Ireland is well prepared for an Ebola outbreak. We are far from the epicentre of the current outbreak in west Africa and there are no direct flights between here and there. The risk posed by the virus to Irish citizens is, therefore, very low.
So goes the official advice on Ireland’s preparedness in the event of the disease reaching this country. It is a reassuring picture, reinforced by the knowledge that a plethora of Government agencies are “on the case” and that any infected patients will be handled by our highly trained doctors and nurses.
Yet a significant number of those same doctors and nurses are raising concerns about aspects of the plans we have to deal with the virus. Meanwhile, other Western countries are imposing stricter procedures than those currently imposed by our Government. The situation with Ebola generally remains dynamic, with the outbreak in west Africa stubbornly growing and well-equipped health services in Spain and the US failing to prevent the onward transmission of the disease.
The concerns of medical professionals fall into two categories. One relates to the failure to provide significant additional resources on the ground and the other arises from concerns about the ability of an overstretched health service to deal with an outbreak.
Anyone who has returned to Ireland from west Africa and becomes ill is being advised to contact their doctor. The exception is returning aid workers who know they have been in contact with Ebola patients, who are advised to get in touch with their local public health doctor.
As Galway GP Mary Rogan points out, public health doctors work nine-to-five, Monday to Friday. "You could have an infectious patient in our premises for hours and no advice or provision of cleaning equipment, in case the poor creature bleeds, spites, pukes or poos in the premises."
She has been issued with just one set of protective clothing, with none for her practice nurse. “Apart from emails, we have received no practical instruction on the use of the protective equipment other than wear the gloves over the sleeves and be careful taking it off. If they present to an already chaotic and overcrowded A&E, God help us all,” Dr Rogan adds.
This is a worry shared by emergency department consultant Chris Luke of Cork University Hospital. "There is simply no surge capacity in our emergency departments to handle an outbreak of something like this," he says. "Overcrowded hospital services are like turbo-charged petri dishes for diseases like Ebola."
The Irish Medical Organisation says the guidelines in place assume a fully operating and functioning health service "and this is simply not the case".
The Irish Nurses and Midwives Organisation has asked whether isolation areas will be earmarked in each of the main hospitals in case of an outbreak, but it is hard to see how this could be done in hospitals which are already teeming with patients on trolleys and chairs.
Medical Council member and GP Ruairí Hanley has suggested a telephone hotline might be a better way of dealing with worried patients rather than advising them to go to their local doctor's surgery. Dr Luke, too, favours the provision of a freephone service manned by trained professionals.
Britain yesterday began screening travellers arriving from west Africa, but this approach has been rejected by our Department of Health. Chief Medical Officer Dr Tony Holohan said that even if people arriving had Ebola, most would show no symptoms and their cases would not be picked up.
This is correct but it may miss the point. Britain’s move is not so much about medical screening as about building up a picture of people’s movements and contact details.
The constituency of aid workers returning to Ireland after working with Ebola patients in west Africa is small. It is also highly educated, well-informed and most probably self-policing. But what about the wider group of people moving between the two regions?
"Ireland now has a large African population, many from that region," according to physics lecturer at Tallaght IT Kevin Nolan, who says more than 5 per cent of his first-year students are from Africa. "Hence, Ireland has an active and current link to that region of the world."
Despite this, there doesn’t seem to have been any attempt so far to communicate directly with migrant groups. We are told the Department of Health and Department of Foreign Affairs are leading the official response to Ebola, yet the Department of Agriculture chairs the Government’s emergency planning committee. It is not reassuring that there appears to be some rivalry between the departments, at least in terms of publicity for their efforts.
Minister for Health Leo Varadkar and Dr Holohan meet the Oireachtas health committee tomorrow. It would be helpful if they were able to provide the reassurances sought by the medical community about our preparedness for Ebola.
