the health service was “unprecedented” and the HSE is trying to protect its services, Dr Colm Henry told Newstalk Breakfast on Friday.

Under the derogation measures, healthcare workers essential to critical services who are identified as close contacts can return to work, with approval from management, if they are asymptomatic and have received a booster vaccine or recovered from Covid infection within three months.

Asymptomatic staff who are fully vaccinated but have not received a booster can return under exceptional circumstances, with approval from the Office of the National Director of Acute Operations or the Office of the National Director of Community Operations

The situation “from a HSE perspective” was very difficult, Dr Henry said, with the 60 per cent community positivity rate and the fact that 25 per cent of the Covid cases in 2021 were between Christmas and New Year.

Staff could not just be redeployed to other areas, chief operating officer Anne O’Connor told RTÉ radio’s Morning Ireland, but efforts were being made to send them where they were needed most.

Confirmed cases in hospital Confirmed cases in ICU



The latest official figures, from December 31st, showed that 8,000 health services staff were not at work because they had either tested positive for Covid or were a close contact. That figure was more likely to be 14,000 to 15,000, she said.

This was “very challenging” for the health service – not just hospitals, but also general practices, community services and disability services, Ms O’Connor added.

Discharge pathways for patients were also proving difficult for hospitals as home supports and step-down facilities are under pressure because of staff shortages due to Covid, she said.

The ambulance service was also under pressure with 260 staff absent on Thursday, she said.

Ms O’Connor said prioritisation would be on the basis of clinical need. Hospitals would continue to do as much as they could and there would not be a “blanket stop” of elective services, she added, saying emergency care and time-sensitive care were “things we have to do”.

When asked when the portal to register positive antigen tests would open, Ms O’Connor said she expected it to open next week.


Meanwhile, Dr Mary Favier from the National Public Health Emergency Team said a potential easing of restrictions has to be looked at “quite soon”.

Dr Favier said general practitioners are concerned that significant non-Covid diagnoses are being missed and restrictions across healthcare and society would be lifted “reasonably quickly”, but not completely, “with a view to getting healthcare workers back to work, getting society functioning when we have a better sense of what those figures mean”.

“There’s always a balance in healthcare with prioritising Covid care and then non-Covid care taking a back seat. And you always have to do that in terms of what’s the most beneficial and what gives the largest health gain,” she said.

“The last thing anybody wants to do is go backwards . . . but hopefully we’re starting to see some glimmer of light,” Dr Favier added.

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