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On 25 October, Minister for Health Simon Harris announced a public health emergency regarding CPE and convened the National Public Health Emergency Team in response to the situation, citing a “rapid and worrying increase” in CPE incidence.
Minister Harris said “known outbreaks” of CPE have occurred in eight Irish healthcare facilities, resulting in “high costs and bed closures”.
A paper prepared for the HSE in December 2016, and seen by MI, described the spread of CPE as “quite advanced”. The paper, prepared on behalf of the National HSE Taskforce on HCAI/AMR, stated that CPE “containment is still possible by vigorous action now”. It was brought to the HSE leadership team in January 2017. The leadership team requested additional data, material and advice.
In early January 2017, senior HSE managers were forwarded feedback from current Lead for HCAI/AMR Prof Martin Cormican and the then Lead Dr Robert Cunney, in response to questions on the issue. This was in the context of ongoing development of a paper for the HSE leadership team.
In response to the statement “I take it we are not declaring an emergency in this case, as defined in our EM policy”, Dr Cunney responded: “Is there a reason why this has not yet been declared a public health emergency? Given the current impact in terms of deaths, avoidable illness and financial costs, and the likely far greater impact if nothing is done, I would have thought this qualifies.”
Prof Cormican wrote that the priority sites were acute hospitals and actions “needed to be done three years ago — it should be done in first quarter of 2017”.
On 20 January, senior HSE managers were issued a revised CPE document. It called for “declaration of a national public health crisis/emergency with regards to the emergence of CPE”.
In March 2017, a finalised briefing paper and proposed response on CPE were discussed and approved by the HSE leadership team, subject to some further work on costings.
This paper called for “an emergency escalation of actions to address the immediate threat to public health and sustainability of health service delivery systems”.
In May, HSE Director General Mr Tony O’Brien issued a system-wide memo. The body of the memo cited an “epidemic” and referred to an “emergency escalation of actions”. It announced a dedicated national response team led by newly-appointed Lead Prof Cormican.
See feature, pages 4-5