HSE chief warns of ‘secondary harm’ from pandemic

Modelling has shown there will be "a price to pay" for the lockdown in terms of increased mortality from cancer, the chief clinical officer with the HSE, Dr Colm Henry, has said.

Discussing the “secondary harm” that is taking place as a result of the pandemic, Dr Henry mentioned loneliness, the negative effect on children from being out of school, malnutrition, late presentations with illnesses other than Covid, and breaks in screening services.

Modelling on delayed cancer presentation indicated that “there will be a price to pay in terms of late cancer diagnosis, more interventional treatment, higher mortality for some time to come, for people with cancer, as a result of lockdown, as a result of cocooning, as a result of people presenting later.”

On the topic of children, and especially younger children, being out of school, he noted that, to date, 2.8 per cent of everyone below 18 years of age had contracted the virus, but for those at school, 98 per cent or more had suffered from absence of schooling.

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Dr Henry was addressing Professionalism in a Pandemic: Lessons from Covid-19, an online conference organised by the Royal College of Surgeons in Ireland (RCSI).

Asked for his view on what would be the “biggest learning” for the HSE from having come through the pandemic, he said it was “just incredible what can be done when you have to do something”.

It was “astonishing” what had happened within the HSE, particularly during the first Covid surge, to save lives, to save services.

“Everyone wanted to help, everyone wanted to stretch beyond their job definition,” Dr Henry said.

“You couldn’t help but feel that when people are allowed, and don’t have to seek permission to take the right decisions, at local level, at hospital level, at every single level, so much more can be done.”

The “peace time” way the HSE has of operating, that demands the verification and validation of decisions and the revisiting of decisions, sometimes “stultifies innovation”.

Dr Henry said some people had described Covid as being like the flu, but this was not the case. Covid can lead to hospital systems and ICU units being overwhelmed.

“This is not the flu. This is a virus that is deadly to individuals... and is highly virulent to healthcare systems.”

He said the experience of the first wave in particular showed that our model for caring for the elderly in congregated settings must be questioned, and there needed to be more investment in helping older people stay in their homes.

In his address to the conference, Prof Sam McConkey of the RCSI said more "space" should be given to public leaders to make mistakes and to learn from them.

Public leaders were responding to a pandemic and “unless they get the space to fail safely and learn from the problems and move on from them, then we won’t have great public policy.”