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Ireland’s dedicated Magazine for the public sector, semi state bodies and civil service

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HEALTHCARE & FRONTLINE SERVICES

COVID-19

Lessons & Challenges

HEALTHCARE OUTLOOK 2020

EVERYDAY HEROES Life on the Frontline www.thepublicsector.org

Is Recovery in Sight?

PAUL REID, HSE

SPOTLIGHT ON THE HSE

JUSTINE MCCARTHY, EY

PANDEMIC PREPAREDNESS

STEPHEN DONNELLY, MINISTER FOR HEALTH

BATTEN DOWN THE HATCHES


Thank you for staying at home. The key to staying safe is in your hands. Stay home, stay safe from all at Mercedes-Benz.

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Public Sector Magazine

A wide choice of online support to help in this challenging time We have a range of informative content available to help keep you and your patients safe during the COVID-19 crisis. • Live webinars on subjects including remote consultation and working outside your comfort zone – all recorded to watch at a time that suits you. • A wide range of online learning modules available, including record keeping, obtaining consent and more. • Podcasts covering a variety of relevant topics – available via Apple Podcasts, Google Podcasts, Spotify and more.

Visit our website to find out more

medicalprotection.org/ireland the Public Sector Magazine

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Public Sector Magazine

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Public Sector Magazine

The hands of time kept moving. Luckily for Ireland, so did yours. We felt trapped in time. But you kept working. You kept us safe. You never stopped protecting Ireland. Now, as we all start moving again, we’d like to thank our frontline workers with a complimentary sanity treatment* with any service or repair booked online at AudiService.ie or with your local Audi dealer. We’re also offering a 15% discount on any products purchased online at AudiShop.ie using the code FRONTLINE15. You never stopped being brilliant. We’ll never stop being grateful. All of Ireland thanks you for your time.

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Public Sector Magazine

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Public Sector Magazine

Contents Ireland’s dedicated magazine for the Public Sector, Semi State Bodies, Local Government, Healthcare and Frontline Services

Editor Trish Phelan trish@devlinmedia.org Sales Helen Fairbrother Linda Hickey Martin O’Halloran Michael Quigley Paul Halley Production Manager Joanne Punch

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Ad Copy Sinead Power

13 HEALTHCARE IRELAND

67 CLEAN AIR

Contributors Jacqueline Bragg Caoimhin Mac Carthaigh

Design Minx Design ruth@minxdesign.ie

21 THE NEW NORMAL

The Public Sector Magazine is an informative guide for Government, Civil, Public Sector and Semi State decision-makers. It is distributed to, amongst others, Government Ministers, Ministers of State, Dáil Members, Senators, Secretaries of Departments, Deputy Secretaries, Assistant Secretaries, Principal Officers, CEO’s of State and Semi-State Bodies, County Managers, County Councillors, Purchasing Officers, Press Officers, IT Managers and Training Officers, the HSE, Emergency Services, Doctors, Financial Institutions, Unions, Representitive Bodies, Embassies, Public and Private Partnerships and Political Commentators.

COVID-19 has placed unprecedented pressure on an already stretched healthcare system.

The current pandemic has changed life as we know it, forcing us to accept that our reality has changed, possibly for good.

75 BEHIND THE MASK

35 BREAKING THE CODE

DNA changes tied to immune reactions, a viral doorway and blood type could affect disease severity.

53 PROTECT & SERVE

The outbreak of COVID-19 has had an explosive impact on the growth of the personal protective equipment market.

The lockdown affecting over half of the world’s population has severely restricted economic activity with the unintended consequence of reducing air pollution.

Face masks are a symbol of the pandemic era; a visual metaphor for the invisible foe that could be lurking around any corner.

83 EVERYDAY HEROES

Coronavirus has brought out the very best in our emergency services and has led to an outbreak of a different kind heart-warming acts of kindness.

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97 LIFE BEGINS

The concept of golden years is changing. Sixty is the new forty according to scientists who say that longer, healthier lives mean people are hitting middle-age much later in life.

117 SUPPORT SERVICES

The continuing fallout from the coronavirus pandemic and the financial and emotional impacts is putting unpredicted demand on support services.

139 HOMELESSNESS

Housing in Ireland has been mired in controversy for decades with most people believing that government is not doing enough to tackle homelessness.

147 ASK THE EXPERTS

Struggling businesses look to outside consultants to recover and prepare for a post-COVID world.

161 DEEP CLEAN

Hygiene controls are vital if we are to return to any kind of normal at home and in the workplace.

169 MONEY MATTERS

Two-thirds of Irish adults are worried about their finances as coronavirus wreaks havoc on the economy.

185 RESTART IRELAND

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2020 will be a year to remember posing enormous challenges to business as they struggle to press the reset button.


Frontline & Healthcare

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Allied Irish Banks, p.l.c. is regulated by the Central Bank of Ireland.

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Public Sector Magazine

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Frontline & Healthcare

Curing the Healthcare System A variety of recent reports and strategy documents have highlighted the intimidating range of challenges facing Ireland’s health system as it seeks to improve its performance.

The health status of Irish people has improved substantially in the last two decades with life expectancy registering huge gains and most people reporting being in good health. Despite this progress, there is a consensus that the health system is underperforming and that a fundamental transformation is needed to make it fit for purpose and to meet future demands associated with an ageing society. Key areas to be tackled include introducing a universal health system, building up the health system to improve access and adequately meet healthcare needs, more consistent workforce planning and better budget management at all levels. COVID-19 has placed unprecedented pressure on the healthcare system. The emergency measures implemented to date are welcome and necessary, however, in the medium and long term the issues of bed capacity, lack of step down care facilities and the need to broaden access to community care must be addressed so the acute hospital system is better placed to deal with any future shock. Before the COVID-19 pandemic ever reached these shores Irish hospitals were already working near full capacity. The occupancy rate for acute care beds is among the highest in OECD countries (Organisation for Economic Co-operation

and Development), and while having a high utilisation rate of hospital beds can be a sign of hospital efficiency, it can also mean that too many patients are treated at the secondary care level. Even though Ireland spends 25% more per capita on health than the OECD average, the number of beds per 1,000 population is considerably less than the OECD average and hospital bed occupancy rates in Ireland reaches almost 95% - the highest in the EU 28. In its report on the Irish Healthcare system in 2019, the OECD found it to be hospital-centric, with significant capacity constraints in primary and secondary care. It concluded that the current health infrastructure is simply not adequate for current demand and unable to cope with the projected increases due to population ageing. And that was before a global pandemic. One of the things that contribute to this situation is the inability to discharge people, often older patients, due to problems accessing support in the community. The problems associated with our high bed occupancy rates are associated with a persistent failure to invest properly in areas such as primary care, community care and step-down facilities. A recent ESRI report highlights the unmet need for formal home support, finding that Ireland provides formal care to only

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Public Sector Magazine

trying to making sense of COVID-19 is to look through a kaleidoscope. Within its brief existence, the virus has unleashed a storm of attempts to make sense of the present against the backdrop of past pandemics.

24% of those needing it and that 38% of people over 65 have unmet needs for care, as do 34% of disabled adults. The HSE estimated in 2017 that increasing availability of rehabilitation beds would potentially free up 12% of delayed discharge beds. In 2019 the OECD came to a similar conclusion noting that the high rate of delayed discharges in Ireland contributes to high hospital bed occupancy rates. Hospital bed occupancy rates could be reduced if post-discharge planning and care arrangements for the elderly were improved and if access to primary care and community care was improved.

The COVID Challenge The failure to properly invest in primary care was having detrimental impacts on the Irish healthcare system long before the arrival of COVID-19, but this lack of investment now leaves the system painfully exposed. In a policy briefing on healthcare system responses to COVID-19, the OECD emphasises that the experience in China and Italy has highlighted the critical need to ensure adequate capacity of hospital beds in general and intensive care. The report finds that given the characteristics of the treatment required for the most severe COVID-19 patients, the most important

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bottlenecks in hospital capacity are taking place in intensive care beds. A preliminary analysis of the most recent publicly available data suggests that across ten OECD countries, the variation in capacity is six-fold, ranging from a high of 33.9 critical beds per 100,000 population to a low of 5.0 beds per 100,000. Ireland is at the low end with just 5.0 beds per 100,000 of population. High occupancy rates of acute care beds are symptomatic of a health system under pressure that has limited capacity to handle an unexpected surge of patients requiring immediate hospitalisation. Ireland has almost no capacity when it comes to this issue with a bed occupancy rate of 95%. This problem has been highlighted for several years and is primarily a result of a lack of an integrated primary and community care structure. Ireland remains the only Western European country without universal coverage for primary care. The correct policy response in the Irish context in the medium to long-term, once this crisis is over, is to focus on developing the primary care and community care infrastructure so that acute care beds can be made available quickly in times of extreme pressure such as we are experiencing at present. This requires investment and a rebalancing from the current system of reliance on hospital care with resources being diverted to primary care and Slรกintecare.


Frontline & Healthcare

Healthcare for All

particularly from the Department of Health and the Department of Employment Affairs and Social Protection. Minister for Finance Paschal Donohoe said, “the extraordinary increase in public expenditure is a result of the government’s commitment to supporting our health service and the wider economy through this unprecedented period, as demonstrated with the announcement of the July stimulus plan to support businesses and get people back to work.” Referring to the €7billion stimulus plan Taoiseach Micheál Martin said the package was an “unprecedented set of measures required by unprecedented times”. He went on to say that the impact of the virus had unleashed a recession more “rapid and dramatic” than ever before recorded.

In May 2017, an Irish cross-party parliamentary committee published the Houses of the Oireachtas Committee on the Future of Healthcare Sláintecare report. The report highlighted the importance of fundamental changes in the Irish health system and the conviction that the system was not performing as well as it could. Sláintecare set out an ambitious roadmap to deliver whole system reform and universal healthcare over a tenyear period. The vision is to establish a universal, single-tier health service where patients are treated solely based on health need and the reorientation of the health system ‘towards integrated primary Health Minister Stephen Donnelly: and community care consistent with the highest quality of patient safety in as short Winter Ready a time-frame as possible.’ Minister for Health, Stephen Donnelly In preparation for what lies ahead, the says that the Sláintecare plan remains the Taoiseach announced a €600 million main route to reforming the healthcare winter plan for the health service which system and that the move towards aims to increase capacity in hospitals universal healthcare had to be accelerated and in the community to boost services in response to the COVID-19 crisis. against the backdrop of the COVID-19 “Covid has created a perfect storm. pandemic. A key part of the plan is an It means we need a very large amount of expanded flu vaccination initiative which additional spending, money that could government sources suggested could cost have been deployed on other parts of the €64 million. The HSE has placed orders healthcare system. The waiting lists have for approximately 1.35 million doses of flu shot way up. The in-patient waiting list vaccine for adults and 600,000 doses for since March has gone up by almost a third. children aged between two and 12 years. “A number of measures are now The winter flu is so-called because needed to address the changes seen influenza thrives in colder temperatures in recent months. We need to expand and prefers the humidity levels in the the capacity within the HSE - that winter months. The virus is also more means running the operating theatres likely to be transmitted when people and diagnostic suites longer, getting keep windows and doors closed. And everything we can out of the primary care in the cold, wet months at the end of the centres and ramping up on telemedicine.” year, staying socially distanced outdoors or in well-aerated The Minister said there was a need to secure short-term rooms becomes much more difficult. At present, it is too early capacity from outside the HSE - a strategic partnership with to determine whether COVID-19 is similarly affected by the private providers. He pointed out that there are 11,000 beds in changing seasons but there is evidence that people can be the public system and 20% of them now need to be kept vacant infected by both viruses at the same time. for infection control measures. “All ideas need to be on the table “We don’t yet understand how that alters the severity of and everyone needs to come together to face the enormous the disease,” Dr Kim Roberts, Assistant Professor of Virology challenges created by the COVID-19 pandemic.” at Trinity College Dublin said. He added, however, that both Budget Implications viruses have an impact on the respiratory system so recovery from one virus could make a case of the other more serious. The health budget implication is one such challenge with the The winter plan also includes the introduction of 1,000 pandemic having bored an €8 billion hole in Ireland’s finances additional acute and sub-acute beds with a workforce of 3,000 due to widespread business shutdowns and an extraordinary people involved in testing for COVID-19, as well as contact increase in government spending. tracing. The plan sees GPs having access to diagnostic services According to the Department of Finance, the increase in for their patients in the community in order to keep them spending reflects the response to the COVID-19 pandemic, out of hospitals as much as possible. There will also be new

“The combination of winter and

what Covid has done to our

healthcare system means that this winter will

probably be the

most challenging

time in healthcare in living memory.”

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Public Sector Magazine

“Protecting public health remains an absolute clarity. We are a resilient people. As a nation, throughout our history, we have come through every manner of trial and hardship. And this too will pass.” community assessment hubs which will aim to deal with patients, particularly those with chronic conditions, without them having to be admitted to hospitals. The provision of several million additional home-support hours is included, to enable people in hospitals to return home or to stay in their homes. Sources suggested that up to three million additional home support hours could be provided for in the new plan. Commenting on the plan Minister for Health, Stephen Donnelly said: “the combination of winter and what Covid has done to our healthcare system means that this winter will probably be the most challenging time in healthcare in living memory.”

Resilience & Recovery Trying to make sense of the difficulties we now face is to look through a kaleidoscope. Within its brief existence, the virus has turned healthcare systems worldwide on its head unleashing a storm of attempts to make sense of the present and protect for the future against the backdrop of previous epidemics and pandemics. All across Europe, the virus is regaining its foothold and spreading at a rate not seen since March and April. Currently,

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Ireland is moving from a short-term emergency response approach to a medium-term approach to managing risk and repairing the damage that the coronavirus has inflicted on society. Taoiseach Micheál Martin said: “we must continue to live with the reality that COVID-19 is potentially deadly, causes long-term illness, and we must limit the spread. “When a vaccine is available we will move quickly to implement a widespread vaccination programme, however, I want people to understand that even before then, we can go much further in opening up economic, social and cultural life in our country. At all times the priority will be to keep schools open while keeping people safe and protecting the resilience of the economy and communities. “Protecting public health remains an absolute clarity,” he said. “We are a resilient people. As a nation, throughout our history, we have come through every manner of trial and hardship. And this too will pass. The great responsibility that rests on each and every one of our shoulders is to do everything we can to make sure that when it does pass, we have brought as many of our families, friends and neighbours with us, alive and in good health, to enjoy the better and brighter days that lie ahead.”


Frontline & Healthcare

FIANNA FÁIL RECOGNISES AND THANKS OUR FRONTLINE WORKERS FOR THEIR CONTINUED COMMITMENT AND HARD WORK, PARTICULARLY DURING THE COVID-19 PANDEMIC.

www.fiannafail.ie the Public Sector Magazine

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Facts about flu.

Public Sector Magazine

Flu causes death and hospitalisation every year. Flu vaccine is the best protection against flu for at risk groups and health care workers. You need to get flu vaccine every season as the viruses change every year.

Flu vaccine contains killed viruses - it cannot give you flu. Healthcare workers are up to 10 times more likely to get flu. Healthy people can have flu without any obvious symptoms and pass it on.

FLU VACCINE IS A LIFESAVER. GET YOUR FLU VACCINE NOW.

www.hse.ie/fl u 18 the Public Sector Magazine Order code HNI01089


Frontline & Healthcare

HSE Seasonal Flu Vaccine Influenza (flu) is a highly infectious acute respiratory illness caused by the flu virus. Flu affects people of all ages, with outbreaks occurring almost every year. Flu symptoms come on suddenly with a fever, muscle aches, headache and fatigue. This is different from a cold which is a much less severe illness compared to flu. A cold usually starts gradually with a sore throat and a blocked or runny nose. Symptoms of a cold are generally mild compared to flu.

Flu is predictable. In some instances, flu can be severe and can cause serious illness and death. Serious breathing complications can develop, including pneumonia and bronchitis, to which older people and those with certain chronic medical conditions are particularly susceptible. Pregnant women may need hospital treatment and hundreds of people die from flu each winter. This year the seasonal (annual) flu vaccine protects against four common virus strains. The flu virus changes each year this is why a new flu vaccine has to be given each year. The best way to prevent flu is to get the flu vaccine. The vaccine is recommended for all those 65 years of age and over; pregnant women; those with long term medical conditions e.g. heart or lung disease and all frontline healthcare workers including carers. Vaccination should ideally be undertaken in September or early October each year. Flu vaccines have been used for more than 60 years worldwide and are very safe. Flu vaccine contains killed or inactivated viruses and therefore cannot cause flu. It does,

however, take 10-14 days for the vaccine to start protecting you against flu. The vaccine and consultation are free to those within the recommended groups who have a ‘Medical Card’ or ‘GP Visit Card’. GPs and pharmacists charge a consultation fee for the seasonal flu vaccine to those who do not have a ‘Medical Card’ or ‘GP Visit Card’. More information is available from your GP, Public Health Nurse or pharmacist. www.hse.ie/flu provides details about flu vaccination, along with answers to any questions you may have about flu.

Pneumococcal vaccine If you are over 65 or have a long-term medical condition you should also ask your doctor about the pneumococcal vaccine which protects against pneumonia, if you have not previously received it. You can get the flu vaccine at the same time as the pneumococcal vaccine.

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Frontline & Healthcare

The New Normal The COVID-19 pandemic has changed life as we know it, forcing us to accept that our reality has changed, possibly for good. This is the new normal.

Scientists and medical researchers have for years differed over the exact definition of a pandemic but one thing everyone agrees on is that it describes the widespread occurrence of disease above what might normally be expected. Cholera, bubonic plague, smallpox and influenza are some of the most brutal killers in human history with smallpox having killed between 300-500 million people in its 12,000-year existence. One of history’s most devastating pandemics, the socalled Spanish Flu is seen as an important benchmark to learn lessons from in the face of the current crisis. The 1918 influenza pandemic was the most severe in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is no universal consensus on where the virus originated, it spread rapidly worldwide. It infected 500 million people–about a third of the world’s population at the time–in four successive waves.

Between 1918 and 1920 the outbreak tore across the globe, infecting over a third of the world’s population. Of the 500 million people infected, the mortality rate was estimated at 10% to 20%, with up to 25 million deaths in the first 25 weeks alone. What separated the 1918 flu pandemic from other influenza outbreaks were the victims. Where influenza had always previously only killed juveniles and the elderly or already weakened patients, the Spanish flu struck down hardy and completely healthy young adults, while leaving children and those with weaker immune systems still alive. With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections associated with influenza infections, control efforts worldwide were limited to isolation, quarantine, improved personal hygiene, use of disinfectants and limitations of public gatherings.

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Public Sector Magazine

The presence of a large reservoir of SARS-CoV-like virus in horseshoe bats, together with the culture of eating exotic mammals in southern China is a time bomb. Almost 90 years later, in 2008, researchers announced that they had discovered what made the 1918 flu so deadly. A group of three genes enabled the virus to weaken a victim’s bronchial tubes and lungs and clear the way for bacterial pneumonia. The 1918 flu lasted until 1920 and is considered the deadliest pandemic in modern history. Today, as the world grinds to a halt in response to the coronavirus, scientists and historians are studying the 1918 outbreak for clues to the most effective way to halt this new global pandemic.

A New Threat Emerges Beginning in December 2019, in the region of Wuhan, China, a new (“novel”) coronavirus began appearing in human beings. The virus spread incredibly quickly between people and no one had immunity because no one had COVID-19 until 2019. While it was initially seen to be an epidemic in China, the virus spread worldwide within months. The WHO declared COVID-19 a pandemic in March and by the end of that month, the world saw more than a half-million people infected and nearly 30,000 deaths. Countries across the world declared mandatory stay-athome measures, closing schools, businesses and public places. Dozens of companies and many more independent researchers began working on tests, treatments and vaccines. The push for the human race to survive the pandemic became of primary concern worldwide. As the world digests the ever-changing coronavirus story, lost in the shuffle are important public health insights about how viruses work and how humans respond. The disease was first spotted by epidemiologists who identified a Sars-like virus that appeared to have emerged from live animals held in a wet market. These markets are still the subject of much scrutiny, but other scientists have argued that the virus probably began elsewhere, as data suggests many of the first patients probably caught the disease before people in the market were infected.

Lying in Wait The coronavirus could have been lying dormant across the world until being ignited by favourable environmental conditions rather than originating in China, a leading expert has claimed. Professor Tom Jefferson, of Oxford University’s Centre for Evidence-Based Medicine (CEBM), pointed to a string of recent discoveries of the infection’s presence around the world before it emerged in Wuhan in December 2019. Traces of COVID-19 have been found in sewage samples from Spain, Italy and Brazil which pre-date its discovery in China. Discussing the possibility the virus didn’t originate in China, Professor Jefferson said that strange things like this happened with Spanish Flu. “In 1918 around 30 per cent of the population of Western Samoa died of Spanish Flu yet they hadn’t had any

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communication with the outside world. The explanation for this could only be that these agents don’t come or go anywhere. They are always here and something ignites them, maybe human density or environmental conditions, and this is what we should be looking for.” Professor Jefferson believes that the virus may be transmitted through the sewage system or shared toilet facilities. Virologists in Spain claimed they found traces of the disease in samples of wastewater from March 2019, almost a year before it struck Europe. Scientists suggested it went under the radar at the time because it was flu season and nobody was looking for it. But other experts questioned how it was possible for the virus to exist at detectable levels but not cause outbreaks. Italian health chiefs also found sewage water was contaminated with the virus in the cities of Milan and Turin in December and Brazilian researchers claimed they found traces of the virus when they analysed wastewater samples taken from Florianopolis in November 2019. Scientists remain baffled as to how the virus jumped to humans. It has been linked to bats, pangolins and snakes. Experts have repeatedly claimed the coronavirus may have been lurking in animals for decades before adapting to be able to strike humans. Sir Jeremy Farrar, Director of the UK-based global health charity Wellcome is convinced that this is not a brand new virus. “It is likely to have been circulating in animals in China and maybe other parts of Asia, probably for years if not decades,” he says. He added that it probably hadn’t had an effect on humans until now or caused such mild infections that ‘no-one was bothered about’ it. But Sir Jeremy said “something changed,” claiming the virus may have adapted to animals or mutated to become infectious to humans.

A Perfect Storm Fever, cough and shortness of breath are the most common symptoms, but the list of Covid symptoms has grown over the months. We now know many common cold and flu symptoms play a role such as a sore throat, headache, body and muscle aches, chills and shivers, a runny or congested nose, intense fatigue (which can last longer than the illness), diarrhoea, nausea and vomiting. Newer symptoms more recently identified include skin rashes and ‘Covid-toes’ where the toes become red and swollen from tiny blood clots. More early signals include pink eye (a highly contagious eye condition also known as conjunctivitis), anosmia (a loss of smell that can also lead to a loss of taste) and a sudden, new onset of confusion, even to the point of delirium. Science now knows that anyone at any age with at least one chronic health condition is at greater danger from COVID-19. The risk rises with increasing age and the number of underlying medical conditions, however, people in their 20s, 30s and 40s -- even some children - have collapsed and died from COVID-19


Frontline & Healthcare

The virus can infect anyone, even babies in the womb. It’s how your body responds to it that is the key question. The answer appears to be a complex interplay between viral load, age and health. when their immune systems overreacted to the virus in what is called a cytokine storm. The virus can infect anyone, even babies in the womb. It’s how your body responds to it that is the key question. The answer appears to be a complex interplay between viral load, age and health.

Risk Factors The list is long and growing. Currently, it includes diabetes, chronic lung disease or asthma, cardiovascular disease, cancer (or are undergoing chemotherapy), organ transplants, sickle cell anaemia, kidney disease with dialysis, poorly controlled HIV infection, obesity and any autoimmune disorder. Early in the pandemic, expecting mothers and their foetus or new-born were not considered at high risk but that too has changed as doctors have found the virus can cross the placenta

to infect the unborn child. We now know that women who are pregnant are 50% more likely to end up in intensive care and 70% more likely to receive mechanical ventilation. Nursing homes have been hardest hit as residents in these facilities are older, weaker and likely to have multiple health issues and frail immune systems. The toll has been devastating. In Belgium, France, Ireland, Canada and Norway it was over 50% while in the US, nursing home residents comprised 35%​of the more than 87,000 coronavirus deaths r​ ecorded as of May 15.

Transmission The vast majority of transmission of SARS Covid-2, the novel coronavirus’s scientific name, is person-to-person. The virus predominately spreads via respiratory droplets sprayed into the air as an infected person coughs, sneezes, sings or talks. For the most part, these droplets can travel in about a six-foot radius

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Particular Sciences located in the Rosemount Business Park, Ballycoolin wish to offer their best to the Dublin West members. We support the many high technology industries that operate effectively in Ireland. As well as the colleges and research groups that provide the graduates and training they need.

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Special Thanks from Cystic Fibrosis Ireland ‘If as we’re walking a hand should slip free I’ll wait for you And should I fall behind Wait for me’ Cystic Fibrosis Ireland, the patient group for those with CF in Ireland, takes this opportunity to say a special ‘thank-you’ to everyone who is keeping our vital public and community services going during the COVID-19 crisis. Your commitment is really fantastic and much appreciated by all of us in Cystic Fibrosis Ireland.

Heartfelt thanks to all who also contributed to our recent 65 Roses Day Appeal. www.65RosesDay.ie


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from the infected person. Heavier droplets fall more quickly to the ground, thus infecting surrounding objects with the virus, which can stay viable to some degree for days. While the virus does break down and become weaker as time goes on, studies have found traces of SARS Covid-2 after four hours on copper, 24 hours on cardboard and two to three days on stainless steel and plastic. Recent studies show smaller respiratory droplets that sputter out of an infected person’s mouth can dry out more quickly, thus possibly allowing the virus to become aerosolized and float away into the air. In extremely large, well-ventilated areas and outdoors, air circulation will dilute the particles, thus greatly lowering any risk. That changes inside smaller, enclosed spaces such as inside restaurants, offices, shops, cars, public transport etc.

Incubation Period Science now knows there is a lengthy and somewhat uncertain incubation period after exposure to COVID-19. Typically, symptoms will appear within five to seven days, but they can show up as early as two days after exposure and as late as 14 days, with a rare few taking even longer. Like many viruses, the novel coronavirus is contagious well before it makes itself known. Researchers estimate anyone infected can spread the virus to others 2 to 3 days before symptoms start and may be the most contagious in the one to two days before they feel sick. One of the deadliest discoveries researchers have made is that the virus can cause no symptoms or possibly such mild symptoms that a person has no idea they have the disease. These asymptomatic and presymptomatic people go about their lives spreading the virus without knowing it, a key reason wearing a mask when in public is so important. Clinical and laboratory studies show cloth face coverings reduce the spray of droplets when worn over the nose and mouth.

Face Protection Early in this pandemic, scientists didn’t know how easily this new virus spreads between people without symptoms, nor did they know how long infectious particles could linger in the air. There was also a shortage of respirators and face masks among health care workers who were quickly overwhelmed with COVID-19. Since then recommendations have changed with the widespread use of face masks in many countries including Ireland. Scientists have made many recent discoveries about this new coronavirus, including: n It’s easy to spread this virus by just talking or breathing. n This coronavirus is highly contagious. Without mitigation efforts like stay-at-home orders, each person with coronavirus infects on average another two to three people. That makes it twice as contagious as the flu. n This virus has a long incubation period – up to 14 days – giving a wide window of opportunity for people to infect others before they even know they are infected. n Carriers may be most contagious in the 48 hours before they get symptoms, making transmission even more blind. In the 1918 flu pandemic, the key to flattening the curve was social distancing. And that remains true a century later in the current battle against coronavirus. “There is an invaluable treasure trove of useful historical data that has only just begun to be used to inform our actions,” Columbia University epidemiologist Stephen S Morse wrote in an analysis of the data. “The lessons of 1918, if well heeded, might help us to avoid repeating the same history today.”

Immunity Scientists around the world have been hoping that being infected with SARS Covid-2 will produce powerful antibodies and immunity against any future exposure to the virus – much like having measles, mumps and chickenpox protects from ever

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getting any of those diseases again. Recent non-peer-reviewed studies show good and bad news. It does appear that people develop antibodies after recovering from COVID-19. Some develop more than others, possibly due to the amount of virus they were exposed to and their body’s immune response. Unfortunately, however, at this time, those antibodies don’t appear to last more than a month or two. That means SARS Covid-2 may behave like other, more common coronaviruses circulating every year known to cause the common cold. “Similar short-lived responses are seen against other human coronaviruses that predominantly cause only mild illness, meaning that we can be re-infected as time goes by and outbreaks can adopt seasonality,” said Stephen Griffins, associate professor in the University of Leeds School of Medicine in the UK. “With the more serious, sometimes fatal, outcomes of SARSCov2, this is troubling indeed,” Griffins added. “It’s possible that lingering memory immune cells may recognise and battle the virus the next time it invades, thus possibly leading to a milder case of but there’s no way of knowing that right now.” How this lack of immunity will affect many of the vaccines under development is also unclear. Will they produce enough of an antibody response to last? “It suggests vaccines will need to be better at inducing high levels of longer-lasting antibodies than the natural infection or that doses may need to be repeated to maintain immunity,” said Dr Mala Maini, a professor of viral immunology and consultant physician at the University College London.

Vaccine Scientists have toiled to create a vaccine in record time, with the Trump White House naming its vaccine Operation Warp Speed as it invests $1.9 billion into the Pfizer project. But after severe lockdowns reduced the viruses spread in Europe, Western researchers looked further afield for heavily infected populations in which to test the vaccine. In Brazil where the virus is rampant, officials reached out to British, Chinese and US firms to run trials in the hope that Brazil might get faster local production of the eventual vaccine. And so it is that in the corner of a COVID-19 ward in Sao Paulo, Brazil, a woman cleaning the mouth of an intubated patient carries an extraordinary hope for pretty much all of us. Slipping a mouthwash-soaked brush into an elderly woman’s mouth, at great personal daily risk, dentist Denise Abranches has something more than courage in her veins. Abranches was the first of an expected 5,000 Brazilian key workers in the healthcare system to receive a trial coronavirus vaccine from Oxford University and multinational pharmaceutical company AstraZeneca, along with volunteers in the UK and South Africa. Across the city, frontline medics like her have enrolled in a Phase 3 test of the vaccine’s efficacy as they battle the pandemic, which has infected more than 2 million Brazilians. And it isn’t just Oxford testing its vaccine in this vast human petri dish. Chinese firm Sinovac recently began trials in Sao Paulo, and US pharma giant Pfizer are well underway in human trials that began in late July, bringing a race among powers to prove their vaccine works first. If successful, the vaccine trials already underway should bring mass-produced vaccines to Brazil faster. AstraZeneca has agreed to let Brazil’s

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Fiocruz Centre make the vaccine locally, producing bulk quantities even before the trial ends, and Sinovac has agreed to share its technology with Brazilian partners. Brazil’s interim health minister also expressed interest in buying doses of the drug that Pfizer is developing. Pfizer and its partner BioNTech released preliminary data showing that one of their vaccines, known only by its experimental name BNT162b1, appeared safe and elicited antibody and T-cell immune responses in a Phase 1/2 trial. They subsequently began an advanced trial of one of their experimental coronavirus vaccines in volunteers in the United States where the first four participants were dosed at the University of Rochester Medical Center. The combined Phase 2/3 trial, which looks for safety, efficacy and optimal dosing of a vaccine or drug, will include up to 30,000 participants. It was the second advanced trial of a coronavirus vaccine to get underway in the USA following Moderna’s Phase 3 trial of its experimental vaccine. Pfizer’s vaccine is different, but also uses an experimental approach that employs genetic material to stimulate an immune response against a key part of the coronavirus. Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases predicts that a coronavirus vaccine will be developed by the end of 2020. “I believe that by the time we get to the end of this calendar year that we will feel comfortable that we do have a safe and effective vaccine.” He added that in a number of vaccine trials,


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While we live in times when humankind possesses the most advanced science and technology, a virus invisible to the naked eye has stopped the world in its tracks. there is “enough data that you would really feel comfortable it was safe and effective for the American public.” Echoing this sentiment Director General of the World Health Organisation (WHO) Dr Tedros Adhanom Ghebreyesus said: “A number of vaccines are now in phase three clinical trials and we all hope to have several effective vaccines that can help prevent people from infection.”

United we Stand The new decade started out as any other but rapidly unfolded into a scenario that will be remembered for centuries. The COVID-19 pandemic has unleashed changes that seemed unthinkable just a few months ago giving rise to a global catastrophe that has devastated society and economies. There are few if any aspects of day-to-day life that have not in some way been changed. Yet while the pandemic took the business world by surprise, epidemiologists had long warned that it was only a matter of time before such a disaster struck. Bill Gates, who has spent much of his time and money looking at viruses and vaccines warned several years ago that a new disease causing a global pandemic was a matter of when, and not if. “The coronavirus pandemic pits all of humanity against the virus,” Gates says. “The damage to health, wealth and well-being has already been enormous. This is like a world war, except in

this case, we’re all on the same side. Everyone can work together to learn about the disease and develop tools to fight it. I see global innovation as the key to limiting the damage.” A picture is emerging of the kind of society needed to withstand the future outbreaks scientists say are inevitable. The COVID-19 pandemic is a wake-up call for multilateralism. It has highlighted the fact that united we stand, divided we fall. Going forward we need strong international cooperation and worldwide solidarity to fight this and future disease – and future diseases will come; they are likely already lurking. In the words of virus hunter and Chair of the Global Virome Project: “When you look back over the last 20 years, our whole approach to emerging viral threats from SARS onward has been to wait and react. Wait and react,” he says. “And that is a recipe for global disaster. Whatever future threats we’re going to face already exist; they are currently circulating in wildlife. Think of it as viral dark matter. A large pool of viruses are circulating and we don’t become familiar with them until we see a spill over event and people getting ill. Chinese Foreign Minister Wang Yi expressed the sentiments of many in a speech to the National Peoples Conference: “The most important thing we can learn from COVID-19 is that the life and health of people in different countries have never been so closely connected. It has never been so clear that all nations live in the same global village and that humanity is, in fact, a community with a shared future.”

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Society of African Missions www.sma.ie

SMA are involved in:

Teaching Radio and TV programming Building schools, clinics and churches Environmental awareness and protection Health care Prison chaplains Running parishes Provision of clean water Training new priests...

Irish SMA priests are working in five African countries. We have a varied and challenging life.

...and much more

Do you want a challenge? Why not be a missionary? 350 SMA priests work in 18 African countries For information on the life of an SMA missionary contact Fr Anthony Kelly at vocations@sma.ie To support our work you can donate online at www.sma.ie

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Sisters of St Joseph of Cluny would like to express heartfelt appreciation to all frontline staff for effective and cheerful service always especially during CoVid


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A Strange New World Marxist revolutionary Vladimir Lenin said, “there are decades where nothing happens and there are weeks where decades happen.” Writer and journalist Jacqueline Bragg visited Ireland in the weeks leading up to lockdown and found herself in a time and place where much and nothing happened.

Tuesday, 17th March 2020 was a St Patrick’s Day like no other. A usually joyous expression of all that it is to be Irish with pubs fill to the brim and noise levels reaching the sky, had all fallen silent. In Temple Bar – the ultimate pub hub of Dublin handfuls of people walked where thousands usually spill over onto the cobbled streets. Even more surreal to those of us who dared to wander, the pubs are all closed. The night before the Irish government has advocated that pubs and nightclubs should be closed before the annual festivities to offset a potential mass contagion of coronavirus. Defined as a pandemic by the World Health Organisation (WHO) on 11th March, the virus had already killed two people in Ireland and 169 cases in total had been reported. This vicious and indiscriminate attacker had been cutting swathes through global populations at an unprecedented level and sending shockwaves of fear throughout the world. The virus had already declared its hand and its lethal reach was only just beginning to

be understood. It was about to change the world as we know it. Governments worldwide react, some slower than others, mindful of their own agendas and working initially with sparse knowledge and conflicting information. They turn to scientific experts and specialist advisors for some form of clarity. Decision-making seems muddled and yet timing is so critical in this crisis scenario as the number of cases grows exponentially. Media reports and gauging the public mood plays an important part in the decision-making process in a chaotic time. Some EU states such as Spain have already initiated a strict lockdown, enforcing social distancing and limiting freedoms of movement with military precision since 14th March. New words and expressions are entering everyday vocabulary and lockdown begin to sound less like a brutal response to a fairly benign infection and more like a rational policy to shore up the tsunami of new infections. Most EU governments attempt to adhere to WHO advice to implement public health practices such as self-

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isolation to help contain the spread of the virus. In Ireland, a containment phase has already been in place since the beginning of March, as the first few infections surfaced and testing began on a small scale. There are initial indications that some people who test positive have no apparent symptoms at all. Others are suffering from what is described as “a new incessant cough” coupled with a fever. Media reports claim that most of the initial primary infected people had recently returned from Northern Italy, including many teens who visited on an ill-advised ski trip. At this stage, government advice to those who think they may have the virus is to self-isolate for 14 days with anyone suffering flu-like symptoms to contact their health service if symptoms persist. Another unknown concept enters the universal psyche ‘COVID-19’ - the strain of coronavirus rampaging through our lives. While coronaviruses are also the cause of the common cold, this one is more virulent. The earlier SARS-CoV and MERS-CoV viruses, originating in 2003 and 2012 respectively are pored over again, both deemed pandemics causing acute respiratory symptoms but with less contagion than COVID-19. Experts with

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backgrounds in various scientific principles try to get to grip with what has become a strange and frightening new reality, but at this stage, it seems no one knows very much at all for sure. The pharmaceutical world pitch in and the race to produce a vaccine is on. A rush to manufacture workable tests where results can be turned around quickly and reliably are crucial and the search to produce an antibody test to prove someone has had the virus is underway. A vaccine would normally take several years to arrive on the marketplace, following thorough research and testing. The talk today is brave – the promise is that the seemingly impossible can be achieved in 18 months. There is one thing that does seem certain if the conspiracy theorists are left aside. The first outbreak of COVID-19 was recorded in Wuhan, China, in a market selling live animals at the end of December, reportedly. Wuhan is a place few people have heard of and many of us find it difficult to comprehend that a virus occurring in a country so far away could possibly affect us. Some people become seriously anxious. Others shrug off the idea that this could have a serious effect and continue as normal. World leaders and politicians in all corners of the globe


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Molly Malone wheels her barrow through empty streets broad & narrow. It’s the heart of the city, yet the heart has stopped beating. Dublin has been muffled to slow the spread of an insidious virus.

start to tread water, turning to scientific experts for help but even they have vastly differing views on what the future may hold. Other politicians ignore the signs in a gung-ho manner but in the meantime, this virus is slicing through everyone’s politicking like cake – no country is left untouched, it is just a matter of time. Less than two weeks following the banning of pubs, a full lockdown is enforced in Ireland. The grim impact of the COVID-19 virus worldwide and its unhalted spread is now blindingly apparent. On March 27th, then Taoiseach Leo Varadkar places Ireland in full lockdown, initially for a fortnight, banning all non-essential journeys over this period. Newly released statistics show that the elderly are at greatest risk of death from COVID-19 and the over 70’s are told to cocoon under the new regulations. At the same time, all public gatherings outside a family household or single unit are prohibited. The only exceptions are for travelling to essential work, shopping for food or household goods, for healthcare appointments or vital family reasons. The two-week ban is extended by the government at various intervals in April and

May, mirroring similar policies emerging across Europe where many shut their borders to foreigners. Fear sets in that healthcare systems throughout the EU could become overwhelmed and completely collapse under the strain of the numbers of potential Covid cases. There is concern that availability of general ward beds, ventilators for aided breathing and intensive care unit bed places (ICU) will be stretched to breaking point. Essential front line health workers have become a high-risk group in both contracting the virus and dying from its assault. The first defence of doctors, nurses, care home workers and all health workers who are on the frontline cry out for more PPE - Personal Protection Equipment. This is their only weapon against the potential of contracting the disease while dealing with multiple cases of a still prolifically contagious disease, with no cure in sight. This is an area where many ill-prepared EU governments seriously failed in their initial responsibility to respond quickly enough to protect health workers. A scramble to purchase PPE at any cost ensues throughout the world, as countries compete to stock up. U2 frontman Bono rows in playing a vital role in procuring PPE from China. “It’s an extraordinary market,” Bono said, explaining how competitive the market is and how difficult acquiring supplies is, with countries consistently being “pushed out of the way”. But the U2 boys with the help of Cork man Liam Casey prevailed. “It was like Indiana Jones and the raiders of the last PPE,” Bono laughed in reference to their trojan efforts. The order, which includes 20 million masks, 100,000 goggles, 100,000 visors and 30,000 gowns amounted to €10m and was footed by U2 as an act of what Bono described as “a national service”. Between 27th March and June 28th, global knowledge of the mechanics of the Covid 19 virus is growing. Scientists work with more solid evidence as understanding improves inch by inch, case by case, country by country. Yet COVID-19 continues to tighten its grip, spreading through continents and reaching stratospheric numbers of new cases daily. The view from the edge is by no means crystal clear. We watch, we listen, we hope. Scientific experts from all sides discuss and agree that: “This is an unknown entity. We are nowhere near the end of it.” New symptoms emerge, possibly unnoticed at the onset of the outbreak - loss of taste and smell, especially in younger

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Matt Damon described the experience of lockdown in Dalkey as being “like a fairy tale”. “Yes, you have to stay within two kilometres of your house,” he said,” but within two kilometres there are trees, woods, there’s the ocean. I can’t think of any place you’d rather be in a two kilometres radius. people; difficulty swallowing and a final assault that can cause severe organ damage, following pneumonia. This last phenomenon occurs in the main where patients are assisted with breathing through a ventilator and have to be cared for in ICU’s. It is now apparent that even those who manage to survive this stage and recover from the illness can be left with debilitating after-effects. During this period, health policy decisions made by EU countries are not exclusively based on lessening the toll from the virus. Other factors are in tension with this goal. Economies are being devastated; loss of jobs and incomes carry debilitating consequences and it is not the normal human state to be kept inside and isolated from familial or other contacts. Education is paramount and children need outdoor space as do their parents to combat going stir crazy. The talk now is of a ‘new normal’, where old freedoms will be returned, but new ways of behaviour to protect the vulnerable will have to be respected.

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A New Reality The world as we know it becomes a strange new reality. Virologists become the new media gods, informing governments on policy decisions - and some go on to ignore their own advice – such is the human condition. Fake news providers have a field day on social media with peaks on Twitter and Facebook feeding off anxiety and uncertainty throughout the world. WHO states that this insidious virus will never be beaten unless the world works as one and individuals change their behaviour dramatically in accordance with the guidelines. They warn that should people not abide by the rules, COVID-19 will strike again and again. In the meantime, the race is on for a vaccine/reliable test/antibody check for COVID-19 and the large private pharmaceutical companies show solidarity with academic institutions such as Oxford University sharing information in


accordance with WHO directives. Outside of Europe, in countries where there is little access to healthcare combined with acute poverty, the virus is picking off the most vulnerable and poorest sectors of societies, as whole nations appear to be left by the wayside. As COVID-19 kicks in wreaking havoc in Africa and South America, the highest numbers of cases and deaths are shockingly observed in the USA. Poverty and lack of access to healthcare for many exacerbate the global crisis.

Living with Lockdown Here in Ireland, a few days holiday turned into a long stay lockdown. It has been fascinating to see the resilience and tenacity of the Irish people despite the challenges we all face. There are stories of people being shuttered up on pacific Islands and of a couple ‘locked in’ at Adare Manor, living the sweet life in the former Guinness Estate as they carry out caretaking duties running showers in each of the guest rooms and flushing all 160 toilets! Hollywood A-Lister Matt Damon and his family arrived in Dublin in early March to film Ridley Scott’s new film The Last Duel. Almost immediately, production was shut down under COVID-19 restrictions. Rather than head back home, the Damon family decamped to Formula 1 star Eddie Irvine’s home in the Dalkey hills. Damon fell in love with the

place and he was regularly seen out and about enjoying his surroundings. He described the experience of lockdown in Dalkey as being “like a fairy tale”. “Yes, you have to stay within two kilometres of your house,” he said,” but within two kilometres of here there are trees and woods, there’s the ocean. I can’t think of any place you’d rather be in a two kilometres radius. I thought it was incredible two months ago, but now it’s blooming it’s ridiculous.” And this mirrors my own sentiments exactly. In a few short weeks, I have learned much about Ireland and it’s beautiful, resilient people. “Ah sure it’ll be grand,” I am told as I’m welcomed universally, if at arms-length. And despite the distinct lack of social gathering, Irish people always find a way to come together, like the old tradition of dancing at the crossroads. Here I find myself immersed in a novel new tradition. There may be no pubs to go to, but an innovative ‘dial a pint’ service is available where the pub comes to you, like a beer selling milkman. With a door to door drop off service and next day glass collection, neighbours can share a cool freshly pulled pint over the garden wall socially distancing, but also socialising. St. Patrick’s Day usually sees a whopping 13 million pints of Guinness consumed globally on March 17th. This year it was likely less, but I did sink a pint of the black stuff on Paddy’s day after all – over a garden wall. It wasn’t quite how I imagined celebrating Ireland on this festive day, but the craic was mighty and the taste of normality was delicious.


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Studying our genes today can lead to amazing discoveries tomorrow. With your help, we can change the course of medicine in Ireland and throughout the world.

usa • iceland • ireland (formerly Genomics Medicine Ireland) the Public Sector Magazine www.genuitysci.com

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Breaking the Code Genetic variability in the human immune system may affect susceptibility to and the severity of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Why do some people fall ill from SARS-CoV-2 while others infected with the virus experience no symptoms? Why do some people develop neurological, cardiovascular or gastrointestinal symptoms while infection sticks to the respiratory system of others? This pandemic has shown that older people and those with underlying health conditions are at greater risk of infection with COVID-19, yet some young and otherwise healthy people barely survive the disease, while some elderly people with multiple risk factors weather it with only minor symptoms. Geneticists are investigating whether in addition to individual behaviour, pre-existing conditions and sheer luck, the answer may lie in people’s genes. Genetic variation explains some of the differences in the strength of immune responses. Certain immune system genes code for proteins called human leukocyte antigens (HLA), which vary tremendously. These variations influence how well the immune system recognises a given pathogen or other foreign entity. An HLA type that leads to poor recognition of SARS-CoV-2 could cause a person to be more vulnerable to the virus. In particular, understanding how variation in HLA may affect the course of COVID-19 could help identify individuals at higher risk from the disease. Research conducted by The American Society for Microbiology shows that individual HLA type likely influences the capacity to respond to SARS-CoV-2 infection and note that certain alleles in particular could be associated with more severe infection, as has previously been shown with SARS-CoV. While some geneticists are scrutinising the human genome,

Viruses can’t infect people unless some of our cells let them in. Certain proteins on cell surfaces grant entry to SARS-CoV-2, while others inside the cell get co-opted to help the virus replicate. others are analyzing the genome of the virus to track the spread of different lineages around the world which may help determine whether any mutations affect the virus’s potency. As SARS-CoV-2 infects people and replicates, the individual viruses evolve, acquiring genetic mutations. Different sets of mutations begin to distinguish different lineages of the virus, which can be linked to different parts of the world. Tracking these mutations allows researchers to study how the virus is moving around.

Genetic Susceptibility The clinical presentation of COVID-19 varies from patient to patient and understanding individual genetic susceptibility to the disease is vital to prognosis, prevention and the development of new treatments.

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For the first time, Italian scientists have been able to identify the genetic and molecular basis of this susceptibility to infection as well as to the possibility of contracting a more severe form of the disease. Professor Alessandra Renieri, Director of the Medical Genetics Unit at the University Hospital of Siena in Italy has been collecting genomic samples from Covid patients across the whole of Italy to try to identify the genetic bases of the high level of clinical variability they showed. Using whole-exome sequencing (WES)1 to study the first data from 130 Covid patients from Siena and other Tuscan institutions, they were able to uncover a number of common susceptibility genes that were linked to a favourable or unfavourable outcome of infection. “We believe that variations in these genes may determine disease progression,” says Prof Renieri. “To our knowledge, this is the first report on the results of WES in COVID-19.” Searching for common genes in affected patients against a control group did not give statistically significant results with the exception of a few genes. So, the researchers decided to treat each patient as an independent case, following the example of autism spectrum disorder. “In this way we were able to identify for each patient an average of three pathogenic (disease-causing) mutations involved in susceptibility to Covid infection,” says Prof Renieri. “This result was not unexpected, since we already knew from studies of twins that COVID-19 has a strong genetic basis.” Although presentation of Covid is different in each individual, this does not rule out the possibility of the same treatment being effective in many cases. “The model we are proposing includes common genes and our results point to some of them. For example, ACE2 remains one of the major targets. All our Covid patients have an intact ACE2 protein and the biological pathway involving this gene remains a major focus for drug development,” says Prof Renieri. ACE2 is an enzyme attached to the outer surface of several organs including the lungs that lowers blood pressure. It serves as an entry point for some coronaviruses, including COVID-19. These results will have significant implications for health

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and healthcare policy. Understanding the genetic profile of patients may allow the repurposing of existing medicines for specific therapeutic approaches against COVID-19 as well as speeding the development of new antiviral drugs. Being able to identify patients susceptible to severe pneumonia and their responsiveness to specific drugs will allow rapid public health treatment interventions. Future research will be aided, too, by the development of a Covid Biobank accessible to academic and industry partners. The researchers will now analyse a further 2,000 samples from other Italian regions, specifically from 35 Italian hospitals belonging to the GEN-COVID Project2. “Our data, although preliminary, are promising and now we plan to validate them in a wider population,” says Prof Renieri. “Going beyond our specific results, the outcome of our study underlines the need for a new method to fully assess the basis of one of the more complex genetic traits, with an environmental causation (the virus), but a high rate of heritability. We need to develop new mathematical models using artificial intelligence in order to be able to understand the complexity of this trait, which is derived from a combination of common and rare genetic factors. “We have developed this approach in collaboration with the Siena Artificial Intelligence Lab and now intend to compare it with classical genome-wide association studies3 in the context of the COVID-19 Host Genetics Initiative, which brings together the human genetics community to generate, share and analyse data to learn the genetic determinants of COVID-19 susceptibility, severity and outcomes. As a research community, we need to do everything we can to help public health interventions move forward at this time.” Viruses can’t infect people unless some of our cells let them in. Certain proteins on cell surfaces grant entry to SARS-CoV-2, while others inside the cell get co-opted to help the virus replicate. By uncovering each of the proteins at play, scientists provide new opportunities to find drugs that act on the proteins and make it harder for the virus to gain a foothold.


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The Appliance of Science The technology revolution has benefitted almost every aspect of healthcare, and genomics is one of the most disruptive advances in healthcare today.

Genomics involves the study of a person’s genome – all the DNA in your body. It is like a blueprint or instruction manual that provides the information needed to make you, run you and repair you. Genomic data, combined with an individual’s background and lifestyle factors, provide a more complete picture for genetic research. Genomics can lead to earlier and more accurate diagnoses, greatly improved prognoses, a better understanding of which therapeutics and at what dosage is best suited for each patient, and a greater potential for novel treatments.

A Catalyst for Truths Genuity Science is a genomics research company headquartered in Boston, USA, with offices in both Reykjavik and Dublin, the largest operation in the group. Genuity Science (Ireland) was previously known as Genomics Medicine Ireland, a start-up borne of the NovaUCD innovation hub in 2015, and which

counts the Irish Strategic Investment Fund (ISIF) as one of its founding investors. The company partners with global biopharma companies to offer deep, end-to-end discovery services aimed at catalysing precision health and improving the quality of life for patients around the world. Unbeknownst to most passers-by of Block 4, Cherrywood Business Park – the location of Genuity Science (Ireland) operations – the ground floor of the building is home to one of Europe’s biggest and most advanced genomics laboratories, accredited to industry standards for clinical laboratory testing. It is the larger of two laboratories in Genuity Science’s international operations, with the other located in Woburn, Massachusetts. Genuity Science’s research is looking to tackle dozens of chronic disease areas, leveraging its over 200+ highly experienced staff, its relationships with the Irish medical research community, and its advanced lab capabilities to find novel solutions to some of our most problematic conditions, including Multiple Sclerosis, IBD, Diabetes, Asthma, and many more.

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Diagnosing the Undiagnosable While many of Genuity Science’s research studies are already showing promise at their early stages, some of its greatest success in terms of research outcomes to date have been through its partnership with the Rare Disease Research Programme at CHI at Temple Street. The Rare Disease Research Programme provides access to whole genome sequencing to children with undiagnosed disorders and their families. The project aims to identify the genetic cause of a child’s disorder. Genuity Science provides sequencing services and analysis services free of charge to patients and consultants through collaboration with the hospital. Consultant Neurologist at Temple Street, Prof Mary King, describes a rule of thumb her profession has long used that “a third of children presenting with a rare disease will have a definite diagnosis, a third will have a probable diagnosis (made based on observation rather than conclusive testing), and a third will be undiagnosed.” Until the 2000s, this rough guideline held true. By way of illustration, between 2012-2014, Temple Street engaged some of the most modern genetic tests on a cohort of children with severe neurological diseases leading to a definitive diagnosis in 25% of the group. Following re-analysis of this genomic data four years later, a definitive diagnosis was reached in a further 25% of the children tested. Prof King said: “The potential for genomics is that it can pinpoint diagnostics accurately and indicate treatments tailored to each patient, saving considerable time and money for both patient and hospital. This ability to re-analyse a case as new genes are being discovered is a major advantage of genomic technology. Genomics really is the future of diagnostic medicine.” A diagnosis can mean access to new or more appropriate treatments, more specialised and coordinated care, and a better understanding of what the future may hold. But the success of genomics in relation to rare diseases diagnoses is not only medical – many families have found comfort in connecting with other families around the world whose children share the same condition. It also allows families to make informed family planning decisions, because many of these disorders are not inherited, but rather they arise spontaneously and so there is often very minimal risk of a similar disorder arising in a sibling. A dedicated research team at Genuity Science works with consultants at Temple Street to analyse a family’s genetic code, along with their health information, to identify potential disease-causing variants that are responsible for a child’s condition. For families who don’t receive a diagnosis, Genuity Science is committed to re-analysing their data over time in the hope new research will arise which may help to identify new genetic variants in future. Genuity does not retain any of the data for commercial purposes.

Flexibility in a Changed World The arrival of COVID-19 on the world stage has disrupted every industry globally, with no sector untouched. While vital research and data analytics continue apace at Genuity Science, regular collaborations with hospitals have paused while the health service battles the pandemic. Instead, thanks to its organisational flexibility, Genuity has pivoted and reassigned

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its world-class facilities and expert teams to help in the fight against COVID-19. In early April, Genuity Science entered into an agreement with the Health Service Executive (HSE) and National Virus Reference Laboratory UCD (NVRL) for the supply of reagents (the material used for the COVID-19 PCR tests) that would enable the NVRL to significantly ramp up testing of patients with suspected COVID-19. To date, Genuity is proud to have formulated 200,000 tests, significantly expediting large-scale testing in the country. The company’s rapid response in producing reagents for NVRL was pivotal in its understanding of the outbreak and in helping decide future courses of action. Later that month, Genuity assisted Irish research facilities, including St James’s Hospital and Trinity College Dublin, participating in global research efforts by sequencing genomes free of charge from study participants infected with COVID-19 across Ireland. The objective was – and still is – to identify protective and risk-bearing genetic factors for COVID-19, with consented anonymised datasets being shared with other authorised researchers throughout Europe through EMBL’s European Bioinformatics Institute (EMBL-EBI) European Genome-phenome Archive (EGA) database. In this study, Genuity Science does not retain any of the genomic data for commercial purposes. Ireland has the potential to be a world leader in genomics and with a large, strong team based in Dublin and an advanced lab at its doorstep, Genuity is well placed to help Ireland deliver the genomic revolution for the benefit of patients and their families across the country.


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Aalto Bio, Disease Chasers Aalto Bio is Irelands fastest growing indigenous biotechnology company serving some of the largest pharmaceutical and diagnostics companies in the world. CEO Philip Noone discusses how Aalto Bio helped the HSE to build COVID-19 reagents during the pandemic and how they are working to protect us from emerging diseases.

The company acts almost an extension of the research and development departments of companies and organisations they partner with to research, explore and develop faster diagnostic solutions for emerging diseases such as Zika Virus, Venezuelan Equine Encephalitis Virus and COVID-19. As market leaders in the development of proteins and antibodies for these diseases, Noone says that if you look at the World Health organizations target list of diseases of concern, there were 18 in total before COVID-19 emerged so there are 19 now. From that list, the top two are Dengue virus and Chagas disease both of which Aalto Bio already has developed diagnostic targets. The aim is to continually develop a library of disease targets for emerging diseases before they reach the world and innovate technologies around faster disease targets for emerging disease targets. Taking COVID-19 as an example,

Aalto Bio has now developed five different diagnostic materials for diagnostic testing of this pathogen in the space of five months. Aalto Bio see themselves as disease chasers, pinpointing future diseases that may emerge and developing solutions to them before they emerge like COVID-19. At present they have almost 300 disease solutions for diagnosing existing and emerging diseases and that library of disease solutions continues to expand. One exciting new product in development at present for an emerging disease is Venezuelan Equine Encephalitis Virus or VEEV for short. The VEEV virus like COVID-19 has jumped from animal to human and is spread via mosquito from animal to human. Aalto Bio is working with a large vaccine company to develop the antibody test for vaccine candidate screening in

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phase 1 clinical trials and they are working to develop wider spread screening for the virus. Such future-proofing will protect against these emerging diseases where the diagnostic tests and vaccines are developed in advance of the actual virus arriving. The company’s recent and first engagement with the Irish Public Sector was in March 2020 when they were contacted by the HSE to see if they could help build a lysis buffer reagent to isolate COVID-19 virus in patient samples. This reach out from the HSE was beneficial in two ways. Firstly it helped Aalto Bio design, build and produce a new product in the fastest time they had ever attempted - the product was designed over a weekend, built over a two week period and scaled within a month. Noone says he was proud to be able to don the green jersey and come up with a working solution for a new product in such a short time which was helping patient screening and saving lives. Moving forward he feels that government and the HSE should engage and use indigenous Irish companies like Aalto to develop and produce products locally at scale to protect supply chains. The company that was building the reagent Aalto produced from scratch was Swiss-based and could not supply Ireland. A private-public partnership model similar to the ones used in mainland Europe is the way forward to guarantee supply in the event of a second wave of COVID-19 or other emerging diseases. Looking to a possible COVID-19 vaccine there are three major companies developing vaccines at an advanced stage at present mainly Moderna, Innovio and Curevac. Aalto Bio is working with two of these companies to help them develop diagnostic tests for faster screening of vaccine candidates and helping them with their clinical trials. Noone believes a vaccine may become available as early as the end of 2020 or early 2021 based on the information they have on the staged development

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Aalto Bio see themselves as disease chasers, pinpointing future diseases that may emerge and developing solutions to them before they emerge like COVID-19 of the vaccines. The company are continuing to expand in their core markets of Europe, US and Asia. They are also hiring additional commercial and scientific staff in response to growth at the Dublin headquarters. Noone says that he would like to speak to government at a senior level in terms of how they can further expand and innovate at Aalto Bio to continue to develop innovative diagnostic solutions around COVID-19 and other emerging diseases like Venezuela Equine Encephalitis where we can build the solutions now and have them ready retrospectively in the event of an outbreak, a far more preferable situation than working to build disease solutions in the heart of a pandemic such as the current COVID crisis. “Aalto Bio remains on hand to help our diagnostic manufacturing partners around the globe meet their COVID-19 diagnostic testing requirements, as we have done since the outset of this world health crisis by delivering first-in-class critical raw material products during this pandemic. We will continue to offer ourselves to help innovate diagnostic testing to faster diagnose this virus,” stated Philip Noone CEO Aalto Bio.


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Supporting Irish Medtech when it matters most Enterprise Ireland works with Irish businesses across the healthcare industry to help them start, innovate and win business. Our work supports entrepreneurship across Ireland, sustaining and creating regional jobs, and contributing to national economic growth. For more information visit www.enterprise-ireland.com #GlobalAmbition

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Pfizer - Changing Lives For 170 years, scientists and experts at Pfizer have addressed global health challenges, bringing forth a multitude of vaccines and therapies for patients suffering from infectious diseases. In the case of COVID-19, the company is committed to bringing forth medical solutions to address this pandemic.

Pfizer is making five promises that will help scientists more rapidly bring forward therapies and vaccines to protect humankind from this escalating pandemic and prepare the industry to better respond to future global health crises:

focus solely on addressing this pandemic. This team is applying their passion, commitment and expertise to a single focus of accelerating the discovery and development process that will deliver therapies and vaccines to patients as soon as possible.

Sharing tools and insights: With very little known about this virus, many are working to develop cell-based assays, viral screening, serological assays, and translational models to test potential therapies and vaccines. Pfizer is committed to making the vital tools they develop available on an open-source platform to the broader scientific community and to sharing the data and learnings gained with other companies in real-time to rapidly advance therapies and vaccines to patients.

Applying drug development expertise: Many smaller biotech companies are screening compounds or existing therapies for activity against the virus causing COVID-19, but some lack the experience in late-stage development and navigating the complex regulatory systems. Pfizer is committed to sharing its clinical development and regulatory expertise to support the most promising candidates these companies bring forward.

Marshalling people: Human capital is the most valuable resource. Pfizer has created a SWAT team of leading virologists, biologists, chemists, clinicians, epidemiologists, vaccine experts, pharmaceutical scientists and other key experts to

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Offering manufacturing capabilities: Once a therapy or vaccine is approved it will need to be rapidly scaled and deployed around the world to put an end to this pandemic. As one of the largest manufacturers of vaccines and therapeutics, Pfizer is committed to using any excess manufacturing capacity and


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protein of the coronavirus without actually making a person sick. Because the virus typically uses this protein as a key to unlock and take over lung cells, the vaccine could train a healthy immune system to produce antibodies to fight off an infection. The technology also has the advantage of being faster to produce and tends to be more stable than traditional vaccines, which use weakened virus strains. “The short, less than four-month time-frame in which we’ve been able to move from preclinical studies to human testing is extraordinary,” adds Bourla.

MEDICAL SERVICES PROGRAMME

Pfizer has a large presence in Ireland with six sites and 3,700 employees potentially shifting production to support others in rapidly getting life-saving breakthroughs into the hands of patients as quickly as possible. Improving future rapid response: To address future global health threats, Pfizer is reaching out to federal agencies including NIH, NIAID and CDC to build a cross-industry rapid response team of scientists, clinicians and technicians able to move into action immediately when future epidemics surface. Commenting Chairman and CEO, Albert Bourla said: “In recent years, the biopharmaceutical industry has brought forward some of the most impactful medical breakthroughs known to society, from therapies for HIV and cancer that have extended millions of lives to novel gene therapies that are seeing cure-like outcomes for some the most devastating rare diseases. Pfizer calls on all members of the innovation ecosystem – from large pharmaceutical companies to the smallest of biotech companies, from government agencies to academic institutions – to commit to working together in addressing this dire crisis. With our combined efforts we know that there is no health challenge that we cannot overcome.”

VACCINE DEVELOPMENT Pfizer and German pharmaceutical partners BioNTech recently announced that their potential coronavirus vaccine began human trials in the United States where the first US patients were administered with the experimental vaccine. The vaccine is based on using genetic material known as messenger RNA, which carries the instructions for cells to make proteins. By injecting a specially designed messenger RNA into the body, the vaccine could potentially tell cells how to make the spike

Pfizer and The Pfizer Foundation have a long history of addressing humanitarian disasters. The company has committed $40 million in medical and charitable cash grants to help combat the global health effects of the COVID-19 pandemic. Additionally, in recognition of the unprecedented demands that the pandemic has placed on health care systems around the world, Pfizer has created a new Global COVID-19 Medical Services Programme that empowers medical colleagues to provide diagnostic, treatment and public health support in the battle against COVID-19. Licensed medical professionals who feel duty-bound to provide their services during this crisis will now have a way to engage in the fight. Colleagues will continue to receive their full pay, benefits and be able to return to their position upon completion of service.

pfizer supporting patient groups in Ireland Meanwhile closer to home Pfizer have supported a number of important initiatives including the Irish Heart Foundation’s COVID-19 response which supports newly discharged Stroke patients. The patient organisation has developed a collaborative process whereby they will work with hospital based stroke services to support hospital to community transition for newly discharged stroke patients. Pfizer Healthcare Ireland donated €100,000 towards this patient focused initiative and this significant funding will help provide support to extremely vulnerable people in society during this time and alleviate some pressure on the health service. Pfizer have also donated further towards an online support forum and telephone helpline for heart failure patients – it is an important new service for heart failure patients being provided by the Irish Heart Foundation. In further support, Pfizer Healthcare Ireland along with Bristol Myers Squibb contributed €5,000 toward Age Action’s emergency response to the COVID-19 crisis through their Hardship Fund that Age Action and the Irish Red Cross launched for older people in Ireland experiencing additional hardship as a result of the COVID-19 pandemic. Speaking about the range of supports provided Paul Reid, Managing Director, Pfizer Healthcare Ireland; “We are proud as a company to have supported a number of patient organisations during this challenging time, organisations like the Irish Heart Foundation and Age Action are providing excellent support to patients across Ireland in response to COVID-19.“

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Rising to the Challenge Irish medtech companies are rising to the challenge of meeting the increased global demand for essential equipment needed for the treatment and prevention of COVID-19. As the second-largest exporter of medtech products in Europe and with the highest number of people per capita employed in medtech in Europe, Ireland is playing a significant part in the global fight against the pandemic.

That response is reflected in the findings of a global survey which has ranked Ireland sixth in the world for producing innovative solutions to the current crisis. The survey is compiled by StartupBlink, a Swiss-Israeli producer of global start-up ecosystem maps, in association with the UN-backed Health Innovation Index (HIEx) and partners such as Crunchbase, a US business information platform. Ireland’s high ranking reflects the fact that within weeks of the World Health Organization declaring the pandemic on 11 March, more than 100 Enterprise Ireland client companies had responded with innovative solutions. These solutions span everything from medtech devices to diagnostic solutions and contact tracing software and place the country just behind innovators such as the US, Canada and Israel. “The response has been inspiring,” says Tom Kelly, Enterprise Ireland’s divisional manager for innovation and competitiveness. “What it demonstrates is the overall national capability across a range of sub-sectors in the life sciences area. Having the

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As the second-largest exporter of medtech products in Europe and with the highest number of people per capita employed in medtech in Europe, Ireland is playing a significant part in the global fight against the pandemic.


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capability to do that should inspire all the UV sanitiser. Because UV-C destroys of us. Irish engineering firms and their the virus very quickly, it is a very good way management have been able to move of ensuring that environments like hospital rapidly to meet this urgent global need. wards, meeting rooms and showrooms The other aspect is the way people came are properly sterilised. It’s a great example together to collaborate to make it happen. of an innovative company moving into Researchers came together with industry to a new dimension. It is impressive too develop new products and processes.” to see a company make what can be a The rapidity of the response has also difficult transition from being a contract been impressive. “It’s amazing how quickly manufacturer to becoming an OEM and Irish firms have been able to pivot and more developing new products for the market.” into new areas,” he says. “For example, EPC Innovate & Diversify in Clara, Co Offaly manufactures highend medicated toothpaste but has set up At the outset of the pandemic, shortages a completely new line for hand sanitisers. of personal protective equipment (PPE) in It partnered with Grants in Tullamore to hospitals and workplaces were a serious secure a supply of alcohol. EPC is also cause for concern. While the government selling into the HSE and other markets. and the HSE moved with great speed They moved in triple quick time to make the Tom Kelly, Enterprise Ireland to secure supplies from overseas, Irish transition and put in place the production companies made a very important systems and the supply chain required contribution to this vital area. for the new product. That story speaks “When you look at the area of PPE, it volumes about the organisational capability is probably outside the pure life sciences in Irish companies.” sector,” Kelly notes. “But it is still vital Another company to pivot was Corkfor our health service. We now have based nutraceuticals firm Mervue Labs, important resources for the manufacture which collaborated with drinks maker of face shields, masks, gowns and so on, Irish Distillers to create hand sanitisers. with a growing list of Irish companies Innovation capacity has also come capable of producing them.” to the fore. “Combilift is in the materials These include Irish mask maker handling business and is not usually Irema, which expanded its workforce associated with ventilators,” Kelly notes. and built a new production line to ramp “The company drew on its expertise in up production of surgical and respiratorengineering and software development grade masks. Automatic Plastics and to create the Combi-Ventilate, a device Key Plastics, companies whose clients which converts ventilators into multiple range from life sciences and food ventilation stations. This was highly packaging to telecoms and aerospace, innovative and demonstrates how pivoted to manufacture face shields for investment in R&D and innovation over use by health service workers. Other the years has supported the development leading manufacturing companies, like of companies in Ireland and enabled them Mergon, also began production of these to respond to the COVID-19 crisis with vital products. Another example is 3-D such agility.” printing company Calt Dynamics, which Similar initiatives have been seen is now making protective visors. among human and animal health Kelly acknowledges the role played by the HSE in that companies such as Univet, Chanelle and Ovelle. “These response. “Particular recognition should be given to the HSE companies have shown the technical capacity to be able to for its willingness to engage with people and companies to help apply deep levels of knowledge and put them to work on define what it was looking for in terms of PPE,” he says. “It new problems.” Another example of an innovative solution created by an Irish was able to advise the companies of the standards required and other essential criteria. The customer insight the HSE was able company is the Muv-X UV-C sanitiser. Developed by Shannonto share was of critical importance.” based CW Applied Technology, the portable room steriliser HSE involvement is valuable in the longer term as well. “It is product uses a particular wavelength of ultra-violet light to hugely important that companies can say they supply the HSE,” sterilise rooms following a normal deep clean. The device works Kelly explains. “If a company can do it for a high-quality health independently, and no special training is required for operators to system in Ireland they can do it elsewhere as well.” achieve optimum results. At the other end of the response spectrum, several Irish “This is another contract manufacturer which made the move companies have been active in the development of COVID-19 to become an OEM supplier,” says Kelly. “The company applied its technical capability in collaboration with a US partner to create tests. Aalto Bio Reagents is manufacturing a particular

The way people have come together

and worked on

the development

of new solutions and responses to

COVID-19 has been quite inspiring.

They have put on the green jersey

and shown what

they can achieve.

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protein for use in diagnostic tests. Known as a lysis buffer, it is used to break open cells. The speed of its development was remarkable. “Aalto Bio Reagents worked very closely with the HSE and the National Virus Reference Laboratory and came up with a formulation within a week. Serosep is another company that is manufacturing test kits. These companies are demonstrating an innovative mindset, which is serving the country and the world very well at present.” With speed of testing becoming an issue, HiberGene successfully obtained CE marking for a fast molecular COVID-19 test in May. The test utilises HiberGene’s proprietary molecular reagent format to accurately detect the virus in nose and throat swabs. Positive results are returned within 30 minutes on average, enabling rapid diagnosis at the early and highly infectious stage of the disease. Negative results are returned within 60 minutes. “Again, this shows the underlying strength of companies here when it comes to responding to opportunities in life sciences,” Kelly points out. “Once they identify a need they can respond to it. That requires a combination of domain expertise and innovation.”

Partnership & Collaboration It also demonstrates a level of adaptability which has served Irish companies well over the years. “Lots of companies in the medtech sector in Ireland didn’t start out in that industry but ended up there by becoming preferred suppliers to medtech customers,” he says. “Bellurgan and Bolger Engineering are examples of precision engineering companies which has

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successfully become a key supplier to the medtech sector. There is an adjacency between the two industries, and companies with strong technical and management capability can exploit that. They have done that on the back of the effort they have put in over the past 30 years and more.” That same coalescence of sectors is now in evidence with the alignment of the ICT sector to the health system. “patientMpower provides the tools for patients with lung complaints to be followed remotely with integrated medication management and is also providing a remote triage service for COVID-19 patients,” says Kelly. “This is another example of the importance of partnership and collaboration with the HSE. Companies can present ideas to the HSE and work with them on the development of solutions to particular needs. “The State, through its agencies such as Enterprise Ireland and its predecessors, has supported companies through sustained investment in R&D, organisational and management development and the resultant capabilities that are now to be found in Irish businesses enable them to tackle this crisis in such a positive, innovative and agile manner. The response to the Covid challenge goes beyond innovation. People are moving out of their silos, breaking down the barriers that may have existed and adopting a multi-disciplinary approach,” he concludes. “Companies are working with the HSE, the thirdlevel education system and the technology centres around the country in collaborative efforts which bring together companies from different sectors with researchers from different fields. The way people have come together and worked on the development of new solutions and responses to COVID-19 has been very satisfying. They have put on the green jersey and shown what they can achieve.”


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Reaction, Resilience, Recovery with KPMG COVID-19 is the most significant global healthcare crisis in a century. While the speed and scale of the pandemic and the response to it have been remarkable, the impacts and changes caused will be profound and long-lasting. Here Paul Toner, Partner & Head of Consulting, KPMG and Kelan Daly, Director, Healthcare Consulting at KPMG give some insights and practical advice for our new reality.

Healthcare systems around the world have borne the full brunt of COVID-19. The pandemic has upended normal operations, backlogging an estimated 28 million procedures globally1, exposed system and supply chain limitations tested the physical and mental limits of health workers and caused rapid adoption of digital solutions. Despite these extraordinary challenges, there are also opportunities to drive positive change through these difficult times. Until a vaccine is found, health systems will need new ways of working to respond to these pressures as they move from crisis reaction through resilience, recovery and into the post-pandemic new reality. COVID-19 has also the potential to 1 CovidSurg Collaborative, Nepogodiev,D., Bhangu A., (2020). Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. British Journal of Surgery. https://doi.org/10.1002/bjs.11746

accelerate existing transformational changes that were already underway in more mature healthcare organisations and move us towards the new reality for healthcare at a much faster pace than previously anticipated. Since the start of the pandemic, KPMG have listened to clients, provided insights and supported over one hundred COVID-19 focused healthcare engagements across the world, including here in Ireland. COVID-19 has vividly demonstrated that ‘no health system is an island’ and every country has something to teach and something to learn from the way it is being managed. Through our intensive global collaboration since the start of the pandemic, we believe there are ten key insights into how health systems around the world are reacting to the pandemic and becoming more resilient as a result.

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COVID-19 has vividly demonstrated that ‘no health system is an island’ and every country has something to teach and something to learn from the way it is being managed HOT & COLD SITES In response to the pandemic, some countries are establishing hot and cold sites. Cold sites deliver non-COVID care in order to lower infection risk, operate efficiently without interrupting acute work and create capacity for elective procedures. Establishing hot and cold sites will be imperative to delivering the kind of new patient flows necessitated by COVID-19. Public Private Partnerships have been formed in some countries to help expand public sector capacity in this way.

SCALED UP SERVICES

Paul Toner Partner, Head of Consulting T: +353 1 410 1277 E: paul.toner@kpmg.ie

DIGITAL FRONT DOOR COVID-19 has caused health care systems and organisations around the world to rapidly adopt digital healthcare solutions. In many countries, the ‘digital front door’ has become the ‘only front door’ for patients to access clinical services. Hospital out-patient and general practitioner appointments across the world have been transformed with significant volumes of consultations now taking place virtually. When the pandemic crisis abates, we do not foresee the digital front door closing because patients and providers have embraced the convenience and flexibility of this type of care. Now and when we enter into a post-COVID-19 new reality, a key concern for any health system will be scaling and sustaining these digital interactions.

DIRTY & CLEAN SITES In response to the pandemic, health systems across the globe such as China, Spain and the US have introduced strict infection control measures including the separation of COVID and non-COVID patients to prevent spread in hospitals and care homes. While an effective infection control measure, a side effect of implementing clean and dirty sites has been reduced capacity, particularly for nonurgent procedures. Now and as we enter the post-pandemic new reality, meeting the backlog of elective cases will be a challenge and will require new patient flows through systems to manage this.

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With COVID-19, we have seen that there has been a continued push by health systems towards delivering care in the right setting, especially in out-of-hospital care settings (e.g. primary care, home and community care, etc). This rapid increase in demand has exposed the lack of scale and centralisation of the primary care and speciality services, which will be necessary in facilitating any health system’s entry into the post-COVID-19 new reality.

AGED CARE SERVICES Elderly populations are particularly vulnerable to COVID-19 and managing the spread of the virus has been a challenge in long-term care facilities across the globe. Amidst this dark time in the sector, a few countries have stood out by taking quick action to protect the lives of their elderly. In Singapore for example, aged care staff were housed in private accommodation and tested before every shift. COVID-19 has exposed flaws in how health and care systems are organised. Traditionally, aged care services have not been seen as a part of the health system. Now and in the post-COVID-19 new reality, there is an urgent and ever-increasing need to invest in and effectively integrate aged care services with health systems.

SUPPLY CHAIN RESILIENCE In addition to the health impact of COVID-19, considerable commercial impacts are being felt globally particularly in the area of supply chain. The coronavirus has exposed the vulnerabilities of offshore and “just in time” supply chains that rely on lean manufacturing principles. Many governments have


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Since the start of the pandemic, KPMG have listened to clients, provided insights and supported over one hundred COVID-19 focused healthcare engagements across the world, including here in Ireland. taken the lead on procuring Personal Protective Equipment (PPE), some like Germany, Russia, the US and Saudi Arabia have seen the relocation of critical supply production incountry. Furthermore, in some places, local supply chains for PPE have cut through regulations and bureaucracy and forged new relationships between manufacturers, universities and procurement specialists. As the ‘new reality’ steps in, health systems will need to digitally transform their supply chain models and other middle and back-office functions to be more resilient and responsive to changing clinical priorities.

COMMAND CENTRES Health systems and organisations in some countries have realised the importance of data-driven insights in strategic and operational decision making. Command centres similar to air traffic control systems, are being developed to manage care in much more effective and efficient ways. While some health systems are making progress in these areas, globally most lack a centralised, data-driven, smart system that can manage resources and assign patient volumes effectively and efficiently which will help navigate the post-COVID-19 new reality.

AGILE WORKFORCE Healthcare workers have been the heroic face of the pandemic. During the response phase, health systems and providers discovered that their workforce planning and deployment models had limitations. To prepare for a ‘staff slump’ due to physical, mental and emotional exhaustion and support operations in a post-COVID-19 new reality, workforce models will need to transform to become agile, employ data-driven insights, and empower their workers.

SYSTEM GOVERNANCE COVID-19 has exposed the need to work collaboratively to deal with the challenges it has placed on workforce, supply chains and infrastructure, amongst others. Through our global network, we have heard of widespread local, regional and national cooperation and this is a trend looks set to increase, as health systems move towards the post-pandemic ‘new reality’.

Kelan Daly Director, Healthcare Consulting T: +353 1 700 4299 E: kelan.daly@kpmg.ie

PROJECT MANAGEMENT Given the fast-paced nature of the changes being implemented in most health systems, an agile project management approach has been adopted by some countries. For instance, in the UK the NHS employed this approach when they converted an exhibition centre into a temporary hospital (Nightingale London) in just nine days. To support the post-COVID-19 new reality, providers and governments will need to adopt more agile approaches to project management that allow them to implement rapid changes and performance improvement initiatives. KPMG is Ireland’s leading professional services firm, dedicated to supporting leaders across healthcare in building a better health service for all. We collaborate with our global healthcare team of 4,500 professionals to help develop local solutions to the challenges and pressures in healthcare including demographic shifts, resource constraints, developing digitallyenabled care and empowering service users. We are proud of our role in supporting the Irish health service during the COVID-19 pandemic and in helping to transform healthcare delivery in Ireland. We are committed to continuing to bring local insight and global expertise to help create a modern, responsive, integrated health system. For more information visit www.kpmg.com/healthcare

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Enabling collaboration anywhere Our industry leading ICT infrastructure is providing secure video conferencing solutions to those operating in the health, public and charitable sectors aross Ireland.

Contact us today to discuss how we can help you with video enabled solutions T: 01 295 0500 | E: sales@hsl.ie

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Our Telehealth offering integrates with existing health ICT systems and enables real time diagnostic information to be shared across locations. Embedded within existing workflows and care pathways, Telehealth operates as part of normal day to day practice delivering care to patients and achieving patient, clinical and operational benefits from the outset. Customer satisfaction is key to HSL and the support for the systems and services we provide is tailored to ensure it meets the operational needs of each and every customer.


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Protect & Perfect The outbreak of the current pandemic has had a considerable impact on the growth of the personal protective equipment market to fulfil the surge capacity during the COVID-19 response.

The World Health Organization has warned that severe and mounting disruption to the global supply of personal protective equipment (PPE) caused by rising demand, panic buying, hoarding and misuse is putting lives at risk from the new coronavirus and other infectious diseases. Healthcare workers rely on personal protective equipment to protect themselves and their patients from being infected and infecting others. Shortages are leaving doctors, nurses and other frontline workers dangerously ill-equipped to care for COVID-19 patients due to limited access to supplies such as gloves, medical masks, respirators, goggles, face shields, gowns and aprons. “Without secure supply chains, the risk to healthcare workers around the world is real. Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding. We can’t stop COVID-19 without protecting health workers first,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

Supply & Demand Since the start of the coronavirus outbreak, prices have surged. Surgical masks have seen a six-fold increase, while N95 respirators have trebled and gown prices have doubled. Supplies can take months to deliver and market manipulation is widespread, with stocks frequently sold to the highest bidder. Based on WHO modelling, an estimated 89 million medical masks are required for the COVID-19 response each month. For examination gloves, that figure goes up to 76 million, while international demand for goggles stands at 1.6 million per month. To meet global demand, WHO estimates that the industry must increase manufacturing by 40%. To this end, PPE manufacturers have collaborated with medical device producers to manufacture personal protective products needed for the outbreak response. For example, the International Safety Equipment Association (ISEA) has collaborated with the federal

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A study from market research firm Research Dive suggests that the global market for personal protective equipment is set to register a revenue of $93.5 billion by 2026. government, which has placed orders for surgical masks, surgical N95s, and 500 million respirators. In addition, the majority of people from developed and developing countries are placing a high emphasis on hygiene and safety equipment to defeat the COVID-19 pandemic. According to data published by the ISEA business blog, the sale of safety goggles and masks has grown between 100% and 400% over the previous few months. These figures show that the demand for personal protective equipment is astonishingly increasing. A study from market research firm Research Dive suggests that the global market for personal protective equipment is set to register a revenue of $93.5 billion by 2026. Furthermore, ventures across the world are following business strategies such as strategic tie-ups, technology innovations and others. 3M, a significant PPE manufacturer, has collaborated with Cummins to defeat the COVID-19 pandemic outbreak along with manufacturing high-efficiency particulate filters known as powered air-purifying respirators (PAPRs). The global market for personal protective equipment is broadly categorized into fall protection, head protection, hearing protection, eye and face protection, respiratory protection, protective clothing, protective footwear, hand protection and others. The market size for the eye and face protection equipment will be $16.0 billion in 2026 and is projected to rise at a compound annual growth rate (CAGR) of 11.0%. Eye and face protection provide versatility and a high level of protection and as a result, the usage of this equipment is increasing extensively. Moreover, there are a wide variety of additional industries who benefit from the use of eye and face protection products outside of the healthcare industry ranging from manufacturing to petrochemical, pharmaceutical, forestry and laboratory. Increasing investment in research and development of vaccines against infectious or novel diseases is expected to further fuel demand, protecting healthcare personnel from contagious disease exposures in the workplace, such as research labs from exposure to bloodborne pathogens and Mycobacterium tuberculosis. Employers must provide their employees with appropriate PPE and ensure that PPE is disposed of or, if reusable, that it is properly cleaned or laundered,

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repaired, and stored after use. Rising cases of COVID-19 has rapidly increased the demand for PPE across the world. The rise in investment from public and private players in the production of healthcare PPE kits to meet the increasing demand is also fuelling the growth of the market. In particular, N95 masks are driving much of the projected market growth as such masks are more effective than other face coverings in preventing the spread of the coronavirus. Goggles, gowns and coveralls are all factors in the projected growth as well. There also appear to be opportunities for innovation on the horizon which is catching the attention of investors. The development of healthcare PPE kits based on bio-materials is expected to usher in many business opportunities which could mitigate any negative impact of PPE on the environment, which is a current restraint on market growth.

Innovation in PPE One positive aspect of the COVID-19 shutdown is that air and water quality all around the planet has gotten cleaner, however, campaigners are concerned it could worsen another epidemic plastic pollution. Much of the PPE being used to protect health workers like gloves, face masks and gowns are used once before being thrown away. This is the case despite there being no scientific evidence that single-use plastics are better than reusable ones, said Kevin Stairs, Policy Director on chemicals and pollution at Greenpeace. A Limerick-based company has addressed the issue with the introduction of the first fully plastic-free certified PPE. EcoShield visors are now available from EcoStraws.ie helping to tackle both the demand for PPE in the Covid era and playing an important role in the reduction of plastic pollution. Established in 2018 by Brian O’Callaghan and Sarah Keyes, EcoStraws.ie originally focused on supplying the largest selection of EcoStraws in the world, expanding into EcoCups, EcoBottles, EcoBoxes and much more. Since the pandemic hit, the business has had to pivot and diversify into sourcing products that were aligned with demand and with their eco values. They have been working with UK colleagues along with international campaign group ‘A Plastic Planet’ to bring the plastic-free certified PPE to Ireland. The clear plastic free EcoShield visors are CE-certified whilst being home compostable and recyclable. They are made from FSC paper board and PEFC cellulose from wood pulp for a clear, mist-free screen and they are lightweight with an adjustable headband. The personal protective equipment market is concentrated and is dominated by some major players like 3M, Honeywell International, Inc., Alpha Pro Tech, Ansell Ltd., and Avon Protective Systems. These major players, with a prominent share in the market, are focusing on expanding their customer base worldwide. However, with technological advancements and product innovations, mid-size to smaller companies are growing their market presence and tapping into new markets.


Frontline & Healthcare

HSL EXCELS HSL leverages adaptability and supplier network to aid healthcare providers in response to COVID-19 Specialist distributor of medical supplies, surgical equipment and consumable products, Hospital Services Limited (HSL) services public and private hospitals across the UK and Ireland from its three bases in Belfast, Dublin and Nottingham. With a staff of 80, HSL is one of the largest privately-owned distributors in Ireland supplying over 250 public and private hospitals across the health sector with PPE, diagnostic imaging equipment, surgical devices, point-of-care technologies and telehealth video-enabled solutions. Led by Dominic Walsh and a widely experienced management team, HSL continues to grow its offering with products of excellence and in recent months has diversified its business with new innovative solutions to help not only those working in the healthcare sector but also within other public and private sector organisations.

Delivering High Quality PPE Supplies Displaying a significant pivot to benefit their established clients amongst the health services in the Republic of Ireland and Northern Ireland, in response to the outbreak of COVID-19, HSL recently leveraged their established global network of suppliers and expanded its business by sourcing over 14 million pieces of personal protective equipment (PPE) to aid the fight against the coronavirus pandemic. Chartering cargo flights and convoys of trucks, HSL helped to ease the PPE shortage on the island of Ireland by providing a variety of surgical gowns, masks and theatre caps which continue to play an important role for healthcare workers treating patients across Ireland and the UK. As a result of global supply issues, and further demonstrating their commitment to supplying customers with high-quality PPE, the team at HSL also implemented a strategy to manufacture face shields locally from their facilities in Dublin and Belfast. Leaning upon the management team’s previous manufacturing experience, and consultations with end-users in healthcare settings, HSL’s face shield has been hailed as one of the most comfortable available in the market, as well as being competitively priced. Following on from the success of this product, a new refreshable version has launched which allows the user to replace the head strap and foam support to reduce wastage.

State-of-the-art Diagnostic Imaging

HSL Refreshable Face Shield

health services in Ireland and the UK, HSL works to ensure the highest standards of patient care and diagnosis by sourcing and providing world-class technologies and consumable products. In response to the urgent need to HSL Shimadzu aid fast and effective imaging MX8 mobile of COVID-19 patients, X-Ray HSL was asked by the HSE to roll out digital mobile x-ray equipment to several hospitals across the

HSL partners exclusively with several world-class manufacturers of diagnostic imaging technologies across several disciplines including Hologic for mammography, Shimadzu for general radiology, and Fujifilm for endoscopy. A trusted long-term provider to the

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country. HSL supplied 18 digital mobile x-ray systems, supported by HSL’s newly appointed HSL Clinical Applications expert Ruth Fry, to aid in both diagnosis and monitoring of disease progression. Hospital-based training has been conducted locally for clinical end-users in Ireland, and the HSL support team adapted their way of working to provide 24/7 cover on COVID-19 critical imaging equipment. In preparation of the resumption of normal services within radiology departments, HSL has also already completed installations of mammography equipment and bone densitometers in a number of acute hospitals. “The Shimadzu system supplied by HSL offers substantial diagnostic and time saving advantages allowing for improved efficiencies in workflow. It offers superior image quality, improved patient care and a more streamlined workflow for clinicians,” said Breidge Flood, Territory Manager – Diagnostic Imaging, HSL.

Seamless Point of Care Technologies Delivering solutions to meet stringent infection control, ergonomic and electrical safety requirements demanded by today’s healthcare facilities, HSL’s Point of Care (PCT) products range from specialist fixed and mobile hardware solutions to high-end diagnostic displays. A team of highly skilled engineers, with a flexible, “can do” attitude provide around the clock remote and on-site support for clinicians spread across the country. As movement restrictions and social distancing were implemented throughout the country, HSL’s team were mobilised to install reporting workstations and diagnostic displays in the homes of radiologists. Through the utilisation of a secure connection back to the health service IT infrastructure, this essentially replicated the hospital working environment at home for patient diagnosis. HSL also reacted quickly to the need for mobile medical computer carts and other technologies in COVID-19 wards, Emergency Departments, ICUs and local test centres. These provide ergonomic, accessible tools, encouraging patient bedside charting and reduce the risk of spreading infection. Building upon the team’s extensive ICT knowledge and reacting to the ongoing need for monitoring patients and the wider general public, HSL added a thermal imaging camera to its carts which reads an individual’s temperature from several metres and can identify those not wearing a face mask.

HSL Thermal Camera Cart

SIGNIFICANT CHALLENGE The COVID-19 pandemic has provided a significant challenge to the healthcare service across the Island of Ireland, and at the same time has also exposed global weaknesses in the supply chain,” said Dominic Walsh, HSL CEO Dominic Walsh CEO, HSL “Over recent months Hospital Services Limited has been fortunate to be able to leverage our long-standing relationships and network of suppliers to provide high-quality solutions to the healthcare service and wider public sector and charitable organisations. We have always prided ourselves on innovative thinking, and an ethos of finding the best solutions for our customers and we are proud to have been able to leverage this company heritage and make quick step changes to ensure we could contribute to the tremendous efforts put forward by our healthcare service.”

Innovative Telehealth Solutions Over the last two years, HSL has established its telehealth business unit, investing in a number of industry experts in the field with many years of operational experience across the health and public sector as well as industry-leading ICT infrastructure to run telehealth and conferencing/collaboration as a medical grade, secure service. In response to social distancing due to COVID-19, demand has surged for telehealth services with care providers seeking out alternative approaches to diagnostics which can ensure patient and carer safety. HSL provides the fullest spectrum of telehealth enabled devices, covering a wide range of health conditions and enabling real-time diagnostic information to be shared across locations as well as innovative, secure video conferencing and virtual clinics to assist healthcare workers with patient consultations. Importantly, HSL also supports integration with existing health ICT systems so that the use of telehealth can be embedded within existing workflows and care pathways to ensure it becomes ‘business as usual’ rather than a separate offering to day to day practice whilst better utilising clinicians’ time and reducing patients’ need to travel. With current telehealth customers including Our Lady’s Hospital for Sick Children in Crumlin, all of the Health Trusts in Northern Ireland, Hampshire Hospitals NHS Trust, Norfolk & Norwich NHS Trust, North Lincs and Goole NHS Trust, Great Ormond Street Hospital for Sick Children, Police Scotland and Scottish Natural Heritage, HSL’s telehealth offering is developing and delivering care to patients in new ways, ensuring patient, clinical and operational benefits for health care providers from the outset. For more information on how HSL is helping healthcare providers deliver the highest level of patient care during the COVID-19 crisis and beyond, visit www.hsl.ie

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Frontline & Healthcare

Saving Lives Saving lives is the greatest job in the world. Everything we do aims to secure the safest and most reliable care and cure within healthcare and life science - Getinge.

Getinge, a leading global provider of products and systems and the world market leader in advanced ventilators for intensive care units, has been working closely with health care providers to support the fight of COVID-19. These are unprecedented times and it is Getinge’s firm belief that every person should get the best possible care, from developing agile training and support for healthcare professionals, increasing production of ventilators and

partnering with WaterAid to ensure availability and sustainable management of clean water, sanitation and hygiene in health care facilities across the world. Let’s take a closer look into Getinge’s efforts throughout the COVID-19 pandemic. Since the outbreak, Getinge has seen an increased global demand for ventilators, extracorporeal life support (ECLS) equipment and advanced monitoring equipment for Intensive Care Units. To meet the global demand, Getinge has temporarily

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increased its production of ventilators by 160% in 2020 compared to 2019 at its production facility in Solna, Sweden. “Our team are working around the clock to support doctors, nurses and hospital administrators in the fight against this global pandemic” shared Avril Forde, President UK & Ireland. “Our production facilities have significantly increased capacity and roll out of ventilators and other ECMO life-support equipment to support caregivers in saving as many lives as possible during the pandemic”.

Knowledge & Training Support

“Our team are working around the clock to support doctors, nurses and hospital administrators in the fight against this global pandemic”

As part of Getinge’s ongoing effort to ensure frontline medical providers have easy access to ventilator training and support material, they have teamed up with several of the world’s ventilator manufacturers to create a newly formed Ventilator Training Alliance (VTA). An app connects respiratory therapists, nurses and other medical professionals with ventilator training resources from alliance member companies, including instructional how-to videos, manuals, troubleshooting guides and other ventilator-operation expertise critical to treating patients suffering from COVID-19-related respiratory distress. Getinge has also developed a number of other educational and partnership initiatives in order to support healthcare professionals through these difficult times. A dedicated COVID-19 Resource Centre which offers help and guidance for healthcare professionals, along with practical information in the form of training material, guidance information, videos, podcasts and webinars, has been established online at www. getinge.com/uk/insights-results/covid-19-resource-center.

Access to clean water, sanitation and hygiene at health care facilities around the world At Getinge, infection control has been a core part of the business for decades. Solutions for the Central Sterile Services Departments (CSSDs), where medical instruments are cleaned, disinfected and sterilised are among the world’s best in preventing infections. Getinge is now working in partnership with the international organisation WaterAid and their joint effort aims to contribute to the important work of ensuring availability and sustainable management of clean water, sanitation and hygiene in health care facilities. Today, thousands of people all over the world get ill because they are being treated at hospitals without clean water, nor the possibility for doctors and nurses to wash their hands with water and soap, or to sterilise medical instruments. WaterAid has so far helped more than 28 million people in some of the world’s poorest communities to get access to clean water and more than 28 million to get access to sanitation. The partnership with Getinge will enable even more efforts around the globe to find new ways of establishing practical and sustainable water, sanitation and hygiene solutions that will enhance the lives of many, worldwide. Concluding Avril Forde says, “we will continue to work closely with our customers to ensure we provide the most appropriate resources and treatment options to support in the fight against COVID-19”.

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About Getinge in Ireland Getinge has offices across the UK and is also located in Ballymount, Dublin, Ireland. With a broad hospital portfolio within cardiac, pulmonary and vascular therapies and intensive care products, as well as surgical workflows and infrastructure, Getinge Ireland supports clinicians in providing vital care to patients in critical surgical and intensive care situations. Each hospital in Ireland has its own dedicated Getinge Account and Service Manager, thus ensuring customers know who their point of contact is for any sales or service related enquiries. Getinge support customers in meeting their challenges in healthcare by providing knowledge, technology and resources. For further information, to arrange a virtual appointment, or to speak to the team, visit Getinge at www.getinge.uk or call 353-1-426-0032.


Frontline & Healthcare

Step inside our Getinge Experience Centre The Getinge Experience Centre Rastatt is an international knowledge hub that shows our products and solutions within a complete, real-world medical setting. Take a 360o virtual tour through hybrid operating rooms, ICU set-ups, cardiovascular areas, and the CSSD and see how Getinge products work together to support your efforts to save lives.

To access the virtual tour, scan the QR-code

Getinge UK Ltd., i2 Mansfield, Hamilton Way, Oakham Business Park, Mansfield NG18 5FB

Phone 01773 814730

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Email uk.marketing@getinge.com

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Medguarding our Health COVID-19 is causing industries across the spectrum to be more conscious of ensuring safe and healthy working conditions for staff, says Paul Clifford, Medguard; one of Ireland’s leading wholesale and retail suppliers of medical devices and consumable products.

Paul Clifford

The enormous challenges faced as a result of COVID-19 are evident throughout Irish society and our economy. The pandemic has changed how we work and interact in a way that is likely to ensure that a ‘new normal’ remains in place for some time to come. However, the Irish people – particularly our frontline healthcare workers – are rising to those challenges on a daily basis. As one of Ireland’s leading wholesale and retail suppliers of medical devices and consumable products, Medguard has seen firsthand the resilience shown by those working on the frontlines. Buoyed by that resilience, Medguard has been delighted to help out in whatever way possible. “We’ve been blown away by the dedication of those working across the healthcare industry and further afield,” Medguard’s Paul Clifford says to Public Sector Magazine. “Their hard work and concern for those around them – whether

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it be their patients, their staff or the general public - is exactly the inspiration we all need in these testing times.” Initially established as a supplier to medical clinics and nursing homes, the Ashbourne Business Park-based firm has evolved to specialise in the supply of a large array of products, such as Medical Diagnostic Equipment, Medical Consumables, Infection Control, Examination Gloves, Medical Equipment, Medical Furniture, First Aid Supplies, Minor Surgery and Procedure Packs. The pandemic has been the catalyst for significant changes not just for those involved in the healthcare industry but for all businesses: “One of the major changes brought about in terms of the demand for our products because of COVID-19 has been the number of orders we’re receiving this year from companies who aren’t strictly operating in the healthcare industry, and we


Frontline & Healthcare

are happy assist,” says Clifford. “So many of the cleaning products we stock, such as cleansing wipes and other safety-related products mostly associated with a hospital environment, are now commonly used in other industries and that has opened up new relationships for us. “Maybe these companies’ product requirements are not quite as extensive compared to the medical or healthcare fields but still, it’s a grave concern to them. Hence the great demand we’ve seen for our sanitisation products and personal protection equipment in particular.” Of course, one of the most challenging aspects for companies like Medguard has been the difficulty in sourcing and procuring products, given the huge demand and the breakdown in global supply chains. For Medguard, they have thankfully been able to mitigate many of these problems through good foresight and diligence. By spotting potential issues early on in the year they began to prepare for the outbreak well before it arrived in Ireland. Their years of experience and strong existing relationships helped in their efforts to obtain and carry large quantities of stock. This was not only essential in recent times but will be of the upmost importance in the months to come. With that in mind, the company is continually expanding its network of manufacturers to help future-proof the business and ensure that they are on hand to help. “We’ve found that the strong relationships we already had with manufacturers and the foresight we showed in the early part of the year has helped us greatly. Servicing the needs of our current customers and the additional customers that have come our way since the spring has definitely been difficult but we’ve risen to the challenge. “We have grown 30 to 40% every year since we started the business in 2009 and in light of what has happened since

Servicing the needs of our current customers and the additional customers that have come our way since the spring has definitely been difficult but we’ve risen to the challenge. mid-March, we’re proud to have been able to continue to help frontline staff.” At the heart of it, Medguard is a people-focused business, believing in long-term relationships, built on mutual trust and reliability. Customer loyalty is of the upmost importance to Paul: “At times we had to buy the product at cost price because we simply had to get it in stock for our regular, loyal, customers. Things have got a lot busier than normal with regard to COVID-19 related products – but we remain committed to being a dependable professional partner for our customers while offering exceptional service and turnaround time. And it’s heartening to know that we have very large orders in the system for our customers for the next for the next six to 12 months.” Heartfelt in his praise for all the brave staff in care homes, hospitals and nursing homes, Clifford says fixing the supply chain issues for Medguard’s customers and the team’s efforts to provide their products at the keenest of prices will focus minds at the Ashbourne company for the foreseeable future. Whether it be COVID-19 or the challenges posed by Brexit, Medguard will continue to aim for the best for its client base.

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The Courage to Care COVID-19 has challenged the everyday lives of our nurses and midwives, but they have more than risen to the challenge. INMO stood with these heroes, providing support and advocacy throughout as they rose with courage and professionalism, caring, consoling and saving lives from this vicious pandemic. Here are some of their stories.

We are all grateful and proud, and as a team, we have managed to remain covid free for our service users to date. We go above and beyond for our service users and we wouldn’t have it any other way.

In an event like a pandemic you do not have a preview, so you need to be able to adapt and function outside your comfort zone. My most valuable nursing skill has been to be able to advocate for both staff and patients, ensuring all decisions were made with staff input and delivering the highest possible level of patient care. There was a lot of guidance and support from the INMO when there were very real concerns with PPE. There are also certain questions you don’t want to ask in work so having the support and reassurance of the INMO made me feel well supported. I am concerned about overcrowding returning, particularly with social distancing guidelines. Where a social distancing policy exists, it is very difficult to control an emergency department environment. We are starting to see this already as people are returning and other services are starting to open. The numbers are increasing and it will not be long until waiting rooms reach capacity. I think things will have to change after this crisis. Healthcare is evolving all the time and this pandemic is ultimately going to reshape the future of our health system. We should return to a more stable, better functioning healthcare environment. I don’t know when that might be, but I know our nursing roles

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will never be the same again. Patience, resilience, confidence and teamwork are attributes I’ve seen coming to the fore with all of my colleagues. I was scared initially, but I had to find extra strength to go on with my shifts. As a clinical nurse manager and shift leader, I am responsible for supporting and leading my team so I must show strong leadership and a high level of resilience. I’ve been an emergency department nurse for over 20 years, but this pandemic has brought whole new challenges. For example, when delivering sad news, you are wearing a face mask so your emotions and facial expression cannot be seen. Compassion and empathy are so hard to convey between the face mask and social distancing. The atmosphere at work feels highly charged and way more emotional. Many of my colleagues are from all over the world and they are missing their families. They are worried about them yet they must carry on with their nursing duties. My parents are back home in the Philippines and they are very worried about me. I know they are keeping me in their thoughts and prayers and that means everything. I reassure my parents about the safety measures I’ve taken at work and at home to keep myself and my family safe. I talk to them a lot and make sure we video chat, so they see me looking well


Frontline & Healthcare

If I were to go back to February, I could not imagine the scale of what was to come. We were preparing for it, but it was still a huge shock. When people work together, the collective power is incredible. and healthy and that helps them. My daughter is doing a prenursing course, so she understands what I am going through. She said to me ‘I want to be called a hero like you’ and I said to her, nursing is full of sacrifices, especially in a pandemic. I call it a good day when I get through a 12-hour shift where all my colleagues are content, happy, and safe; patients are looked after and admitted to beds on the wards. I’ve learned to take each day one step at a time and that has calmed the often overwhelming feelings as well as knowing I have a great team to work with every day.

there for one another. Initially my family were concerned about me getting the virus but having changed my routine going to and from work I have left those concerns behind for myself and my family. I think more about the service user’s family and how they must be feeling. I have come to realise how important seeing people is and we ensure regular contact is kept up with phone calls. We are all grateful and proud and as a team, we have managed to remain covid free for our service users to date. We go above and beyond for our service users and we wouldn’t have it any other way.

Intellectual Disability Services

Maternity Services

Social distancing is a very difficult concept for the service users where I work. Staff understand there is a virus and that they need to wash their hands, but maintaining a safe social distance can prove difficult due to the nature of our work. Lockdown has had a huge impact because it means a lack of family visits and changes to routines and services that are very distressing. Our day and respite services have also had to stop leaving many families at home providing constant 24-hour care. Knowing the toll this takes on people and how important support and regular breaks can be to families is very sad. When day and respite services closed many staff were redeployed, meaning new faces for the residents. New staff won’t be as familiar with the routine and everyone’s likes and dislikes. As much familiarity as possible is key, and seeing routines and services stripped back is heart-breaking even though I know it is crucial. Knowing that we’re like an extended family for the service users keeps me going. My colleagues also keep me going with little chats and light-hearted moments. We are a team and we support and respect one another. We are also conscious of the obstacles outside of work such as childcare. We work together to be flexible and that boosts morale within the team. We are 100%

Huge changes have been implemented very quickly and we’ve tried to introduce them safely while maintaining quality care in maternity services. We have introduced virtual working where possible and most of the patient history-taking is now done over the phone. We opened our maternity day unit so fewer people need to come in as in-patients. We set up early transfer home to give postnatal women additional support in the community. Antenatal education is delivered via the MLU Facebook page. What drives me to keep going is trying to give the best experience possible to women, their babies and their families. Staff have been fantastic. They have been redeployed, changed shifts, worked extra shifts and supported their colleagues. This period has brought people together and there is a real sense of camaraderie. At the end of the day, I feel exhausted. This is so different from anything we have seen before, so you have to think differently and the routine way of doing things has to change. I have a different outlook now and we have found more innovative ways of doing things and I’m inspired by that daily. If I were to go back to February, I could not imagine the scale of what was to come. We were preparing for it, but it was still a huge shock. When people work together, the collective power is incredible.

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COVID-19: Business Continuity in General Practice COVID-19 has resulted in widespread disruption to the healthcare system. To reduce the risk of exposure to COVID-19, practitioners have altered the way they consult and treat patients.

Keeping the practice running smoothly can be a challenge during this pandemic. There is greater demand from often anxious patients, changes to usual procedures and processes, and all practice team members are under pressure in terms of balancing workload and personal life. Suzanne Creed, Clinical Risk and Education Manager at the Medical Protection Society (MPS) provides advice on a range of issues to help maintain business continuity. First things first - your safety and that of your staff are as important as the care of your patients. If you have ever been on a flight with young children, you may recall the advice is to attend to your own oxygen mask first before attending to your child. Similarly, you need to look after your own health and wellbeing in order to take the best care of your patients. If you have any underlying health issues or concerns, you should seek advice from your own GP. Protecting yourself is essential; implement good self-care, and use PPE as per your local guidelines. While it may be difficult for some, ensure that you sleep well and can spend quality time with your family. Pay particular

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attention to your own mental wellbeing, nutrition and exercise. Make sure you take lunch to work with you and that you have regular breaks throughout the day. If you can get some fresh air at lunchtime go for a walk or sit outside.

Teamwork In times of crisis we rely on the support of those around us. Often in challenging times we really see how great our practice teams are. Support each other and take that extra few minutes to chat with colleagues and ask them how they are feeling. Working efficiently is important for all practice teams. Plan your practice workload as far as possible. Make sure everyone is kept up to date on a daily basis. The information around COVID-19 is continuously evolving. All clinicians should be mindful of evolving changes in current guidance, sharing updates so that everyone is abreast of the latest information. Disseminate any new information as it arises – you may consider a daily ‘huddle’ where all staff get a brief on the latest up to date information.


Frontline & Healthcare

Communication with Patients Naturally patients will be anxious in the current climate. They also need to be kept informed of how systems are running at the practice. It is important that they have correct and reliable sources of information readily available to them. This can be achieved via information on your website, a poster at your front door and a message on your answerphone. You could also consider signposting patients to the appropriate websites for further information such as the HSE and HPSC. A key message for all patients during this pandemic is that they should always phone the practice in advance to arrange an appointment and not attend unannounced. Following telephone triage some patients may require phone or video consultations based on their symptoms. MPS has developed some very specific guidance to assist members with remote consulting during the COVID-19 crisis1. It is important to highlight to patients and remind the general public that it is clinical care as usual for many scenarios in general practice at this time. Non-COVID issues, acute and chronic conditions, antenatal/post-natal care and childhood immunisations still need to be managed in general practice albeit with infection-control measures in place.

Managing Test results The referring clinician is responsible for making sure that a robust system remains in place to ensure all investigations are promptly reviewed and appropriately followed up. This system should include a ‘buddy system’ for colleagues who are absent from the practice to ensure their results are not overlooked. In some scenarios, GP’s who are not working within the practice may decide to manage their tests remotely with remote login to your computer system.

Repeat Prescriptions The practice should consider taking requests for repeat prescriptions in a written or electronic format to reduce footfall at the practice. This could be achieved by using email, a portal on your website or using a prescription request form. Practices should be aware that there are specific risks associated with prescription requests over the phone. Sending prescriptions directly to pharmacists will reduce footfall at practice, lessening the likelihood of patients and staff being exposed to COVID-19. There are a variety of ways in which this can happen. Following recent legislative changes, prescriptions sent via Healthmail are sufficient. However, if using email or e-script the pharmacy does require a signed hard copy. The doctor should carefully check all prescriptions. This will mean checking the clinical file to ensure the accuracy of the prescription. Ensure all relevant blood tests for monitoring medications have been returned and are satisfactory.

Protecting yourself is essential; implement good self-care, and use PPE as per your local guidelines. Recent changes to prescription regulations have increased the validity of prescriptions from 6 months to 9 months from the date on which the prescription was signed. This is for the duration of the COVID-19 crisis. Where patients’ run out of their usual medicines their pharmacist can usually provide a 5-day emergency supply. This gives adequate time to prepare the prescription without being under pressure. Similarly, with hospital discharge prescriptions a pharmacist can also issue an emergency supply.

Referrals to secondary care Clinicians should continue with their usual system for referrals to secondary care. Where possible use the electronic referral system on Healthmail. Given that hospital capacity may be greatly constrained due to COVID-19, patient expectations will need to be managed accordingly, in particular around delays for non-urgent referrals. Doctors should be aware that the RCSI has recently announced a new initiative called GP Surgeons Connect telephone advice3. This is an advice line available directly to GPs to support them in the management of patients in the community or to assist in the decision to escalate a patient’s care to the hospital setting. This service is aimed at optimising appropriate referrals during COVID-19.

Conclusion COVID-19 is a rapidly changing situation and a very anxious time for many. MPS has some useful additional resources and information available on their website. Members can also contact the expert medicolegal team 24/7 for advice on any concerns or queries. As COVID-19 guidance is continuously evolving MPS strongly recommend you also keep yourself updated on the most up to date guidance available on the HSE, HPSC and ICGP websites. References 1 COVID-19, and remote consultations- how can we help https://www. medicalprotection.org/ireland/resources/articles/view/covid-19-andremote-consultations-how-we-can-help 2 Department of Health, Minister for Health signs regulations to assist with prescriptions during COVID-19 https://www.gov.ie/en/press-release/d80ca9minister-for-health-signs-regulations-to-assist-with-prescriptions-d/ 3 Royal College of Surgeons of Ireland, GP- Surgeons Connect; https://www. rcsi.com/surgery/surgeons-connect

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Air Purification systems Reduce the risk of airborne virus transmission while improving your air quality and protecting employee health. Reduce particulate levels Protect against airborne viruses Protect your indoor environment

www.camfil.com/en-ie

01-8484977

info@camfil.ie


Frontline & Healthcare

A Breath of Fresh Air The lockdown imposed in at least 89 countries, affecting over half of the world’s population, has severely restricted economic activity with the unintended consequence of reducing air pollution.

Even before the COVID-19 pandemic, many countries had come to see air pollution as a major health issue. More than 90% of people worldwide live in areas exceeding WHO guidelines for healthy air with more than half living in areas that do not even meet WHO’s least stringent targets for air quality. The State of Global Air/2019 Report noted that air pollution was the fifth leading risk factor for mortality worldwide in 2017, with ambient air pollution contributing to around 5 million deaths globally – or one in 10. The report found that more people were dying from air pollution-related diseases than from traffic accidents or malaria. To slow the spread of the disease, we need to better understand why some places have higher numbers of cases and deaths than others. One factor that could partially explain this is air pollution. Air pollution affects our lungs insidiously, indirectly, gradually. In fact, even when it doesn’t actually trigger disease, air pollution ends up compromising and weakening the human lungs, making us more vulnerable to respiratory viruses like the SARS, MERS and now the novel coronavirus, SARS-CoV-2, which causes COVID-19. Research has shown that long term exposure to pollutants such as fine particulate matter (called PM2.5, as these are particles smaller than 2.5 micrometres), nitrogen dioxide (NO²) and sulphur dioxide (SO²) can reduce lung function and cause

The report found that more people were dying from air pollution-related diseases than from traffic accidents or malaria respiratory illness. These pollutants have also been shown to cause a persistent inflammatory response even in the relatively young and to increase the risk of infection by viruses that target the respiratory tract. A nationwide cross-sectional study carried out in the USA - Exposure to air pollution and COVID-19 mortality found that tiny pollutant particles PM2.5, breathed over many years, sharply raise the chances of dying from coronavirus. Researchers from Harvard University’s T.H. Chan School of Public Health analysed data on PM2.5 levels and COVID-19 deaths from 3,000 U.S. counties covering 98% of the U.S. population. Counties that averaged just one microgram per cubic meter more PM2.5 in the air had a COVID-19 death rate that was 15% higher.

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“If you’re getting COVID, and you have been breathing polluted air, it’s really putting gasoline on a fire,” said Francesca Dominici, a Harvard biostatistics professor and the study’s senior author. The fine particles penetrate deep into the body, promoting hypertension, heart disease, breathing trouble and diabetes, all of which increase complications in coronavirus patients. The particles also weaken the immune system and fuel inflammation in the lungs and respiratory tract, adding to the risk both of getting COVID-19 and of having severe symptoms. Evidence from older studies conducted during the SARS outbreak in China also validates this. Researchers at UCLA’s School of Public Health showed that patients with SARS were more than twice as likely to die from the disease if they came from areas of high pollution. The same seems true for COVID-19. In short, every day, emerging research shows new linkages between air pollution and respiratory viruses such as SARS-CoV-2, weaving them together in a tighter web.

Clear Blue Skies The pandemic has given air pollution researchers and data scientists an opportunity to monitor, record and parse how air pollution levels have responded to a situation of almost complete stoppage of economic activity and what we can learn from this for the future. “This is a model scientific experiment,” NASA scientist Robert Levy said about the lockdown and its effects on pollution in the same news report that noted the lowest pollution levels in twenty years. Researchers in the US are building a case that suggests air

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Studies suggest that persistently high levels of air pollution have significantly increased deaths from Covid-19 pollution has significantly worsened the Covid-19 outbreak and led to more deaths than if pollution-free skies were the norm. As well as predisposing the people who have lived with polluted air for decades, scientists have also suggested that air pollution particles may be acting as vehicles for viral transmission. These new findings could have a significant impact on how governments choose to ease lockdowns in the coming months, as scientists say that improving air quality could play an important role in overcoming the pandemic. While pollution inhaled in the past is still causing harm today, the temporary experience of cleaner air brought about by widespread shutdowns may offer lessons for the kind of world we want to build after the pandemic. Will the air once again become polluted, or is there a possibility for countries to use economic recovery programs to grow back stronger and cleaner, thereby averting another health crisis? As the government prepares a stimulus package to reinvigorate a stalled economy, now is the time for decision-makers to reimagine and redefine a greener and more sustainable path towards socio-economic growth.


Frontline & Healthcare

Clean Air Solutions An Irish company based in Clonshaugh, Dublin, with an extensive global profile and in-depth expertise in their field is proving central to the battle being fought against the COVID-19 pandemic.

CAMFIL Ireland has worked consistently since its inception in 1985 to research and manufacture clean air solutions such as air filters for HVAC systems, HEPA filters for clean environments as well as air purification systems and molecular solutions for odour removal. All of these products have been used within a hospital environment and other shared workspaces to great effect over the years in combatting disease and infections. The company is now working alongside the Council of Ireland to combat this new and insidious coronavirus. The company’s thrust in relation to air quality solutions has positioned them at the forefront of the industry in response to critical needs to reduce the contagion of the COVID-19 coronavirus in both public and private domains. In hospitals and care homes particularly, the concern is for both workers and patients. In addition, in high-density populated workspaces such as factories and offices where employees are working in enclosed situations and where any contagious disease could run rife, these systems are crucial for the improved safety of all. Paul Flanagan, Managing Director of CAMFIL Ireland spoke to Jackie Bragg and acknowledged how the company reacted immediately to the World Health Organisation (WHO) as the virus evolved from January and developed into a defined global

pandemic by the middle of March. “We were totally aware that this could not be a one-man show in terms of solutions. We needed to share our expertise and bring in the knowledge of others. It was and still is a new and changing phenomenon and it would be extreme to ignore potential educated partners when confronting the reality of COVID-19. “At the very beginning, we realised that we were a critically essential service and product provider even before the unprecedented situation of lockdown. Prior to this particular virus, it was recognised that clean air could be an important aid in lessening the contagion of viruses generally. We were already implementing systems that insured clean air in hospitals which have been proven to reduce the advancement of airborne diseases. We have been prepared for years and are ready to help in any way we are able.” Manufacturing has been ramped up within the company to cope with the increase in production necessary for escalating demand. Within the 60 plus workforce in Clonshaugh, there have been no cases of COVID-19 according to Flanagan. “Our workplaces function under strict CAMFIL conditions and perhaps this is evidence that our products really work,” he said. Sustainability is yet another string to CAMFIL’s bow – an element of the company which has not always reached the media

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over the years. The company has followed a government remit to reduce Ireland’s carbon footprint by working with their systems to become the most efficient in Ireland and beyond, and have proven that the installations have a longer life compared to other more throwaway and energy inefficient products. They have used rigorous testing in situ to ensure that performance is evidenced and documented. “We recognise that the way forward for us and for others who can influence what is happening in this new world with COVID-19 is to partner, share and collaborate,” says Flanagan, “Yes, we need to design and build new systems at a rapid rate and we cannot do this alone. We are working closely with the IHEEM (The Institute of Healthcare Engineering Paul Flanagan, Managing Director of CAMFIL Ireland and Estate Management) to understand the risks and ensure all buildings are equipped to deal with the pandemic.” CAMFIL also work in close collaboration with the HSE in Ireland in a consultancy role, designing and building systems in the healthcare industry. With a close history of side-by-side service, system implementation and exchange of information, CAMFIL was well placed to be at the forefront of the immediate response to reducing indoor infections to great effect. CAMFIL’s aim has always been to provide clean air solutions in a safe and effective manner and to deliver the safest indoor and exhaust air quality sustainably. Clean air is an “absolutely necessary” consideration for all workplace environments, stresses Flanagan: “Often, it can be passed over as an ‘out of sight, out of mind consideration’ - it is not something that everyone sees or understands. Clean air is a requirement for all businesses from hospitals to pharmaceutical plants to food and beverage production and of course any space where people work closely together and are sharing air in an enclosed environment. This has now become an essential and even crucial consideration as the virus spreads, as has always been the case with any type of colds, flu and other socially spread viruses and contagions. We have worked strenuously and continuously to reduce the probability of this type of contagion emerging.” The revelations in July published in the Lancet magazine by more than 200 scientists worldwide that COVID-19 could be spread by breathing out microscopic air particles, and not necessarily from large droplets from coughing and sneezing have spurred on investigations at CAMFIL.

Clean air is a

requirement for all businesses

from hospitals to pharmaceutical plants to food and beverage

production and any space where people work

closely together and are

sharing

air in an

enclosed

environment.

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“Our high-spec filters work on UltraFine Particles (tiny particles in the air) and we do believe that our filter systems are reducing the potential for the coronavirus to spread in certain environments, but we too agree that we must all return to the testing table to check exactly how all systems are working - or not - against this onslaught under the uncertain and changing conditions that the coronavirus is creating.”

Building on Success CAMFIL has sustained substantial growth and success over the years. It can now claim a huge market share in relation to air quality in the high dependency areas (especially in areas where air quality impacts heavily on those within the buildings) and it works with both local and global authorities openly and transparently. Acquisitions in Sweden and Australia in 2019 have only strengthened the direction that the company is heading in. The aim according to MD Paul Flanagan is to help customers achieve their zero carbon emission goals, and this starts locally. Ultimately this means that there will be significantly reduced carbon emissions overall from any CAMFIL products - or in other words, ecologically and environmentally friendly to the nth degree. An important aspect of this ambition is that their primary products, Panel & Bag Filters used primarily in HVAC Systems will be made entirely of materials that can be incinerated. This means they can contribute hugely to the waste to energy effort on the island of Ireland. In parallel with these measures, CAMFIL Ireland is growing its distribution network in Ireland. Alongside its manufacturing facility in Dublin and two regional offices in Cork and Belfast, they are about to launch a new distribution centre. This they claim will also lower their carbon footprint and enable the company to hold more essential stock locally, therefore improving delivery timescales.


Frontline & Healthcare

Oxygen A Life-Saving Molecule The COVID-19 pandemic is unprecedented in living memory and has changed life as we know it, so much so that the start of 2020 seems a distant memory given all that has happened.

Now is the perfect time to reflect on how this crisis has touched every fabric of society, including of course our health services and businesses supporting this vital sector. BOC Healthcare is one such business as it has supplied medical gases to the Irish healthcare system for more than 80 years. BOC manufacture oxygen to pharmaceutical quality in two air separation plants in Cork & Dublin and, from these plants, they supply oxygen in bulk liquid or cylinder form to hospitals throughout Ireland. Oxygen is of course life-critical yet at the same time, it’s not one of those “spotlight” medicines muchlauded in the media. However, if anything, this crisis has taught us that oxygen is the vital drug in the treatment of COVID 19 and having a secure supply is critical. As a member of The Linde Group, BOC Healthcare had early sight of the impact of COVID 19 in countries such as Spain and Italy. Reports emanating from these countries were stark and told of significant increases of 3-5 times the normal demand for medical oxygen in hospitals that were, in some cases, overburdened without time to prepare for COVID 19. However, it wasn’t that oxygen was in short supply. The raw material is the 21% oxygen present in atmospheric air (of which there is a continuous supply) and there

are numerous production plants across Europe. In fact, in normal circumstances, only 15% of oxygen produced for end-market-use is for healthcare purposes (Gasworld, April 2020). So, rather than there being a supply problem, the issue was delivery, as hospital systems in many cases were not designed with pandemics in mind. When things did go wrong in Europe it was typically because the medical gas infrastructure had too much ‘draw’; i.e. where an unusually high number of patients were utilising oxygen at the same time and at significantly higher flowrates than normal. All of this combined caused pressure to drop in medical gas pipelines. Some of these lessons, whilst tragic, were key to understand as planning took place between the Health Service Executive and BOC whilst events unfolded across Europe. For example, in the first instance, BOC took significant steps to boost production of Medical Liquid Oxygen at their Cork and Dublin plants. Work was undertaken with regulatory authorities including the HPRA & MHRA to allow up to six UK sites supply additional quantities of oxygen into Ireland where required. In addition, many thousands of industrial cylinders were converted to medical use in line with the scenario of patients being treated at multiple new, greenfield hospitals.

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Forging Alliances BOC retrained and redeployed staff, worked with the Department of Defence in case reserve drivers were required and continued to work closely with the HSE as its model of care evolved to ensure that the correct quantities of oxygen were available across a variety of settings. BOC also worked with health authorities in Northern Ireland and shared learnings from the north into the south and vice versa (the virus knows no borders!) Hospitals received supplies on a 24/7 basis and a body-of-work was undertaken to ensure that oxygen cylinders circulating from BOC production facilities to hospitals and back again were disinfected. This required large-scale disinfection procedures at production sites and the assistance of HSE staff to clean cylinders prior to collection is an example of partnership in action. A key project stream was, of course, medical gases engineering taking into account European learnings. This involved understanding the theoretical maximum delivery of oxygen into each hospital and measuring this in real terms. This exercise was conducted by the HSE, BOC and the COVID Engineering Alliance – a group of Irish engineering companies with multifunctional expertise all collaborating in the national interest. Any pinch-points or areas-of-concern were focused on to put in place works to improve a hospital’s ability to store, convert and deliver oxygen to wards or newly-opened treatment areas. One prime example is University Hospital Limerick where a higher-capacity liquid oxygen storage tank was installed in only 3 days, a critical project owing to

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Limerick’s catchment area, population base and relative lack of surrounding hospitals (unlike Cork & Dublin for example). This vital work, completed in a very short space of time, is a real example of crisis management with interlinked parties making decisions quickly as covid continued to spread throughout our community. The real hero of the hour, however, has to be the Irish public who took the advice of Government to stay at home to limit transmission. This had a definite impact as it helped to ensure that worst-case scenarios did not happen. Hospital intensive care units and other wards did not have to deal with the numbers of patients envisaged. However, it is good to know that the work done by all parties involved in the delivery and administration of oxygen meant that there was a good understanding of how many patients could be safely treated in each hospital and that, in-extremis, BOC had oxygen to meet this demand. So, are we out of the woods? Obviously not. As alluded to earlier, hospital medical gas systems were not designed with pandemics in mind; they are designed to safety requirements such as the UK’s Health Technical Memorandum (HTM O2), however, even this level of resilience would have been severely tested had the curve not been flattened. It is important therefore that work continues to improve the resilience of oxygen supply in our hospitals. BOC Healthcare is proud to play its part in the manufacture, production and delivery of oxygen to healthcare facilities throughout Ireland. It is indeed a life-saving molecule. BOC Healthcare applauds all frontline healthcare workers for the care they give and warmly thank their staff and customers as well.


Frontline & Healthcare

Have You Considered Using ENTONOX® For Gastroscopy? Rapid Onset ENTONOX works quickly, effects are apparent within a matter of breaths and analgesia is maximal within 2 – 3 minutes.

Reduced Recovery Time The patient may drive home 30 minutes following cessation of administration of ENTONOX, providing a healthcare professional judges them competent and the patient agrees that they feel able to.

Minimal Side Effects ENTONOX administration reduces the often serious side-effects associated with using other analgesic agents (e.g. midazolam, fentanyl).

ENTONOX delivery is not invasive so offers potential savings for departments on a number of items including: drugs, cannula, dressings, needles and a potential for avoiding overnight stays.

For more information on this, or about BOC Healthcare, please contact Eugene Clark on 00353 (0) 87 115 5345 or email eugene.clarke@boc.com

“I am pro-ENTONOX use for upper GI endoscopy, because in my experience I find the patient is more compliant during the procedure as they can understand what the patient nurse is communicating to them. Another positive with using ENTONOX is that it provides the patient with a quicker discharge process. This also benefits the endoscopy unit because the beds are available for the patients who require sedation.“ Charlotte Madgwick Nurse Endoscopist, Hampshire Hospital NHS FT

BOC Healthcare is the trading name of BOC Limited registered office, The Priestley Centre, 10 Priestley Road, The Surrey Research Park, Guildford, GU2 7XY, England. Number 337663 – English Register. Authorised and regulated by the Financial Conduct Authority, register number 715528. BOC is a company name used by Linde plc and its affiliates. The BOC logo, BOC word and ENTONOX® are trademarks or registered trademarks of Linde plc or its affiliates. Copyright © 2020. BOC Ltd.

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HLC/702290/CST/0520

Potential Cost Savings


Frontline & Healthcare

Behind The Mask Face masks are a symbol of the pandemic era; a visual metaphor for the invisible foe that could be lurking around any corner. While a few months ago anyone wearing a mask in public would have drawn attention, masks are now an everyday part of the strange times we live in.

To understand why masks might work, it is important to look at how the virus that causes COVID-19 spreads in the first place. Once it has infected someone, the Sars-CoV-2 virus responsible for the disease hijacks their cells to replicate itself. As it multiplies, new virus particles burst out of the cells and become suspended in the bodily fluids in our lungs, mouth and nose. When an infected person coughs, they can send showers of tiny droplets (aerosols) filled with the virus into the air. A study carried out by virologist Neethe van Doremalan at the US National Institute of Allergy and Infectious Diseases found that the Sars-CoV-2 virus has been found to survive in these aerosol droplets for at least three hours but a more recent as yet unpublished study has found that the SarsCoV-2 virus is still infectious for more than sixteen hours after being suspended in aerosol droplets. It found the virus was “remarkably resilient in aerosol form” compared to other similar coronaviruses studied. Together, they suggest that in the right conditions, the virus can linger in the air for several hours and still infect people if breathed in, and in indoor environments, they seem to be particularly prone to spreading through the air.

According to the World Health Organisation, current information suggests that any person who is in close contact (within 1 m) with someone who has respiratory symptoms (coughing, sneezing) is at risk of being exposed to potentially infective respiratory droplets. Droplets may also land on surfaces where the virus could remain viable, thus the immediate environment of an infected individual can serve as a source of contact transmission. Evidence from 10 studies outlined in The Lancet across SARS, MERS and COVID-19 with 2,647 participants found benefits for face masks in general. Risk of infection or transmission when wearing a mask was 3% vs 17% when not wearing a mask. Government advisor Damien Nee, who represents patients on the Expert Advisory Group to the National Public Health Emergency Team (NPHET), said wearing masks was key to combating the pandemic in other countries. “I am speaking out of frustration that easy wins are not being taken,” Nee said. “That anybody who wants one can wear one and they should be obligatory, especially going into any food shop, because that

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will ensure that the pandemic does not rise up rapidly again,” he said in an interview on RTÉ’s Prime Time. When I look at all the wise countries that have coped well its a core element. It’s central to their successfully coping with the growth of coronavirus.” Latest government guidelines agree, and from 10th August face coverings will be mandatory in shops, shopping centres, cinemas, public transport and other public settings across Ireland with those in breach of the rules potentially facing a fine of up to €2,500 or six months imprisonment. Minister for Justice Helen McEntee has said if an individual remains inside a shop

or other outlet without a mask, the owner or staff would engage with them in the first instance. Only as a “last resort” would gardaí be called to deal with the matter, she said. Life in Ireland has changed radically, and these new public health measures have become the new norms. In response to this new reality, brands and designers are combining their talents and creativity to offer aesthetic and even haute couture versions of the mask, persuading even the most reluctant to wear them. Are protective masks about to become the new must-have in our changing rooms?

MASK MANAGEMENT For any type of mask, appropriate use and disposal are essential to ensure that they are effective and to avoid any increase in transmission. The following information on the correct use of masks is derived from practices in healthcare settings. n Place the mask carefully, ensuring it covers the mouth and nose, and tie it securely to minimize any gaps between the face and the mask. n Avoid touching the mask while wearing it. n Remove the mask using the appropriate technique: do not touch the front of the mask but untie it from behind. n After removal or whenever a used mask is inadvertently touched, clean hands using an alcohol-based hand rub or soap and water if hands are visibly dirty. n Replace masks as soon as they become damp with a new clean, dry mask. n Do not re-use single-use masks. n Discard single-use masks after each use and dispose of them immediately upon removal.

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Frontline & Healthcare

Safety & Sustainability from RashR With €2 from every mask sale donated to the Irish Lung Fibrosis Association, “RashR” masks remove ocean plastic from our seas while helping against the transmission of COVID-19.

Irish company “RashR” has joined the charge against COVID-19 transmission by pivoting their business to produce eco-friendly, reusable face masks with filters, for the general public with €2 of the proceeds per mask going to the Irish Lung Fibrosis Association (ILFA). In an effort to think outside the box as a result of a temporary decline in their core business, and in the pursuit of helping the ILFA and the people of as a whole in the fight against COVID-19, Cork-based company “RashR” is now producing washable ecofriendly facemasks with filters. Since 2017, the company has been a leading supplier to luxury resorts across the world (such as the Four Seasons, Sixth Sense, and Richard Branson’s luxury resort, Necker Island) with their sustainable clothing and accessories (including rash vests, compression tops, boardshorts and caps). However, with the onset of COVID-19, the company is now using the materials they traditionally used in the production of their internationally renowned rash vests (protective skin clothing for surfers in hot climates) to produce high-quality face masks on an industrial scale. Speaking about the decision to launch “RashR” facemasks, CEO, founder and Carrigaline-native, Tom Cotter said: “In response to the current pandemic, we have committed to utilising our wide international network and considerable industry experience to source reliable good quality, eco-friendly materials

in the fight against COVID-19 at realistic cost by working directly with top manufacturers. The masks have been manufactured using recycled polyester at just under medical grade standard so will not be interfering with the supply of PPE equipment for healthcare workers. However, the masks will be suitable to those in a general work and public environment as businesses slowly begin to open their doors again based on public health guidelines. “We also wanted to help a charity as we know they are especially struggling during this time, so with that, we chose to donate €2 of each mask to the Irish Lung Fibrosis Foundation. We chose to do this given the significant number of members suffering from respiratory diseases at the moment, a lot of their members would suffer from symptoms very similar to COVID-19 constantly and with our masks helping to protect the lungs, it felt like a good fit for us.” Tom added. “We’re also delighted to be working with several companies around Ireland and internationally to recreate branded facemasks from reclaimed ocean waste for the ‘new now’. This is a great option for corporate customers to have their own branded facemasks” he concluded. The masks have also recently received the support and backing of none other than Leonardo Di Caprio, who is well-known for being a devout environmental activist. The facemasks are machine washable and reusable and are

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manufactured in two sizes – an adult one-size-fits-all version and one for children aged 3-10 years. Each facemask has a pocket which is suitable for optional PM2.5 filters which are also supplied by the company. The five-layer filters are non-woven fabric, activated carbon and melt down fabric to conform to GBT 32610 -2016 standards to filter bacteria, particles, dust and smoke and to increase filtration levels. Each filter which can be worn for up to eight hours, has been tested to conform with the EPA requirement of having a DOP particle efficiency of 99.7% or better. “Rash’R” has teamed up with several of their European manufacturers to produce the masks – and up to 25,000 can be produced with a lead time of three weeks. Company-specific branding is also available. In addition to their conformities with public health guidelines, the masks also meet global recycling standards. In terms of caring for these masks, “RashR” has advised that all masks be washed regularly, with any filters removed before washing. All masks are also machine washable at 40c for 30 minutes, with no bleach, and must be ironed at medium temperatures only, with no tumble drying of the masks or dry cleaning advised. Each mask is €19.99 and includes 1 filter (with €2 per mask donation going to The Irish Lung Fibrosis Association). A Pack of 5 filters is available also at €7.50. For further information on the masks or to place an order, see rashr.com or follow @TeamRashR on Instagram, Facebook and Twitter.

Carrigaline. He is employing 8 people locally and is looking to double this by the end of 2020. Nearly 97% of what Tom and the team do is shipped overseas. They work with some of the leading luxury resorts around the world including the well-known Necker Island owned and live on by Sir Richard Branson. Heavily involved in local community sport, Tom is a member of the Crosshaven Triathlon Club and is currently in training to complete a half Ironman. He is a keen windsurfer and scuba diver. At college, he attended Kinsale FEC where he qualified as a rock climbing, windsurfing, sailing and kayaking instructor.

Behind the Mask After spending most of his 20s travelling around the world flitting between various outdoor instructor jobs, Carrigaline man Tom Cotter returned home in 2016 when he began working on a new project that focuses solely on sustainable fashion. Now, almost three years later, he finds himself selling to an impressive list of the worlds rich and famous. Upon arrival home from Melbourne Tom had a desire to start his own business coupling his love of water and business development that he acquired managing one of the largest sailing centres in Australia. Through market research, Tom saw an increase in demand for rash vests (a sun protection top usually worn by surfers and sailors) due to the rise in skin cancer awareness campaigns and the growing active lifestyle. Rash Vests were becoming a mainstream product that all family members were buying to cover up on holidays. The plan was soon set to become the world’s biggest rash vest company. While still in the product development stage Tom saw how damaging the traditional fashion and retail industry was on the environment. So, Tom and the team set out to address the major issues of the industry. Fabrics, supply chain and manufacturing were the three pillars they focused on. After months of testing various fabrics, they eventually found one that fitted in with their brand ethics and ethos. Tom launched his company in 2017 and quickly realised the difficulties and enormous challenges of growing a global brand. It wasn’t until the company started getting contacted by major events around the world that wanted to create their own design but use RashR’s sustainable fabric that Tom realised they may have stumbled upon something unique. Fast forward to the end of 2019, Tom has opened an office in

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OCEAN WASTE MATERIALS: Almost every product has a manufacturing process that consumes energy and water and produces carbon dioxide emissions and as such has an environmental impact. Recovered ocean waste plastics and post-consumer plastic bottles are collected and brought to an approved recycling facility. At the recycling facility the conversion process of turning waste into wearable fabric begins: • A flotation and separation process separates the different types of plastics and in the case of bottles removes the caps and labels from the bottles, as they are made of plastics with different characteristics. • The selected Polyethylene Terephthalate materials are then processed into flakes. • After being washed the flakes are melted. • Yarns are pulled from the melted polyester. • The result is a clean, valuable, and recycled raw material perfect for textile fabric production. • The raw filament yarns are spun into yarn and ultimately woven into a variety of different Oceanbalance fabrics.


Public Sector Magazine

FACEMATE … xxa trusted partner in the fight against Covid-19

xx

The equality debate is regularly in the spotlight and it is fair to say that an overwhelming majority of people now believe that success is earned on the basis of an individual’s application and ability rather than their gender, ethnicity or religious beliefs. and, more importantly, it is the right thing to do. By sharing experiences and ideas we can all learn from each other and drive the change that is needed. PwC recent research has identified ten lessons on how diversity might be approached: n Tailor the business case, then make it resonate n Recognise there is no ‘quick fix’ COMPANY: n No leadership commitment, no accountability, no progress n UseIreland data analytics in planning the programme… Irema … and use data analytics in executing the programme n One size does not fit all cultures n Embed Diversity within organisational DNA BRAND: n A focus on inclusion from day 1 FACEMATE n Recognise performance over presence n Engage the masses

FOUNDED: 1985 There is no doubt that the 30% Club has made a significant in a Theimpact Covid-19 pandemic brought a huge sense of uncertainty to the relatively short period of time. And if women require a role model they operational side of the health sector as global supply more than LOCATION: can surely look to the impressive achievements of a woman determined to struggled to keep up with the unprecedented demand for PPE. As shatter the last remnants of the glass ceiling!

Kilmallock Business Park, Kilmallock, Co Limerick

health services across the globe exhausted all existing and new channels for supply, the HSE found itself being able to look much closer to home due to domestic production of face masks provided by Kilmallock based Irema Ireland.

SELECTED PRODUCTS: FACEMATE Surgical Tie On FACEMATE Surgical Earloop FACEMATE Respirator FFP2 FACEMATE Respirator FFP3

Manufacturing the FACEMATE brand of surgical and respirator face masks for 35 years, Irema Ireland quickly pivoted from being a predominately export led manufacturer to providing an instant and continuous domestic supply to the HSE through its Dublin based distribution partner Promedicare.

CONTACTS: Tel: 063 98544

‘TRUSTED BY PROFESSIONALS’

John Rice jrice@irema.ie Sean Cooke scooke@irema.ie

With the proliferation of imported masks and ‘pop-up’ suppliers , FACEMATE has offered the security of a domestically produced, fully regulated and fully compliant face mask that was already a trusted brand among leading European healthcare professionals.

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“The team at Irema have been through Swine Flu, SARS and other outbreaks but the scale and urgency presented by Covid-19 is something that nobody had every experienced before. At the flick of a switch in early February, we needed to ramp up production, secure raw material supply, acquire new machinery and embark on a hiring spree in order to try meet the unprecedented and critical demand from the HSE for our surgical and respirator masks. Working closely with HSE procurement and our distribution partner, Promedicare, we identified the what, when and how and have worked closely over the last number of months to ensure a consistency of delivery while not compromising on our commitment to quality. I’d like to to compliment and acknowledge the hard work and sacrifice of the front line healthcare professionals throughout the pandemic. Irema is pleased to support these medical professionals though the supply of comfortable and effective FACEMATE PPE.” John Rice Managing Director Irema Ireland

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PPE RESPIRATOR MASKS Of particular importance to the HSE during the onset of the pandemic was securing a consistent supply of FFP2 & FFP3 (PPE) respirator masks that offer greater protection to people working in environments where harmful particles, pathogens and aerosols present a danger to their respiratory system and long term health. Established as a mask of choice pre Covid, FACEMATE consistently scores in the 90% + bracket in controlled ‘Face Fit’ quantitative testing providing excellent fit for the majority of wearers and making it one of the most effective masks on the international market. SURGICAL MASKS FACEMATE provides a continuous supply of surgical face masks to the HSE that are fully certified by internationally accredited independent laboratories. The range of disposable face masks for doctors, nurses, surgeons and healthcare professionals meet the highest industry standards for bacterial filtration efficiency BFE (> 98%). Our clinical 3-ply & 4-ply, latex free FACEMATE range of surgical masks are available in tie-on and ear-loop formats providing continued comfort during extended wear.


Public Sector Magazine

ABOUT IREMA Irema Ireland was established in 1985 as one of the first global suppliers of disposable surgical face masks and face mask media.

We built our business from humble beginnings of a singular line of surgical face mask products. Growth quickly followed, due in part to the efforts of our research and development team and to the continued utilisation of the most pioneering technology including our in-house melt blown production technology that allows us deliver exceptional quality media for face masks. ‘Protecting people through excellence and innovation’ Irema has been a consistent and valued regional employer for 35 years but the Covid-19 pandemic has necessitated a major and rapid expansion. The company has significantly increased employment in its in Kilmallock base and has invested in a number of new machine lines specifically for the provision of FACEMATE respirator & surgical masks to the HSE.

PROMEDICARE Irema Ireland’s trusted distribution partner is Dublin based Promedicare who have exclusive distribution rights for the FACEMATE range in the healthcare sector. Promedicare is a product and service focussed Medical Device and Pharmaceutical supplies company with the aim to partner with innovative manufacturers and to provide an emphasis on delivering quality proven medical and pharmaceutical products to the healthcare market. Now established as a trusted supplier to the HSE and to numerous private hospitals in Ireland, Promedicare has grown to become a reputable provider of quality medical devices and pharmaceutical products in the healthcare market. Promedicare Ltd., c/o Allphar Services, 4045 Kingswood Road, Citywest Business Park, Co. Dublin, Ireland. Tel 01 468 8485 or email info@promedicare.ie

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COURAGE TO CARE Working Together 24/7 with our Frontline Colleagues

Irish Nurses and Midwives Organisation The Whitworth Building, North Brunswick Street, Dublin 7 Tel: 01 6640600

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Frontline & Healthcare

Everyday Heroes From one day to the next we never know what life will bring and the current pandemic is a case in point. Coronavirus has brought out the very best in our emergency services and has led to an outbreak of a very different kind - heart-warming acts of human kindness.

Not all superheroes wear capes; some wear scrubs and gowns. Since the outbreak of the COVID-19 coronavirus, frontline staff have been the glue holding our society together. Their mettle and resilience are to be commended. Even when faced with life-threatening risks that come with working on the frontline, these brave individuals selflessly put the needs of others above their own. Leaving aside the physical threat, the mental health implications of working in these extreme circumstances can be detrimental. Doctors, nurses and paramedics must selfisolate to prevent spreading the virus to family members. In times of crisis, people seek comfort in the arms of others. However, many healthcare workers are denied this basic comfort when they need it most, yet they persevere through an insurmountable workload.

The risk of being a healthcare worker in Ireland has never been so high. Medical staff had to deal with limited supplies of personal protective equipment when the virus first struck. National supplies were so low that the Health Service Executive (HSE) placed a two-hundred-million-euro order for Personal Protective Equipment (PPE) from China. The HSE came under immense pressure over fears of hospital overcrowding and lack of ventilators and PPE. Paul Reid, Chief Executive of the HSE was gushing in his praise for healthcare workers across the board saying that he wanted to “express my gratitude and thanks to staff, all our healthcare staff, all across the country. Your response has been phenomenal. I’ve worked in many sectors and I have never seen anything like the mobilisation and commitment of all our healthcare workers.”

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Doctors, nurses and paramedics must selfisolate to prevent spreading the virus to family members. In times of crisis, people seek comfort in the arms of others, yet many healthcare workers are denied this basic comfort when they need it most.

Behind the Frontline As the pandemic took hold, the media spotlight focussed on healthcare. The ‘clap for carers’ movement garnered immense support from the public as it erupted over social media. Yet all across Ireland there were countless others who dedicated themselves to serving their local communities. These people include those in fire and ambulance services, An Garda Síochána, the coast guard and the defence forces. These everyday heroes face some of the most extreme challenges, doing so calmly and selflessly.

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Yet not all heroes wear uniforms and not all work on the frontline. When the virus first crossed the borders into Ireland there was pandemonium in supermarkets across the nation. Stock-pilers and doomsday prophesiers proceeded to empty shelves in near-hysterical fashion. The increased demand meant that supermarkets had to impose limits on products such as toilet paper and hand sanitiser increasing pressure on staff. These everyday heroes, many of whom earn close to minimum wage, went above and beyond the norm by keeping shelves stocked, relentlessly disinfecting countertops, dealing with disruptive customers and expertly


Frontline & Healthcare

implementing social distancing and sanitisation protocols in their workplaces. Supermarkets have always been a constant in our daily lives but the current crisis highlights the fact that we take essential services for granted as we have always had access to a steady, reliable supply of food and essential items. Now more than ever, we as a society need to show support for the people who keep essential retail outlets in business. These men and women are just as essential as frontline workers and have been vital in maintaining a level of normality in today’s ‘new normal’.

The Human Spirit In times of crisis, it is not uncommon to see the more fortunate members of society answer the call of duty by helping those less fortunate. A great example of this came from one of Irelands sporting superstars, the notorious Conor McGregor. The infamous McGregor is well known for his expertise in mixed martial arts and for bad-mouthing his opponents. McGregor spent a lot of time under the media spotlight for misconduct, however, this dynamic shifted when he bought and donated 1.3 million euros worth of personal protective equipment to hospitals

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LAW SOCIETY DIPLOMA CENTRE SPRING 2020 COURSES OPEN The Law Society of Ireland’s Diploma Centre is pleased to offer a range of postgraduate certificate and diploma courses for Spring 2020 The Law Society Diploma Centre, a leading provider of continuing professional legal education and training for over 20 years, is now accepting applications for a range of Spring 2020 courses, many of which will be of particular relevance to those working in the public sector. Courses on offer include the: • Certificate in Public Procurement • Certificate in Commercial Contracts • Diploma in Compliance and Risk Management • Certificate in Data Protection Practice • Certificate in Advanced Negotiation

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around the country. He even went as far as to personally deliver some of the equipment. A total of 18,000 gowns, 30,000 face visors, 120,000 gloves and 30,000 face masks were donated. McGregor took to Twitter to share the news of his donation: “28 counties, 165 locations, 18 vans. A real solid day for the team! Tomorrow we go again. Thank you to all involved,” he said after delivering PPE to 28 counties in Ireland - an incredible feat indeed! Doctor Nina Byrnes was full of praise for McGregor after the unexpected donations started arriving. Byrnes said that without McGregor’s kindness, her surgery would have run out of medical gowns. “We could only find them at €9 a gown and you had to order 200 and we just couldn’t afford to do that. I would have had no gowns if it were not for this charity,” said Byrnes. “When McGregor’s team went out the door we opened the box and realised that they contained badly needed gowns, and honestly it was like Christmas. My manager and I ran downstairs after them to thank them because we had been trying really hard to get gowns,” said Byrne in an interview on The Tonight Show on Virgin Media One. “Where we would be without those brave men and women, I do not know,” said McGregor when announcing his donations. Another high-profile individual who carried an extra load in the height of the pandemic was former Taoiseach and current Tánaiste, Leo Varadkar TD. Mr Varadkar, formerly a practising doctor of medicine, re-registered as a medical practitioner and

committed to working one shift a week to help tackle the virus. Varadkar offered his services to the HSE despite the immense pressure of being Taoiseach at the time. He was seen to be truly inspirational as he reassured citizens in televised announcements and guided the country through the worst of the pandemic.

Local Heroes Around the country lesser-known heroes are offering free meals, collecting and delivering groceries, walking dogs and collecting vital medical prescriptions. These random acts of kindness are of no surprise to Liz Hughes, CEO of Charities Institute Ireland. Liz believes goodness is in our bones. ‘‘It’s the small things that make the difference, texting €4 to your favourite charity, checking in on your neighbour, tidying their garden or leaving a litre of milk on their doorstep. It’s in our DNA.” Ireland is the most generous country in Europe when it comes to charitable donations according to recent research. The Charities Aid Foundation World Giving Index ranks Ireland as not only the most generous in Europe, but the fifth most generous in the world. Little wonder therefore that in the face of adversity people like Rodney O’Connor literally step up to the plate to feed workers at Tallaght Hospital. Rod had to close the door on his catering business due to the pandemic, but he still wanted to contribute. Rod’s Kitchen is

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just five minutes from the hospital, so he came up with the idea of inviting staff passing by to drop in to his kitchen for a hot meal. “I put up a post on Facebook saying that if any emergency workers were passing, to drop in and I would make them some lunch,” said O’ Connor. Such was the demand for his service, Rod was asked if he could deliver to the hospital, especially on Saturday and Sunday when the staff kitchens close. Rod began supplying the hospital with free of charge meals with the assistance of his brother Ian, another Dublin based

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businessman. “To date, we’ve made and distributed over 2,500 meals and we will continue to roll this out over the coming weekends,” said Ian to RTÉ news. Aside from the generosity of the O’Connor brothers, their staff also give up their time voluntarily, many of whom are unemployed. “The nurses and doctors have all been coming down thanking us for what we are doing,” said Rod. “Actually, it’s really emotional when you see how much it means to them just to get a hot meal.” Another Dublin based duo, Cian O’Flaherty and Tad


Frontline & Healthcare

The risk of being a healthcare worker in Ireland has never been so high. Everyone from doctors, nurses and paramedics to hospital porters wake up each morning knowing that their job places them at high risk of infection yet despite that they carry on regardless. the Public Sector Magazine

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Frontline & Healthcare

McAllister, wanted to do something to recognise and support the thousands of healthcare staff working on the frontline. They set up a Go Fund Me page to pay for meals for healthcare workers in hospitals countrywide. Within 72 hours of setting up the fund, more than €188,000 has been raised. The critical importance of self-isolation in combating the Coronavirus pandemic is now evident. This is particularly important for the elderly or those with pre-existing medical conditions. But how can those people who are self-isolating manage to get food, medicine and other essentials? One man up for the job is John Morris, a postman in the Tuam postal district in Co. Galway. “In the 39 years that I’ve been serving the post, I’d have seen a lot of changes but this is the biggest change of all,” said Morris when referring to the massive increase in postal traffic due to the closure of many business and social distancing protocols. “Since the coronavirus, the quantities of parcels for delivery far exceed the deliveries we would make on normal days,” said Morris. Despite the extra workload however, Mr Morris is not only delivering parcels, he also delivers newspapers to cocooning elderly citizens. “It’s handy having him so we don’t have to go into town at all,” said one of the recipients of Morris’ generosity after receiving his daily delivery. Fellow postman Dickie Murphy from Enniscorthy showed the same grit, running errands for the elderly in his area during the pandemic. “Last week I collected someone’s pension. I went to the chemist to collect a prescription. I did a bit of shopping for someone and the post as well,” said Murphy. On any given day An Post delivers approximately 2 million letters and parcels to homes in Ireland. This figure trebles leading up to Christmas and through the pandemic the average daily figures have likewise trebled. The fact that these two postmen like many others maintained a regular and consistent postal service as well as assisting the elderly is truly heart-warming.

Human Resilience The clear message from these stories is one of human resilience, adaptability, perseverance and hope. Humans have been beaten down throughout the ages by wars, plagues, famines and all manner of natural disasters. For all our faults, we have persevered and positively thrived. Despite the trials and tribulations, our small island has endured, Ireland has evolved as its own sovereign state, pockmarked with popular tourist attractions and goliath Fortune 500 companies. We have overcome many challenges and evolved into one of the world’s most prosperous and most progressive countries. The same logic of resilience and ultimate prosperity can be applied to less than ideal situations such as the one we now find ourselves in. Humans have endured pandemics before such as the Spanish Flu which ripped through the global population in 1918 infecting approximately 500 million people. By the summer of 1919 the virus had died out due to heightened immunity within societies and the human race persevered. Yet back in 1918 there was no modern medicine, no vaccines or ventilators and governments didn’t have the means to implement stringent social distancing protocols. However, the year is 2020, modern medicine has saved many lives and vaccines are being developed at lightning speed. This is no coincidence. As a world collective, we have banded together to fight the virus head-on. The Everyday Hero is within every single human being on this planet and is expressed by ordinary actions in extraordinary times. Across the island of Ireland, thousands of people are selflessly doing what they can to play their part in tackling this terrible foe. Whatever the damage wreaked by Coronavirus, it has served as a reminder to us all about the power of community. The effect of ordinary people pulling together is an incredibly powerful force.

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Honk for Heroes Ireland paid a special tribute to its frontline heroes as part of the annual National Services Day celebrations.

In previous years National Services Day would have been marked with a major parade through the streets of Dublin with large swathes of the public out in force. However, the current pandemic put paid to those plans this time around. Despite this, people from across every corner of Ireland were eager to mark the day and acknowledge the incredible efforts of these key workers over the last few months. Firefighters, gardaí, paramedics and lifeboat crews sounded horns and sirens across the country as a show of respect for colleagues working near and far. Three helicopters were dispatched from the Irish Air Corps to conduct a flyover of Dublin city centre that not only marked the occasion but served as a special tribute to the victims of COVID-19. A special ceremony took place at Collins’ Barracks in Dublin with Justice Minister Helen McEntee joined by representatives of 24 agencies for the event. The day which honours all frontline and emergency services saw a particular emphasis on the health services this year. The National Ambulance Service was represented by Director Martin Dunne who paid tribute to staff who have worked tirelessly for months. He also acknowledged the families of health service workers, saying: “Families have been a huge support to allow health service workers to do what they’re doing and that should also be applauded and recognised.”

Owen Medland, the RNLI’s lifesaving manager, described it as a day to remember those who had passed away from the virus. “They’re in the forefront of our mind,” he said. “We’ve got many, many people within our services who have been touched both in their own loss or just witnessing and I think it’s a time for reflection as well.” Ms McEntee said it is her “deep privilege” to work closely with some of the frontline emergency services, such as An Garda Síochána and the Irish Prison Service. “I have seen at first hand their tremendous professionalism and dedication, in what can be very challenging circumstances,” she said. “I am delighted to have the opportunity to publicly thank them and all our emergency services for the quiet heroism of their chosen career.” The Justice Minister also used the ceremony to reflect on Detective Garda Colm Horkan, who tragically lost his life in the service of the State earlier this year. “On this day, I think particularly of Detective Garda Colm Horkan, who tragically lost his life in the service of the State this year. “In his selfless commitment to community and country, Detective Horkan represented the very best of An Garda Síochána and indeed of all our frontline services. We remember and honour him today.”

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THE NATIONAL AMBULANCE SERVICE

The National Ambulance Service (NAS) is the statutory pre-hospital emergency and intermediate care provider for the state. In the Dublin area, ambulance services are provided by NAS and Dublin Fire Brigade (DFB). Aero Medical services are provided by the Irish Air Corps and the Irish Coast Guard by agreement with each organisation. At a local level, the NAS is also supported by over 275 (Mar 2020) Community First Responder schemes, responding to particular types of medical emergencies (i.e. cardiac arrest, respiratory arrest, chest pain, choking and stroke) where it is essential for the patient to receive immediate lifesaving care whilst an emergency response vehicle is en route to the patient. In recent years, the NAS has embarked on a strategic investment programme to develop a modern, quality service that is safe, responsive and fit for purpose. The service is implementing a significant reform agenda which mirrors many of the strategic changes underway in ambulance services internationally as they strive for high performance and efficiency whilst coping with a continuously increasing demand on services.

CAREERS IN THE NAS

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EMERGENCY MEDICAL CONTROLLER

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First Responders The National Ambulance Service is the statutory pre-hospital emergency and intermediate care provider for the state. It responds to over 340,000 ambulance calls each year, employs over 1,900 staff across 100 locations and has a fleet of approximately 500 vehicles. On 4th March 2020, the NAS responded to the COVID-19 emergency. It moved quickly to perform COVID-19 home testing by redeploying frontline ambulance clinicians from emergency response to COVID-19 testing, as solo responders in Rapid Response Vehicles (RRV). NAS staff were trained in nasopharyngeal/ oropharyngeal swabbing and sample handling. Supply chains for testing kits and PPE were put in place and arrangements made to facilitate expedited transport of completed tests to the National Virus Reference Laboratory. Since 4th March 2020 to end of July 2020 the NAS has conducted over 111,000 tests. As the situation evolved, the NAS then introduced pop-up testing centres to allow for testing of large groups of people in a controlled environment and further developed into static site testing with their colleagues in community health. The NAS also engaged with the Department of Defence in conjunction with the Irish Navy and established two sites, one in Galway and one in Dublin, utilising Irish naval vessels and navy staff to test patients in a static environment. In parallel, the NAS also engaged with other state agencies and educated staff within community services, staff within Safetynet, An Garda SĂ­ochĂĄna, prison service staff, doctors and other stakeholders to ensure a strategic approach in managing the situation. The NAS has implemented a dedicated COVID-19 dispatch centre and further reinforced its clinical hub with extra doctors who can advise on alternative pathways for low acuity patients, thus avoiding unnecessary hospital admissions. The NAS continues to deliver home testing, nursing home testing, special requirements and testing for healthcare workers. On Friday 17th April 2020, the NAS further responded to COVID-19 emergency by deploying resources specifically to nursing homes and other residential settings to test residents and staff within these settings. Given the current threat of COVID-19, the delivery of prehospital care services will occur within the context of the ongoing risk of infection. As the advice issued by NPHET

continues to evolve, there is a need for the NAS to address risks in a planned, appropriate manner which optimises patientcentred care while minimising risk to staff, the public and the wider health services. In addition to complying with the evolving guidance/rules of NPHET, requirements that NAS must give cognisance to can be broadly classified into infection control requirements, organisational management (control guidelines and appropriate staff training), physical distancing, patient confidence, remote alternatives and wider health service integration. These can be further broken down into our patients, education, integration, communication, resourcing, technology and structures. To ensure that the NAS can deliver a service in this changing environment it will be relying heavily on education in the form of NAS and public awareness campaigns, enhancement of technology to ensure the best care, availability and quality of fleet and equipment, complete interagency co-operation and the support of the public in maintaining a culture of health & wellbeing. In terms of future planning as part of the long term evolution of the service, the NAS is progressing from an Emergency Medical Service (EMS) to Mobile Medical Service (MMS) in line with SlaintĂŠcare and other system reconfigurations ensuring that patients receive the right care in the right place at the right time.

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Life Begins The concept of golden years is changing. Sixty is the new forty according to scientists who say that longer, healthier lives mean people are hitting middle-age much later in life.

According to a report by Cigna Insurance Services (UK), life begins at 60. Previously it was said that life begins at 40, a tantalising tagline from American psychologist Walter B Pitkin who argued that people could look forward to many enjoyable, prosperous years after their prime was over. Back in 1932 this was a radical thought, but researchers are now saying that it is never too late to ‘begin’ and to embrace new experiences you need to become a little bit older, bolder and wiser. In recent years we hear how each decade makes us younger. Forty is the new 20, 50 is the new 30 and 60 is the new 40. At this rate, ageing sounds positively exciting! For many, reaching 60 brings newfound freedoms. Pensions kick in; home is a quieter, less frantic space; you can eat whatever and whenever you want, go out without worrying about the children; book a guiltfree break. Leisure time is at long last, leisurely. There’s also a better feeling of oneself with fewer constraints. ‘Grown-ups’ become aware of gratitude at a higher level looking at life with a glass half full attitude and smelling the roses. At 40, we are still going through the motions without stopping long enough to even notice that sweet scent. In addition, and Coronavirus restrictions aside, the golden population are now travelling more, learning more and keeping busy in ways that their parents and grandparents could never have imagined.

A new piece of research has found that baby boomers (those people born from 1946 to 1964 during the post World War II baby boom) are young at heart. Life doesn’t end at 60 - actually, it begins. The report re-examines the premise that American psychologist Walter Pitkin came to arguing that the machine age which set workers free from back-breaking labour meant that people could look forward to many more years after their 30s were over. In this new piece of research, a group of 2,000 adults were asked at what point people become ‘old’. The average response given was 68 years. The report also found that our concept of what is old changes as we age. According to those under the age of 35, the word old applies to those aged 61 and over. For those in their seventh decade, the concept of being old doesn’t begin until they are 77, only four years short of Irish average life expectancy. Participants complained that as a society we treat older people as being ‘past it’ and dismiss their potential to contribute to society. 36% of those over 64 complained that businesses treat them as old even if they don’t feel it, while almost half specifically level this complaint at insurers who focus on funeral planning and ill health. Paul Flatters, chief executive of the Trajectory Partnership and expert in the over 50s marketplace believes that the changing social outlook of people in late middle age is one of

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the defining characteristics of our era. “This is a generation that views maturity as empowering and retirement as liberating. People are refusing to be defined by a number that ticks up as each birthday goes by. Older people are happier, more confident and more adventurous than ever before. “A time of life that would once have been seen as twilight is now viewed as a time of adventure, opportunity, and change. Older people are refusing to be defined by their age and they will bristle at being put into a box marked ‘past it’ or labelled as ‘grey’ or ‘silver surfer.” Average life expectancy has increased at a remarkable pace. The length of time we can expect to live grows by two and a half years every decade. That amounts to average longevity for the population in modern societies rising by six hours every day. The point at which people consider themselves to be ‘old’ is extending further into the late 60s as people recognise that instead of hitting their sixties disadvantaged, the reality is that they have decades of active years ahead.

Older & Wiser With age comes experience and to this end, our senior population are an important piece in the glue that holds society together. The combination of their historical and societal experience can provide great insight into what society used to look like, and how in a relatively short time span it has changed

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so dramatically. A study in Topics in Cognitive Science pointed out that older people have much more information in their brains than younger ones, so retrieving it naturally takes longer and the quality of the information in the older brain is more nuanced. However, while younger people were faster in tests of cognitive performance, older people showed “greater sensitivity to finegrained differences,” the study found.

Ageism Sadly, some sections of society show very little sensitivity to difference. People will argue that we live in an open, nonjudgmental society, but ageism is still alive and well. A classic example is the discrimination US presidential candidate Joe Biden has faced throughout his campaign. Biden has faced constant abuse at the hands of Republicans, the bones of which is focused on his age and his competency to lead at 77 years old. There can be little question of his competency; Biden received the Presidential Medal of Freedom with an additional level of veneration from former President Barack Obama. Having served as the 47th vice-president, Biden was thanked by Obama for a “lifetime of service that will endure through the generations,” a testament to his political, social and cognitive ability. This is in stark contrast to the treatment of the head of the U.S National Institute of Allergy and Infectious Diseases, Dr Anthony Fauci.


Frontline & Healthcare

Fauci has been commended and widely lauded for his outstanding response to the COVID-19 Crisis, with the majority of Americans regardless of political affiliations heeding his public health advice. There are even tee-shirts in circulation in the US with the term “What Would Fauci Do?” emblazoned on them. Despite being two years older than Biden, Fauci is revered and respected which is a massive double standard and is mainly down to how malleable people can be when consuming knowledge from social media. Both Joe Biden and Anthony Fauci are defying societal odds despite their age. There is no typical ‘older person’. Some 80-year-olds have levels of physical and mental capacity that compare favourably with 30-year-olds, Biden and Fauci being prime examples.

Community Care

Yet another member of staff possessed no valid forms of ID. These residents were entitled to and had paid for a place where they could relax and find solace. They trusted the carers and the healthcare system yet were treated inadequately. Fortunately, this is the exception, not the rule and there are very real alternatives to the nursing home model. With today’s technology designed to help people stay healthy at home, care providers like Home Instead offer a service combining home help and personal care with technology that monitors seniors living alone keeping them connected, while giving family the reassurance that they’re safe and well.

This is a

Decade of Healthy Ageing

2020 marks the beginning of the Decade of Healthy Ageing (2020-2030) – an opportunity to bring together governments, civil society, international agencies, professionals, academia, the media and the private sector for 10 years of intensive action to improve the lives of older people. Many societies in the WHO Western Pacific Region are ageing rapidly. Now adults over 60 years are the fastestgrowing age group in the region, the result of increasing life expectancies coupled with declining fertility rates. Rapid social and economic development and notable public health successes have also contributed to people living longer. Population ageing comes with challenges; many people live longer, but not all live well. With preparation, however, population ageing can be an opportunity to improve services for older people while also transforming health systems more broadly. For example, preparing for an ageing population requires that so-called social determinants of health be addressed, such as living conditions, social inclusion and social security. It also requires reorientation of health systems to focus more on services that accompany people throughout their lives as part of community-based primary care. The benefits of these changes reach everyone in the society. In the words of the French author, Guy De Maupassant, “Life is a slope. As long as you’re going up you’re always looking towards the top and you feel happy, but when you reach it, suddenly you can see the road going downhill. It’s slow going up and quick going down,” As a society, we must all heed these words because after all, we are all climbing that slope.

generation that views maturity

While age is just a number, the higher the number, the longer the body has suffered wear and tear, so for some, residential care is a necessity. According to the ESRI, demand in the residential longterm care sector which covers nursing homes, is projected to increase by up to 54%, “posing challenges for providers, for the regulatory authorities and for the exchequer to ensure that an appropriate standard of care and level of funding for care is provided for these vulnerable residents with intense care needs”. Sadly, some nursing homes have fallen far short of the mark. An instance such as this came in the form of Glenbervie nursing home in Bray being shut down in 2010. The closure came after the Bray District Court heard that the nursing home had been continuously failing to care for approximately 30 if its patients, as reported by the Health Information and Quality Authority (HIQA). HIQA investigated incidents in which the lack of care and attention was to the detriment of residents with one incidence of a resident who fell and fractured her hip in the bathroom while unsupervised when she should have been. This incident was only the tip of the iceberg. Another resident on antibiotics for a chest infection had not been receiving his prescribed nebuliser which could have been fatal to him. These incidents could in many ways be tied back to the poor staffing within the home. One nurse was said to have completely disregarded basic hand hygiene before administering eye drops to a patient while a kitchen worker with no experience in caring was working as a carer.

as empowering

and retirement as liberating. People are refusing to be defined by

a number that

ticks up as each birthday goes

by. Older people

are happier, more confident and

more adventurous than ever before.

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A life-changing association Older people have their own particular set of challenges in relation to physical and mental health and wellbeing and ‘Active Retirement Ireland’ is providing older citizens with a specialised personal and social support which is urgently needed.

The old adage that ‘Life begins at 50’ has arguably outlived its original meaning. Today, with people living longer lives, there is a general acceptance that life begins at whatever age you want

it to - 60, 70, 80 and even beyond. “Old age” is very much a subjective matter, and Active Retirement Ireland is proof of that, boasting members aged between 40 to 100.

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“Active Retirement Ireland promotes a model of older people doing things for themselves – a community based development model rather than a medical model – this is what makes us unique” For generations, those considered to be ‘senior’ have arguably been one of the most marginalised groups in Ireland, but over the course of the current COVID-19 pandemic, they have found themselves to be front and centre of the national media’s attention. Over recent months the issue of vulnerability of those over a certain age has been illuminated like never before and the challenge posed to them by the coronavirus has ignited a nationwide conversation about their physical and mental well-being. “Currently we have close to 25,000 members and there are more members in active retirement associations than there are people in residential nursing homes. However, our minds have been concentrated for the most part, this year, on the families of those who lost their lives in our nursing homes,” says Maureen Kavanagh, CEO of Active Retirement Ireland.

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“Each one of the hundreds of deaths has been a sad blow to those who have been left grieving, but we have to congratulate the HSE on how they have managed the COVID-19 crisis. “That said, now that lockdown opening is underway, there’s little detail and information for the over 70’s which, to be honest, isn’t good enough.” Active Retirement Ireland prides itself on maintaining open and active communication lines across every level of the organisation. Back in April Active Retirement Ireland put in place a communication plan for its members that was appropriate for the times we now live in, while taking into the fact that 85% of its members aren’t online and aren’t particularly tech savvy. In an attempt to hone its communication plan, Active Retirement Ireland rallied and co-ordinated its volunteers on


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the ground in each of its nine regions. who we believe matter. Our network of “Our regional volunteers did a associations come together to talk about physical ring around to our local groups issues and we bring their concerns to and then encouraged the local groups to the attention of government and their ring each other and text each other,” CEO policymakers.” Kavanagh confirms. The COVID-19 statistics spell out “Our job was to relay our online at the tragic effect on Ireland’s third information down to the grass roots of generation in Ireland in stark and bold the organisation and while it was difficult numbers. to reach people who are very isolated in The irony behind the focus which rural Ireland, I hope and trust that our has been placed on older citizens since efforts at streamlining the information mid-March this year isn’t lost on the ARI from the Government – as regards their chief. “Before COVID-19, most of the instructions, advice and guidance to older issues we were concerned about involved people – has been successful.” the visibility of older people in society,” Those at the helm of Active Retirement she says. Ireland are committed to enabling older “Our members range in age from their people to lead a full, happy and healthy late forties to 100 years and they tell us life through a range of opportunities that they would feel invisible at times. organised by local people of the same The issues of isolation and loneliness are Maureen Kavanagh, CEO of Active Retirement Ireland generation through local associations of a constant with them. The feeling of being the organisation. “Older people doing forgotten is part of their thinking on a things for themselves” regular basis. We all want to grow old - but we want “Sometimes what we represent and to get there in good health and in good what we are about can be misinterpreted. company. Active Retirement Ireland is We want to be seen as a haven place of an organisation that focuses on helping excellence for people who are retired or those aspirations become a reality for its semi-retired, in paid or unpaid work or members. The first Retirement Association who are on permanent illness benefit was set up in Dún Laoghaire in 1978 for and can never work again. Somewhere retired or mostly retired men and their they will have fun and engage in new wives who found there was little for them activities and just feel valued” to do once they reached this stage. Over “Since the first active retirement the past four decades, there has been a association was set up over 40 years ago, ripple effect in terms of the growth of the the perception and attitude to retirement Association across the country. and ageing has changed. We’re still The network of retirement living in a fairly ageist society and associations organically came together to everyone – especially those in the media share ideas and join in various activities – must be mindful and careful how we and events such as learning art, sharing present the whole business of growing physical activities, attending race old and being old. meetings and creative writing courses. “Ageism is very prominent in There are now over 500 active retiree the workplace. It’s much harder to retirement associations across Ireland. get alternative work as a 50-year-old The organisation is well structured if you’re going for the same job as a into nine regions covering the whole 30-year-old. Sadly, in most cases it of Ireland. Every region hosts an AGM and has an autumn doesn’t happen for that 50-year-old.” meeting bringing together local groups to feed back into the Life expectancy is increasing. And in recent times, the work of the organisation and to national policy on ageing. retirement age in Ireland has been raised. People are expected to “Active Retirement Associations are all about reaching out work to 66 years now. By 2028, the age of retirement is expected to older people through friendship and support,” adds the CEO to rise to 68 years; something Active Retirement Ireland will be of ARI. “It’s aim is to end loneliness and encourage people to keeping a keen eye on. tell us how their lives have completely changed through being “I believe people should have a choice in terms of their involved in their local active retirement association. Some have retirement age,” Kavanagh states. “A person shouldn’t be forced told us that they had never been on a hotel holiday until they into retirement, especially if they’re physically able to continue joined our association. We don’t provide a service though. We to work. “My fear is that the government will increase the provide a mechanism for people to make new friends and to retirement age just because of economic necessity. And in doing join new activities. To expand in the third stage of their life. that they will be forgetting about people who physically cannot “Active Retirement Ireland wants to be a voice for those go on after the age of 65 or in some cases 60.”

“Ageism is very

prominent in the workplace. It’s

much harder to get alternative work

as a 50-year-old if you’re going for the same job as a

30-year-old. Sadly, in most cases it

doesn’t happen for that 50-year-old.”

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AGE ACTION COVID-19 APPEAL

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Empowering older people to stay Informed, Connected, Supported throughout the COVID-19 pandemic.

Please Donate at www.ageaction.ie/donate or call 01 475 6989 to assist us in raising funds. 104

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Charity Number: CHY 10583 | Reg. in Ireland No: 198571


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Realising Rights of Older People Ensuring dignity and security for all older people is one of the hallmarks of a civilised society. To achieve this, a rights-based approach to the design and implementation of COVID-19 policies and future public policy is urgently needed.

This approach means improving our focus on enabling participation and input into policy development of older people, planning to ensure access to services, and asking ourselves hard questions about our assumptions about older people’s capacities. A rights-based approach is what is required of all public bodies in Ireland under the Public Sector Equality and Human Rights Duty which originated in the Irish Human Rights and Equality Act. This means that the promotion of equality, the protection of human rights and the prevention of discrimination is a legal obligation for all public bodies. Now that the rush of impromptu policymaking of the first wave of the COVID-19 pandemic has eased, there is an opportunity to refine and enhance policy approaches to better

embed our social values: equality, participation, and dignity. The best place to start improving participation is to make time to hear people’s experience and preferences about future COVID-19 measures directly from older people themselves, as well as from groups working with older people. In the past, we have seen unintended negative outcomes from disparate legislation and policy introduced without adequate consultation with older people or the sector representing them. The solution to avoiding this in the future is to learn from the past and simply listen well. It’s also important to understand that rights-based policy needs to start by considering those who are hardest to reach and in the most vulnerable situations. In the case of participation,

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this means considering that many older people are not online, in fact, 70% of people over the age of 65 in Ireland are not online. How will those offline engage, and what are the consequences for policy effectiveness if they cannot do so? We commonly forget to ask these questions and as a further example, of eight open consultations on nationwide public policy documents in November 2019, only one offered public consultation workshops offline. In real terms, it is estimated that this means that over 300,000 over 65’s can’t easily contribute to the policymaking processes that affect their lives. We now need to move to address the knock-on impacts of COVID-19 response measures on older people which is not a homogenous group. We must guard against a narrative that devalues not only the status of older people as equal citizens but the value that we place on their contributions and their lives in our society. Planning for future covid measures needs to urgently recognise the particular challenges to date of response measures, the diversity of experience and levels of resilience amongst older people to adequately plan to meet and prioritise their needs. According to Age Action, beyond approaches within individual government departments, the coordination of policies as a whole of government approach is critical to ensuring the realisation of older people’s rights and equality. In many cases, the complexity of the issues is not sufficiently integrated into government policy to promote rights. For example, the current Minister for Mental Health and Older People, in the Health portfolio, is inadequate to promote equality and rights in the lives of older people. The role’s focus must be on the equality and rights of older people, which would be better achieved as a Minister for Ageing within the Department of An Taoiseach,

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We must guard against a narrative that devalues not only the status of older people as equal citizens but the value that we place on their contributions and their lives in our society. working across government departments. The appointment of a Commissioner for Ageing is a further measure that should be implemented by government. This is the best-practice method of ensuring older people’s concerns and needs are considered to create robust, sustainable, rightsbased policy and services. A Commissioner can protect the needs of older people, provide quality independent advice to government, undertake best practice research and consultation and review the adequacy of policy, legislation and services affecting older people. Greater consideration for older people’s rights through better engagement, a dedicated Minister for Ageing, and the appointment of a Commissioner for Ageing is the surest path forward out of the risks of some of the early COVID-19 policy responses, and towards equality, participation and dignity for all of us as we age.


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Keeping safe at home How Home Instead is helping older people maintain quality of life and independence during a public health crisis.

COVID-19 has greatly impacted all our lives. However, the group that has been most affected is the older generation. As men and women over the age of 70 are recommended to cocoon at home for their own safety, this also raises concerns about issues like loneliness, mobility and care. One home help service that has gone above and beyond to make sure that they continue to serve older adults during this crisis is Home Instead Senior Care. Founded in 2005, Home Instead is Ireland’s largest private

homecare company. They currently have 25 local offices around the country and provide relationship-based care services to almost 6,000 clients. “Our mission statement is to enhance the lives of older adults and their families,” explains Michael Wright, the company’s Director of Public Affairs. “A key thing that we do is look at the relationship that we can build with a client. We do what we can to improve their quality of life and ensure that they remain independent in their own home for as long as possible.”

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Care during a crisis Naturally, COVID-19 has led to a number of challenges for the home care sector, but it has also highlighted the value that private home care services can offer older people and their families. “If you think about the challenges older adults face such as rural isolation, loneliness and lack of transportation, the relationship they have with our caregivers is really important, especially during this pandemic,” Michael adds. “We think about how we can improve somebody’s wellbeing by doing things that are stimulating. “We think beyond the standard home help service. We think more about what we can do to help and enhance the lives of older adults. We have a model of care called relationship-based care and it’s all about how we can improve outcomes for people.”

A personalised approach Home Instead works with clients and their families to create personalised care plans. “We have the expertise in terms of care planning, carer training and implementing relationship-based care plans,” explains Michael. “Caring for an older adult requires certain skills that cannot be underestimated. “All our caregivers are supported by care managers. The majority of our care managers are nurses, we also have some who are occupational therapists and so forth. It’s the care manager who is responsible for the care plan of the individual in consultation with the family and the person we are providing care to.”

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In light of the current crisis, Home Instead is doing everything that they can to protect their clients, whilst they cocoon. Putting client protection at the fore In light of the current crisis, Home Instead is doing everything that they can to protect their clients, whilst they cocoon. “We’ve been updating safety information that is sent out to all our 3,000 caregivers,” Michael states. “We share the advice being given to us by the Government on how to help people who may have COVID-19, people who are maybe symptomatic but not diagnosed and how to assist our general population and ensure that we do all we can to manage the transmission risk.” The company has even launched an innovative live-in service to help families with their care needs. “Live-in care is where a caregiver is resident in someone’s house,” he explains. “They move in with a family for a set period of time. During the day they provide a certain amount of care and then at night time they have a room in the house where they can stay. ” As the pandemic continues, options such as live-in care will become invaluable to families across Ireland. “If we’re waiting for a vaccine, we might be waiting many


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months,” Michael says. “What we know from COVID-19 so far is that it is impacting older adults more than anybody else in our community. Older adults need to take greater care than other people. ” “We don’t want older people to put off asking for help when they need it. If you’re struggling as a spouse caring for your loved one who has dementia, if you’re losing a bit of weight or you’re finding it difficult to keep on top of the housekeeping, make sure that you ask for help. We can deliver the help in a really safe way in terms of providing infection control and we all have the required PPE. Don’t put off looking for help.”

Home Care Tax Relief In fact, employing home help isn’t as expensive as you might think. “Many of our clients are recipients of State-funded HSE Home Support Services packages, where, upon referral by a public health nurse, they receive a certain number of hours care per week,” explains Michael. “Other clients receive private care services, where they or a family member pay directly for our home care service. The bill-payer for private clients can claim up to 40% of the cost back under the Home Care Tax Relief scheme, which significantly reduces the cost of private care. Many clients who are receiving a certain number of hours of HSE Home Support Services will also supplement their package with private care hours.” To book a free, no-obligation care consultation, or to find out more about how Home Instead Senior Care enhances the lives of older people and their families, call 1890 930 847 or visit HomeInstead.ie

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Enhancing homecare in a time of crisis The safety of our clients is and has always been paramount to our business,” explains Richard Mullins, Strategic Marketing Manager at Home Instead Senior Care, “and we are delighted to see that the measures we have taken in the past few months have helped protect our office staff, our CAREGivers and our clients.

“There has never been a more important time to care for older people, and we appreciate the trust that our clients have placed in us during these challenging times. “We are proud of our wonderful team of CAREGivers who have stepped up to ensure that our clients can get the care they need. Here are just a few of the steps Home Instead Senior Care has taken to enhance the lives of older people and their families at this time: Online Training for COVID-19: Gives CAREGivers and clients alike the confidence that we can provide safe services

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Infection Control Training: Significantly reduces the risk of transmission. Less than 0.5% of home care recipients have tested positive for COVID-19 Personal Protective Equipment: We might look a little different with gloves, masks and aprons, but the standard of care is just the same! Sanitisation: We’re sanitising homes, especially door handles and utilities, to give extra peace of mind Mental stimulation: We use board games, crosswords and other activities to reduce isolation and loneliness


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With our customised laundry service developed specifically for your residents, you know their clothes are in safe hands.

Residents Laundry

Linen

Uniforms

Washroom

Care Tex, part of the Elis Group, offers a bespoke laundry, textile and hygiene service solutions. To find out more contact 1850-777 464 Excellence in Business Awards 2020

Elis

Excellence in Laundry Services for Nursing Homes Nationwide

We have been awarded the EN 14065 RABC, meeting HIQA standards. All Elis sites are independently audited to the ISO 9000:2015 and I.S EN 14064:2000 standards by the NSAI

www.elis.com

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Elis Innovates Elis is the principal provider of laundry services in Ireland offering the rental and laundering of bed linen, towels, uniform, resident clothing in addition to washroom facilities and supplies.

Here in Ireland, many clients will remember Elis as Spring Grove – the company has been of part of Irish life since the 1960s. Elis offer bespoke rental and maintenance services to customers, with seven plants nationwide. As a multi-service provider, they work to ensure that customers can focus on their core business, assured of the safety and wellbeing of employees and residents. Elis are continually investigating ways to support their customers. They acknowledge that in order to develop services that support clients they need to understand the challenges and developments that are emerging within many respective industries. To this end, Care Tex, a division of Elis, was established as a result of research conducted in 2011, identifying that laundering residents clothing and possessions was creating a real issue for nursing homes. Managing the laundering of bed linen, towels and the personal items of residents including clothing, blankets etc., was diverting the energies of staff from their key roles, that of caring for residents. Based on that research Elis designed a service specific to these requirements, creating a purpose-built facility to service nursing homes and care homes across the country.

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The service enables staff to do what they do best: provide care to residents, while Care Tex do what they do best: take care of their laundry. Personal Care Care Tex is a laundry service designed to meet the laundry requirements of residents, their entire personal wardrobe and miscellaneous items. A dedicated unit based in Dublin services the entire country and provides 7/6/5 days services depending on requirements. The Care Tex system allows for full traceability with each item being barcoded, (even pair of socks gets labelled individually) and held in the residents’ personal net bag which includes their name and a unique barcode as a personal identifier. Set-up is handled by the Care Tex team who will also


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be on hand to ensure that staff are fully trained and understand the process to ensure a smooth transition to the new procedures. The Care Tex customer service team are also always available to answer any queries that may arise, providing confidence that all residents clothing, flat linen and staff uniforms have been safely processed through the Elis validated wash process. The Care Tex service has been awarded the EN 14065 RABC, meeting HIQA standards and as with all Elis sites, it is independently audited to the ISO 9000:2015 and I.S EN 14064:2000 standards by the NSAI to provide the assurance that the service meets infection control standards.

Adaptive Thinking A clear illustration of how services must be prepared to evolve is the required adaptation that all industries faced during the COVID-19 pandemic. An area of concern that came into sharp focus during the pandemic was that of transmission routes and the part that uniforms can potentially play in the spread of the virus at care homes and nursing homes. Here in Ireland healthcare worker uniforms are commonly laundered at home - a distinct difference between us and the practice in mainland Europe where uniforms are either washed within the facility or at an industrial laundry. Dr Laird, Head of Infectious Diseases Research Group of DeMontfort University conducted extensive research into the domestic and industrial wash processes of healthcare uniforms and has reported that the practice of taking uniforms home heightens the risk of contaminating home environments, including the washing machine, because unlike in-house or industrial laundries, there is no segregation of laundry based on designated soiled and clean areas. As a result, in the event of the virus being present on a uniform, there is a risk of transmission within the home. There is the added concern that domestic machines do not always get up to the temperature shown. A domestic washing machine may be set at 60°C but may not hold that temperature long enough to destroy present pathogens increasing the risk of transference. The pandemic has elevated the need for strict protocols for all laundering services. It has been heartening for the Care Tex team to be able to assist homes who were suddenly in need of the services Care Tex provides due to breakdowns and staffing issues. Knowing that Care Tex has been awarded EN 14065 RABC, meeting HIQA standards gave clients piece of mind, confident that residents clothing, uniforms, linen and towels were being returned hygienically clean and pathogen-free.

The Elis Ethos Margaret Mullen has managed the Care Tex service since its inception in 2012, “My team now service over 50 locations across the country. We keep in close contact with each of our customers and it is heartening to hear how transformative this service can be to the day to day lives of managers and their staff,” she said. “Only when the service has been initiated can clients appreciate how much time and energy had been devoted to their laundry service; staff rotas, machine breakdowns, replenishing laundry supplies, discussions with concerned family members because a beloved item of clothing was misplaced or worse still, shared with another resident”. Through the development of this bespoke system Care Tex can provide the assurances that client’s need – residents clothing is professionally laundered, tracked throughout the process and returned to its owner in a timely fashion. Margaret continues: “Here at Elis, we never stop investigating, developing and providing innovations for textile, hygiene and well-being sectors. Myself and my team appreciate the specific requirements within the nursing home and community care sectors and we are ready to provide tailored solutions to ensure the best results. Our services allow you to focus on your core business, while confident that your budgets will be consistent. We are here to assist you in whatever way we can. We work with over 10,000 customers across the island of Ireland and over 440 sites across the world. Our experience is unrivalled”, Margaret Mullen, General Manager at Care Tex.

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Bunratty Castle Hotel, BW Signature Collection by Best Western Sophistication and luxurious style are the hallmarks of the renowned Bunratty Castle Hotel, BW Signature Collection by Best Western, which is part of the Blarney Group. The hotel has been restored to its rightful position as one of the most intimate and charming hotels in the west of Ireland. It embodies the highest of traditional values with a diverse range of luxury accommodation, glorious dining and a spa of exquisite indulgence, not to mention the Bunratty Mills Shopping Village, located at the foot of the hotel grounds. Bunratty is an ideal base for touring the unspoiled, cultural West of Ireland with Galway and Connemara, the Cliffs of Moher, Wild Atlantic Way, the Burren and the beautiful Lakes of Killarney all within an easy day trip.

The Address Connolly The Address Connolly, a WorldHotels™ Elite property, is in the heart of Dublin City Centre and is the perfect downtown haven if you’re visiting Dublin city for business or leisure. The owners have re-imagined the customer journey and turned it into reality through significant enhancements to their hotel facilities and the guest experience. This design-driven hotel offers an eclectic mix of luxe interiors and traditional design pieces all sourced from and crafted in Ireland. The Address Connolly promises the ultimate 4-star hotel experience full of special touches that surprise and delight. Located in the heart of the city, guests are just a short walk to everything including some of Dublin’s most popular venues, business districts and tourist attractions: 3 Arena, Dublin Convention Centre, Bord Gais Energy Theatre, Aviva Stadium, Croke Park Stadium, IFSC, Dublin Docklands, Dublin Port, Epic Museum, Dublin Zoo.

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SUPPORT SERVICES The continuing fallout from the COVID-19 coronavirus pandemic and the ensuing deep suffering from social, financial and emotional impacts is culminating in unpredicted demand on support services.

The need for immediacy in dealing with the physical impacts of the illness at its outbreak was arguably the most important concern but the unseen and unknown long term effects of the coronavirus, in part precipitated by social distancing and lockdown are equally worrying. The effects of loneliness or being cooped-up with others; stresses on relationships; grief, loss and bereavement; depression, job and financial insecurity and a myriad of emotions and change of behaviour patterns are all now of great concern. Charitable support services in these areas are being stretched to their limits as they are experiencing a sharp increase in demand combined with a lack of cash input and a vastly decimated workforce. The huge difficulties faced by those that were vulnerable pre-COVID 19 are now exacerbated by the pandemic. This is leading to even further pressure on the existing agencies with responsibility for helping others. The importance of mental health support services, either charitable or otherwise across the board has never been in doubt, but the help they aim to offer is being stretched to its limit as expertise and time required has shot up in these times of adversity. Studies show that the number of people describing symptoms of depression is climbing rapidly and that help is

needed by many who have never before required support in this way. Frontline health workers, emergency workers and care home staff, in particular, have been under intense pressure in these unprecedented times. While perhaps coping on the surface and ‘doing their job’, many suffer heavily from the stresses and strains of their workload and responsibilities.

Mental Health crisis The UN has warned that a global mental health crisis is looming: “After decades of neglect and underinvestment in mental health services, the COVID-19 pandemic is now hitting families and communities with additional mental stress,” said Secretary-General Antonio Guterres. “Even when the pandemic is brought under control, grief, anxiety and depression will continue to affect people and communities.” The UN brief stressed the need for countries to include access to psychosocial support and emergency mental care in all aspects of their response to the pandemic. A recent report in The Washington Post quoted Michele Obama, former First Lady of the United States and wife of former President Barack Obama as expressing that she too

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felt an underlying sense of low-level depression during these difficult times. She told columnist Michele Norris that she had experienced some very low points recently. Mrs Obama said: “There have been periods throughout this quarantine where I just have felt too low,” adding that her sleep was also affected. The United Nations (UN) described the mental strains on people who fear that they or their loved ones will be infected or die from the coronavirus, which has now killed almost three-quarters of a million people worldwide to date. The international body also pointed to the psychological impact on vast numbers of people who have lost or are at risk of losing their livelihoods, have been separated from loved ones or have suffered under drastic lockdown orders. Devorah Kestel, head of the World Health Organisation’s mental health and substance use department stated: “We know that the current situations, the fear and uncertainty, the economic turmoil - they all cause or could cause psychological distress.” She called for a significant hike in investments in this area, pointing out that before the crisis, countries on average dedicated only two per cent of their public health budgets to mental health support. Health care workers and first responders under stress are particularly vulnerable, Kestel pointed out, where media reports indicate a rise in suicides among medical workers. Other groups also face psychological challenges brought on by the crisis, she added. People who are homeless form a large number of the especially vulnerable and this group includes many who struggle with substance use and addiction issues. Homeless charities in Ireland are voicing concerns that a new wave of homelessness is on the cards if protection policies put in place earlier in the year, such as the provision of emergency accommodation for the homeless and the banning of evictions are lifted too early.

Fear & Uncertainty Emergency accommodation, hostels and family hubs, already struggling under the burden of a homelessness crisis in Ireland, are now taking drastic measures to protect homeless people from the coronavirus. Facing something of an unprecedented situation, charities and homeless services are trying to work together to coordinate a response. “We were in crisis before this came along,” Mike Allen from Focus Ireland says. “Now it’s more like “crisis squared”. Harm reduction services, in combination with housing, health and homeless agencies in both the public and private sectors were expanded rapidly in Ireland to good effect in response to protecting the homeless from COVID-19, experts such as Dr John Collins (Drug Policy Unit at LSE) claim. But fear and uncertainty remain that should the Covid crisis recede, so too will the newly implemented support service facilities across the board. Listening and responding to the fear, distress and anxiety

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precipitated by the virus and to any other personal crises since 1953 is the global frontline voluntary telephone and face-to-face support service - the Samaritans. Four in ten crisis calls received by the Samaritans in Ireland at the moment are connected to the COVID-19 pandemic, according to Niall Mulligan, the Executive Director. While coping with an average number of 1,000 calls in local branches, the support service is also having to cope with a fall in volunteer numbers. Mr Mulligan said in a recent report in The Irish News: “Coronavirus isn’t necessarily the main feature of most calls but it’s in the background if not the foreground of quite a lot of calls at the moment.” The charity has to ensure the remaining volunteers are protected, however, so face-to-face visits have been suspended. “At this critical time of need for the public, we are doing everything humanly possible to keep open our 24/7 helpline,” added Mr Mulligan. “The COVID-19 pandemic is a massive challenge for all charities at the moment and the Samaritans organisation is no different. “We have experienced a drop in volunteer numbers due to self-isolation, shielding and cocooning. This has impacted on branches, but we were able to deal with this by many volunteers doing additional shifts per week. “While our service is confidential, we know that in general when people ring Samaritans for emotional support, they often mention several concerns including isolation and loneliness, anxiousness and mental health, as well as family and relationship issues and it is no different in the current crisis which has magnified some of these issues for callers.” Mr Mulligan added: “Even with restrictions easing, we are quite aware that many people face an uncertain future, and some will be concerned about losing their jobs and their businesses. “Others may be facing challenging financial circumstances, while some may still have to remain isolated. “Samaritan Ireland’s key message is that if you’re struggling with the impact of COVID-19 if life is difficult and you’re feeling anxious, stressed or unable to cope, don’t struggle through it alone. “Don’t bottle it up. We are here to listen to whatever you’re going through.”


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Whatever you’re facing We’re here to listen

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Call free day or night on

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4 Asks for a safer Ireland Samaritans Ireland recently launched its manifesto calling for support on ‘4 Asks 4 a Safer Ireland’.

Every 90 minutes, someone in Ireland or the UK takes their own life. Every single one of these deaths is a tragedy and everything we do at Samaritans is working towards our vision that fewer lives are lost to suicide. In 2018, 352 people in the Republic of Ireland took their own lives. Suicide kills nearly three times more people than road accidents and is the leading cause of death of young people aged 15-24 and the third leading cause of death of men under 55. While the suicide rate continues to fall in the Republic of Ireland, it remains a gender and social inequality issue. Overall, men are four times more likely to take their own lives than women, with men living in the most economically deprived areas being particularly vulnerable. Samaritans Ireland believes suicide is preventable, not inevitable, and it is our vision that fewer people die by suicide. Realising this vision is everyone’s responsibility. Suicide prevention

is a cross-party, inter-departmental responsibility. Only by working together on this issue can true progress be achieved. To help achieve this vision, Samaritans Ireland is calling for support on our ‘4 Asks 4 a Safer Ireland’: help for men in relation to their mental health; support to everyone who selfharms; measures to address loneliness; and action to improve online safety.

Help for men & their mental health Fewer than 20% of men over the age of 18 who are experiencing mental health difficulties will seek help from a mental health professional, and less than 35% will speak to their GP during a tough period. In particular, middle-aged men on low incomes have been the highest risk group for suicide for many years. Far too little is known about what really works to support these

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men when they are struggling. In order to address this situation, we need a specific national plan, backed with proper funding, for reaching and supporting middleage, low-income men. We need evidence-based services which are built on an understanding of how best to reach these men, and what they actually want, supporting them to deal with the full range of issues they are facing.

Support to everyone who selfharms

Fewer than 20% of men over the age of 18 who

Everyone who selfharms should have access to support to help them identify and address the reasons for their distress, and to find alternative coping mechanisms. Levels of self-harm are rising among young people. There has been a 29% increase from 2007-2018 in reported cases of self-harm from persons aged 10-24, with a 6% overall increase between 2017-2018. According to the National Suicide Research Foundation, while 72% of people who presented to hospitals in 2018 were assessed by a member of the mental health team, there was considerable variation in recommended next care. A streamlined approach is imperative to ensure the same level of care is provided to patients regardless of geographical location.

are experiencing mental health difficulties will

seek help from a mental health professional, and less than 35% will speak to their GP during a

Measures to address loneliness 30% of Samaritans callers experience feelings of loneliness or isolation – this is the second most common reason why people reach out to Samaritans. However, people who are isolated and withdrawn from others and don’t have support networks to call upon in times of difficulty can be more vulnerable to suicide than those who are well-connected and have a stronger sense of connection to society. Interventions focused on promoting social

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tough period. connections at an individual, familial, community and societal level should be supported and developed.

Improve online safety Harmful content relating to suicide and self-harm is far too easily accessible online. Samaritans want to see this content minimised, while opportunities for support and help online are maximised. The Government should be leading international action to set out a framework for a suicide and self-harm safer internet. Current proposals as laid out in the Online Safety and Media Regulation Bill are a good first step in further regulation of the harmful content readily accessible online. It is important to not only block dangerous content and hold organisations allowing this content accountable, but to also actively teach people how to safely navigate the digital world and empower them to make smart decisions online. You can read the manifesto at: https://www.samaritans.org/ireland/news/ samaritans-ireland-launches-2020-manifesto/


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A Self-Care Toolkit for Crisis Communities across Ireland are looking after the most vulnerable during the COVID-19 crisis by being vigilant: self-isolating, hand-washing and socially distancing. This vital strategy to protect us all has put increasing pressure on the resources we use to look after our mental health. We must stay apart, but in isolation some become disconnected. We must stay home, but home is not a safe haven for all. We are on the frontline and must go to work, but being there puts ourselves and loved ones at risk. We need media to follow guidelines to protect each other, but too much news fills us with anxiety and fear. Most of us develop tools over time to support our emotional wellness, like going to the gym or daily meditation, but current restrictions may have depleted our self-care resources. Let’s Get Talking’s counsellors and psychotherapists have a few ideas for replenishing your Self-Care Toolkit:

Don’t Bottle Up Emotions We can’t ignore the emotional impact of this ‘new normal’. It’s normal to feel afraid, anxious, angry, sad and frustrated and it’s important not to bottle up those feelings. If we acknowledge them, we can address them.

Get Talking Recently, even the most techphobic among us are using video calls to stay connected to family and friends. During crises we are driven towards solidarity and togetherness. It helps to give each other time to vent how we are feeling. We can’t ‘fix it’, but there is comfort in solidarity and normalising each others’ experience.

Cover the Basics While the daily commute is on hold for most, it is easy to allow your sleep pattern slip and forget about preparing nourishing meals. It can also be more difficult to sleep if your head is full of worries. Having a self-care routine to fill your day can prepare your body for rest at night.

Have a Self-Care Routine Now there is an opportunity to be creative and try new experiences to support your emotional wellness. If a yoga class usually helps you manage day-to-day stresses, find an online

class or test out the hundreds of YouTube yoga videos. Try mindfulness to manage stress and anxiety – there are plenty of great apps, like Headspace and Calm. Try the weekly ‘one new thing’ challenge – try out baking, gardening, knitting, etc. – all those things which you never had time for before. You may discover joy and meaning in a new activity which you can integrate when we return to our usual busy lives.

Look after your Relationships Being in isolation with limited space away from your partner, family or housemates is a recipe for irritation and conflict. People are working from home, often in the same room, while looking after children. It’s vital to ‘own’ how you are feeling and communicate to avoid tensions boiling over. Starting with “I feel....when you....I need....” can be helpful. For example: “I feel frustrated when you start a Zoom meeting without telling me as it affects my work. I need to know your schedule so I can plan mine”. If you are feeling frustrated and angry, be aware others might be too – listen carefully and be prepared to compromise - it goes both ways.

Ask for Help If you feel your mental health would benefit from some additional support, ask for help. Professional counsellors and psychotherapists are now available online & by phone to support you. Let’s Get Talking’s team of almost 100 therapists are available nationwide. For more information or to book an initial consultation, call 091 765 500 / 01 456 9158 or see www.letsgettalking.ie

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Rutland Centre Resumes Full Services Founded in 1978 the Rutland Centre has grown into the most recognised addiction rehabilitation centre in Ireland. The Rutland Centre is a registered charity that has been providing independent addiction treatment services to people in Ireland for over 40 years. In a normal year, the centre treats over 400 clients per annum, helping them to transform their lives by providing the highest quality research-based treatment and aftercare services in addiction. Its multidisciplinary team specialises in helping individuals and families struggling with addictions to substances including alcohol and drugs (prescribed or otherwise) and behavioural addictions including gambling, sex and eating disorders. Like most of us, the Rutland Centre has spent the first half of this year working through the most challenging period of its 42 years in operation. In February 2020, like many other organisations, the centre was faced with the huge challenge of facilitating remote working for its staff alongside the even greater challenge of supporting its clients and former clients in addiction treatment and recovery. Emma Kavanagh, Clinical Manager at the Rutland Centre said: “2020 so far has been a hugely challenging time for families and especially so for those in which a family member is in recovery from or in active addiction. What we saw during the first few months of the pandemic was that in many cases addictive behaviour became more visible in the family home and the pandemic may well have highlighted just how serious a family member’s problem behaviour is. The result was that the addiction had nowhere to hide and the impact on family life and on other family members was and is still quite significant. For those in recovery, many have been seeking support to cope with increased anxiety and the feelings of isolation and loneliness caused by the pandemic. We are also concerned about the formation of other maladaptive behaviours amongst those in recovery caused by the lack of access to the usual coping and support strategies that we would recommend. During the crisis, in many cases people have not had access to the face-toface support of family members, friends and peers and have been relying on new measures to cope, some of which have the potential to develop into unhealthy habits in their own right. For example, people have had to become self-reliant or over-reliant on online platforms. In the long term, we would see these as unhealthy habits that are counter-productive to the philosophy of recovery.” Over the last months, the Rutland Centre has been offering a full-service including peer and phone support to its clients enrolled in the ‘Aftercare’ programme (those who had completed the Rutland Centre’s five-week residential treatment programme). The centre has now resumed full services including residential treatment, outpatient therapy and aftercare

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services while adhering strictly to the public health guidelines. The centre will also continue to make some services available online during the coming months. Maebh Mullany, Chief Executive at the Rutland Centre said: “At the end of the day, the health and safety of our staff and our clients is paramount. We are working hard now to ensure our premises and our processes remain fully compliant with the public health guidance from the HSE and the Health Safety Authority so that the people who have been contacting us can get the help that they need in a safe, comfortable and trusted environment.” For support in addiction and recovery, the Rutland Centre is continuing to advise that its phone lines are open and its team are there to provide support and information. The centre is also encouraging people to contact their support networks such as Alcoholics Anonymous, Narcotics Anonymous, Gamblers Anonymous and the HSE for additional assistance as required. www.rutandcentre.ie


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Give a family the Gift of being by their child’s bedside. To make a difference please visit

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Cliona’s, Roselawn House, University Business Complex, National Technology Park, Limerick. 126

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Telephone 061 331 333 | Freephone 1800 90 10 90 | info@clionas.ie | Charity Number: CHY18127


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Cliona’s Foundation Established in 2007 by Brendan and Terry Ring following the tragic loss of their daughter, Cliona’s Foundation provides financial assistance directly to parents of children with life-limiting or chronic complex care needs to help meet the non-medical expenses related to caring for their child.

As the world continues to wage war against one of the most infectious diseases ever to befall mankind, Cliona Ring’s infectious personality remains as luminous and vivid as ever to those who knew and loved her. Cliona was just 16 when she lost a seven-year-long war on December 2nd, 2006 with an inoperable brain tumour. Her loss left the sort of indelible mark on the Ring family that COVID 19 has bequeathed Planet Earth. Faced with the mountainous task of coming to terms with their enormous grief, Cliona’s parents, Brendan and Terry Ring, established Cliona’s Foundation in 2007 to honour the memory of their beloved daughter. The charity provides financial assistance directly to families with children who have life-limiting or chronic complex care needs. Since its launch 13 years ago, Clionas Foundation has seen applications for support steadily increasing each year; a reflection no doubt of the organisation’s increased profile but also of the increasing numbers of families struggling financially with the additional cost of caring for a sick child. Amazingly,

the Limerick-based organisation has raised a figure just shy of two million euro since its genesis and last year, it was able to provide financial support to 148 families nationwide. Like most charity organisations, the numbers’ game can be all-important in terms of the demands being placed on Cliona’s Foundation and its capacity to make a difference. In that respect, it is sadly a reality that, on average, there are 4,000 critically ill children in Ireland being treated on an annual basis with an additional 400 new seriously ill children diagnosed each year. The funding requirement to support these families is in the region of €4m per annum. Cliona’s Foundations capacity due to limited funding to cater to the financial needs of the children’s families is approximately €320,000 per year. The Ring family’s brainchild relies 100% on income raised through a range of activities including events and fundraising, corporate donations, philanthropy, private donations and partnerships with other charities. Pointedly, it’s the Rings’ all too intimate understanding of the stress brought upon families

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It is sadly a reality that on average, there are 4,000 critically ill children in Ireland being treated on an annual basis with an additional 400 new seriously ill children diagnosed each year. The funding requirement to support these families is in the region of €4m per annum. Cliona’s Foundations capacity due to limited funding to cater to the financial needs of the children’s families is approximately €320,000 per year. of critically sick children that has spawned the diversity of expenses covered by Cliona’s Foundation – from rent, food, utility bills to transportation for chemotherapy or alternative therapies, to a treat for a sibling and even covering the cost of a child’s funeral. “Terry and I couldn’t get it out of our heads just how some people still managed to continue to look after their other children at home while also meeting the bills that were coming their way, such as a mortgage and everyday household bills,” co-founder Brendan Ring explains. “I remember the time the penny dropped. We arrived with Cliona in St. Johns Hospital in Crumlin and I met a man who had come from Waterford with his wife and their very young baby. We were all sitting in the same room and I got chatting to him and I asked him where he was from and what his journey to the hospital was like? He told me his child suffered from travel sickness while coming up to Dublin for chemotherapy. He didn’t have a car because he couldn’t afford one and he had to get a taxi from Waterford to Dublin. I was stunned. His child was very ill, just like Cliona. That was when it dawned on me. Aside from our trips to Dublin we also spent a lot of time in the Children’s’ Hospital in Cork and you’d hear the same story from other parents there. I noticed there were very few people visiting the sick kids in the wards during the day because their families and relations were busy working to meet their financial obligations. So naturally, the children were bored but we were able to put SKY television into all the wards in Cork which helped a lot.” Brendan, Terry and the entire team behind Cliona’s Foundation firmly believe that no family should have to face any added financial stress when already struggling with the devastation and trauma of a seriously ill child. Currently, Cliona’s Foundation is the only charity which offers financial support solely for non-medical costs which can amount to significant sums. But without the assistance of state funding, the people at the vanguard of Cliona’s Foundation work tirelessly to achieve the organisation’s goals. “Cliona’s Foundation is a voluntary organisation, a small charity with just two full-time employees,” CEO Brendan explains. “We’re not a particularly well-known charity but what we have is good governance with an excellent structure that is triple-locked by the Charity Institute of Ireland. Our ethical fundraising and annual financial reporting meet the triple lock standard. Our structure is overseen by a team of volunteers who form the organisations’ Board of Directors. Above all though, it’s the massive work ethic inherent in the organisation

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which allows us as a team to make positive decisions for the betterment of a lot of hard-hit families.” Given that Brendan is CEO and wife Terry is Secretary of Cliona’s Foundation, it is inevitable that the Ring-led organisation will be forever associated with the young lady who gave her name to the charity. However, Brendan is inclined to tone down the subjective. In his mind, Cliona’s Foundation is all about the collective: “The Foundation has nothing to do with Cliona. We are not looking for accolades for our daughter. The charity is only named after Cliona. It is in her memory and we do think about her all the time obviously and we will never forget her. But we are acutely aware that 400 children are dying every year and we want their voices heard and that of their families. “When we started this charity we probably got fifteen to twenty applications in the first year and we were able to help each family because with 5,000 euro each. Nowadays we are only able to give 1,500 euro to families because we’re getting 16 applications per month. Sadly it costs between ten to 12,000 euros of net income to support a child with life-limited conditions. We should be able to give the families around 12,000 euro. The problem is that every year the demand is growing so we have less to give. That said, we are proud of the fact that in 2019 we raised just over 330,000 euros and supported 148 families and at the end of June 2020 we have supported 797 families in total since 2007. Looking after the affected families is clearly at the core of what Cliona’s Foundation is all about and as 2020 gathers pace, more and more people are indebted to the Rings for their generosity in helping to offset travel and accommodation costs, car parking charges, household bills, home adaptation costs, specialised equipment purchases, income support and family breaks. The success of Cliona’s Foundation is so sadly ironic given that it emerged from a tragic loss. “Cliona was a very outgoing happy bubbly child who loved life,” Limerick-based businessman Brendan declares. “She was a Jolly child. She kind of took her illness on her shoulders. She went through it remarkably strong, at least inwardly. A huge outpouring of sorrow and solidarity flowed forth from the local community following Cliona’s death. With the help of family and friends, the Rings put together a very simple fundraiser. It was designed to be a one-off effort as payback o the community who had been so kind and supportive to Cliona’s family in their greatest time of need. Crucially, 13 years on, that sense of giving-back-to-the-community continues to provide critical and desperately needed support to families caring for extremely sick children.


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SOSAD Ireland 2020 Save Our Sons And Daughters (SOSAD) is an Irish suicide prevention and awareness support charity working tirelessly to reduce Ireland’s high suicide rate.

SOSAD Ireland first came to fruition in 2003 when founder Peter Moroney started the charity after his son Simon died by suicide. In 2008 the first centre was opened in Drogheda. There are now centres in Navan, Cavan, Dundalk and Carrickmacross, with outreach offices in Bailieborough and Cootehill and in October 2020 a new outreach is planned for Kells, Co. Meath. The charity works to reduce Ireland’s high suicide rates. “As we all know suicide is not always the result of a mental health problem or a moment of distress,” explains Carol West, General Manager. “To be understood, it needs to be seen in the wider context of a person’s life.” Carol says that we need a strong system that supports wellbeing in the community and that way more needs to be done to deliver a mental health service that is active, rather than reactive. Currently SOSAD Ireland provides support for clients in several ways, proving a safe and comfortable place to talk and be listened to; holding initial meetings to establish need; providing professional counselling and bereavement support with follow-up support and where necessary referrals to the most appropriate support service available. SOSAD operates a 24/7 365-day helpline for anyone feeling depressed, suicidal, anxious and who needs someone to talk to and listen to them. This involves admin staff who answer the phone throughout the day and those who operate the calls at night. “It is both an honour and privilege to work with people who trust you with the story of their lives,” explains Carol. “They deserve the best possible support and care and at a time when mental health is the poor relation in our health and social system, we feel it’s imperative to keep improving the service we offer. To be the best we can be so that we can hopefully empower people to take control of their lives and for them to

pay this forward.” The age range of people who use the service is diverse with the youngest at just 16 and the eldest in their 80’s. SOSAD currently has 450 clients across their five centres attending services and they provide free counselling to over 400 people every week. “We are passionate about the work we do,” adds Carol. “Our service is completely free and we are financially supported by local and national fundraising events and by small funding grants from our local PPN and Community Groups.” With the onslaught of COVID-19, SOSAD finds itself in unchartered territory and like so many other organisations they have shifted the nature of their work in an incredibly short space of time to assist vulnerable service users across the community. Their top priority is to maintain a viable service for clients. Counsellors are conducting sessions by phone and online via Skype and Zoom and the 24/7 helpline is also in full operation. Carol says that the topic of mental illness has been difficult to openly discuss over the years and many people view mental health with a negative stigma. With these issues becoming increasingly prevalent, mental health must be moved to the forefront of conversation topics. In some ways she says, COVID-19 has done just that, and now more than ever we need to support people’s mental health and mental strength to help them through this current crisis but more importantly, to be there when we come out of lockdown and are entering a new and challenging chapter in our lives. Closing she says: “We look to the future, a new and more community-oriented place to live. If this virus has taught us anything, it is the importance of family, friends and neighbours. As a charity, we pledge to play our part in making this happen.”

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“You matter because you are you, and you matter to the last moment of your life. We do all we can do, not only to help you die peacefully, but also to live until you die” Mayo Roscommon Hospice Foundation exists to fund palliative care services to people with life limiting illnesses and their families in County Mayo and County Roscommon. The Foundation affirms life, respecting the uniqueness of each individual, by caring and supporting to meet the physical and emotional needs of patients and their families living with life threatening illnesses. The Service enables patients to live out the remainder of their lives in comfort and dignity. The Palliative Care Service is provided free of charge to all.

Mayo Roscommon Hospice Foundation Main Street, Knock, County Mayo, Ireland Phone: + 353 (0) 94 9388666 Email: info@hospice.ie Charitable Status No: 10980  CRA: 20029098

Help us to continue to provide vital palliative care services in our community by donating online today at www.hospice.ie or by calling 094-9388666 130

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Hospice Care Fundraising through Covid Sadly, just like COVID 19, the demand for palliative services is not going away. Indeed, while the number of cases of the coronavirus continues to go down in Mayo and Roscommon, the number of terminally ill people in need of specialist services in both counties remains on the rise.

Mayo Roscommon Hospice Foundation Staff: Back row (L-R) Joe Brolly Mayo Roscommon Hospice Ambassador, Laura Coleman Family Therapist, Angelina Nugent Head of Fundraising and Communications, Mary Brett Fundraising Administrator, Martin Golden Manager Hospice Household Shop, Michelle Wynne Accounts, Josephine Ganley Fundraising Administrator, Laurita Blewitt Donor Relations Manager, Kathy Grogan Shop Area Manager, Brigid McGurrin Accounts/Administration, Kathy Andrewartha Shop Area Manager. Front row (L-R) Ann McGarry Accounts and Retail Operations, Martina Jennings CEO Mayo Roscommon Hospice Foundation, Minister Michael Ring, Joanne Hynes Chairperson Mayo Roscommon Hospice Before Mayo Roscommon Hospice Foundation was established by a group of dedicated and far-seeing volunteers in 1992, local terminally ill patients often found themselves partaking in a lonely journey from hospital to their home where they often suffered a difficult and painful death.

Right from its inception, the people at the vanguard of the Foundation agreed to work in association with the Western Health Board (now HSE West) in an effort to meet the needs of its most vulnerable citizens in Mayo and Roscommon. With the loyal and ongoing generous support of its many

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“In September 2017, Joe Biden, former Vice-President of the United States (and current Democratic Presidential candidate) turned the first sod on our site at Knockaphunta. That day was a great source of pride and satisfaction to all our volunteers, support groups and staff. “ 132

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benefactors, Mayo Roscommon Hospice Foundation continues to fund the service in association with HSE West. “The whole aim of Mayo Roscommon Hospice Foundation is to provide dignity and respect to people with life limiting illnesses to both end of life and on their journey to end of life,” Foundation CEO Martina Jennings explains. “Around the time the Foundation was set up, palliative care really didn’t exist. Even now, people generally relate palliative care services to just cancer but 43% of our patients are dealing with non-cancer issues. They may have Motor Neurone, COPD and other illnesses that are debilitating, life-limiting or life-ending. “Aside from the hundreds of volunteers who assist us, we have a great team of professionals. In that regard, we employ a family therapist but she doesn’t just work with palliative patients. She mostly works with the families. She could be working with them up to a diagnosis, but also for a long time afterwards for bereavement counselling. Years ago, there was no counsellor. There was no such thing as anyone talking to you. That has all changed. We pride ourselves on our holistic approach.” It seems - in simple parlance - that the Foundation’s approach is all about the provision of really good care for the patients and their families. Indeed, at the Foundation’s Mayo Hospice, each patient will be treated as a unique individual. A beautiful, purpose-built facility consisting of Day Care, Community Care and a 14 Bed In-Patient Unit providing symptom control support, respite and end of life services, the Mayo Hospice also has a café shop and reflection room. “We’re extremely proud of our Hospice in Mayo,” Ms. Jennings states. “Every single cent came from fundraising or from donations and 100% of our income is ploughed into palliative care services and the development of our Hospices. Mayo Roscommon Hospice Foundation built the facility entirely from fundraised income and it is fully paid for. All of this was achieved while also funding palliative care services in the two counties. Our presence and influence in Mayo and Roscommon has evolved greatly, year by year and the dream has always been to have a Hospice in both counties. With every fundraising


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“Unfortunately, for the most part of four months this year, the COVID-19 pandemic eviscerated the best money-raising efforts of Mayo Roscommon Hospice Foundation and its 12 shops – nine in Mayo and three in Roscommon - were closed from March 12th to June 9th.” drive that was made, money was put aside into a reserve account to build a hospice, firstly in Mayo. “In September 2017, Joe Biden, former Vice-President of the United States (and current Democratic Presidential candidate) turned the first sod on our site at Knockaphunta. That day was a great source of pride and satisfaction to all our volunteers, support groups and staff. We completed the construction of Mayo hospice last year. It was really pleasing too that we came in under budget; the cost amounted to just under nine million euro. The budget was 11.5 million.” The ambition of the Foundation wasn’t sated by the emergence of the Mayo masterpiece though. Perched on the horizon at that time was a would-be sister hospice/palliative care centre on a site known locally has Hannon’s Field, situated adjacent to Roscommon Hospital. Construction work continues at Hannon’s Field and when completed, the Roscommon facility will provide Day Care and Community Care and an 8 Bed In-Patient Unit providing respite and end of life services. The project was granted planning permission in June 2019 and the sod was turned in January 2020 with construction commencing in March last. The bill for the Foundation’s Roscommon Hospice is expected to be in the region of six million euro. Fundraising is getting no easier, of course, and six million euro is not to be scoffed at. Unfortunately, for the most part of four months this year, the COVID-19 pandemic eviscerated the best money-raising efforts of Mayo Roscommon Hospice Foundation and its 12 shops – nine in Mayo and three in Roscommon - were closed from March 12th to June 9th. “Seeing the shops close was very difficult for all of us, especially for our hard-working, loyal volunteers and staff who run them as if they were their own,” adds Ms. Jennings who was appointed CEO of the Foundation in February 2017, having earlier in her career spent 17 years working in telecommunications and 3 years with Miele Ireland as Head of Commercial Sales. “So it was such a relief and a happy breakthrough for us to be able to re-open our shops to the public and accept donations from June 9th. It’s important to say that every precaution is being taken and all protocols are being followed to ensure the safety of our customers, staff and volunteers. It’s due, in the main, to our income from the 12 shops and community fundraising that monies that we are able to provide palliative care services in the communities of Mayo and Roscommon. The fact that we are continuing to fund and provide palliative care services during the whole COVID-19 crisis is a testament to the volunteers, staff, donors and fundraisers that support Mayo Roscommon Hospice Foundation.” Three decades on and the Foundation continues

Martina Jennings CEO Mayo Roscommon Hospice to delight and comfort in equal measure with its voluntary support groups across Mayo and Roscommon the marrow of the bone. In 1992, the Foundation’s palliative care ‘unit’ consisted of one doctor and one nurse. That palliative team has now grown to 11 in Mayo and a further eight based in Roscommon. “We are funding a team of over 20 medical professionals now,” Martina says. “The Foundation has really been built from nothing, thanks to people who came before me with the vision and dedication to make things happen. “When I took on the role of CEO I soon became aware of the tireless efforts that went into growing the Foundation over the years. I too set out to work with a vision for the future while having respect for the selfless work that had been done in the past. “Obviously, there’s no way we would have our two hospices without people having, literally, put massive foundations in place. “It wasn’t a matter of me coming in and changing things; more a matter of overseeing continued development.” If you wish to donate to Mayo Roscommon Hospice Foundation www.hospice.ie/donations/donate-online or call 094-9388666.

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A Foundation for Hope A personal tragedy provided the impetus for the establishment of The Saoirse Foundation which provides vital supports to children suffering serious illness across Ireland. Founder, Tony Heffernan talks to Public Sector Magazine.

Just over ten years ago, The Saoirse Foundation was established. Not many could have imagined it – least of all foundation founder Tony Heffernan – but March 31st, 2010 would become a seminal day in the delivery of support to critically and seriously ill children throughout the island of Ireland. Since its inception, the foundation has made enormous strides in the business of raising funds to deliver services and supports to seriously and terminally sick children; funding vital research as well as providing guidance and information for the children’s’ carers and families. The Saoirse Foundation came about after four-year-old Saoirse Heffernan, daughter of Tony and his wife Mary, was diagnosed with Batten Disease (Neuronal Ceroid Lipofuscinosis) – a rare and fatal neurological condition which can affect babies, toddlers, children aged 9, 10 and 11 and even adults. After hearing the news of their precious daughter’s diagnosis, Tony and Mary left the hospital with little information about the disease or where they might seek support. Devastated by the news of their daughter’s fatal condition and alarmed at the paucity of support available, the Heffernan’s determined that other parents would be

spared a similar experience and became advocates for families of children with rare and genetic disorders (not just NCL), putting in train numerous awareness-raising activities and medical research initiatives which eventually spawned The Saoirse Foundation in 2010. “The main reason we set up Saoirse’s Foundation was to try and get Saoirse on a treatment trial and to provide help for all the other children on the island of Ireland who were also suffering from Batten Disease,” CEO Tony explains. “We desperately wanted to try and save Saoirse and support the research work going into Batten Disease but we found there was an incredible lack of information in the health system, a lack of compassion and lack of care. It was challenging. At the time, we were the only parents with two children in the Republic with Batten disease. “But rather than give out about the hand we’d been dealt, we decided to go away and set up a national charity to deal with this deficit. And if anyone came down the road behind us, well, at least they would have someone who had been through it to lean on and support them through the challenges that they would inevitably encounter.”

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Saoirse, “an energetic, loving, caring and conscientious child”, was born in June 2005 but by the age of four had begun to suffer from uncontrollable seizures. After undergoing constant tests, she was diagnosed with the rare and fatal Batten Disease in September 2009. Saoirse passed away in January 2011 and further tragedy followed three years later in May 2014 when the Heffernan’s second child, five-year-old Liam who had also been diagnosed with Batten lost his own battle with the deadly disease. Tigerish Liam had proven to be a courageous and tenacious little fighter. Just two months shy of his third birthday, he became the youngest patient ever to undergo pioneering brain surgery in New York, spending nine hours in theatre in May 2011. His bravery earned him a National Child of Courage Award. Liam’s participation in various medical trials produced positive results which may yet lead to a breakthrough in the fight to defeat Batten Disease.

Making a Difference Saoirse Heffernan The Saoirse Foundation’s first project was ‘Bee for Battens’, a support network that raises awareness and is a credible source of information for anyone affected by the disease. The second major initiative undertaken by the foundation saw the creation of ‘BUMBLEance’, the Children’s National Ambulance Service and the first of its kind in the world to be designed and tailored exclusively for children. It is also the first fully interactive ambulance on the planet specially designed for children. The high-spec BUMBLEance offers children safe and stress-free trips, as well as providing a wide range of entertainment on board to distract and entertain our young patients. BUMBLEance was added to the Saoirse Foundation’s portfolio in September 2013 as a direct result of the Heffernan’s travails in transporting Saoirse to and from her centres of treatment. Tony and Mary had to travel with Saoirse hundreds of miles from the south of Ireland to Dublin to access specialist services and care. This constant travel, and the loss of dignity that Saoirse endured on these journeys, motivated the Heffernan’s in 2013 to add to the Foundation’s portfolio with BUMBLEance. “I remember driving from Kerry to Temple Street,” recalls Tony who is a key member of the Minister for Health’s National Steering Group tasked with developing Ireland’s first national rare disease plan and strategy, “and then when arriving searching for an hour for a car park place. It just didn’t make

“The children used to get completely stressed when they saw the hospital. They would know when they were

going on a long car journey and that it meant just one thing, Temple Street

or Crumlin. We created the happy bubble concept, a purpose-made ambulance for children with wonderful music, DVDs,

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PlayStation and toys.” sense. That is why we created BUMBLEance. “The children used to get completely stressed when they saw the hospital. They would know when they were going on a long car journey and that it meant just one thing, Temple Street or Crumlin. We created the happy bubble concept, a purposemade ambulance for children with wonderful music, DVDs, PlayStation and toys.” Young Liam Heffernan had the distinction of being the firstever child to travel on board the Saoirse Foundation’s purposemade ambulance in 2013. Liam’s final trip on BUMBLEance


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was his Angel Trip when he came home for the last time from hospital in 2014. Incredibly, BUMBLEance’s fleet of vehicles has grown from zero to 13 in just six years and it continues to support hundreds and hundreds of families every year. Meanwhile, the journey to finding a cure for Batten Disease is destined to be a long and painstaking one. For many families sadly in the same situation, time is of the essence. “We know the speed of Batten Disease,” adds Tony Heffernan, the first President of the Batten Disease International Alliance. “We know about the progression of the disease, so our charity acts exceptionally quickly - whether that involves getting a wheelchair or getting the relevant house adapted or adapting the family car. “We’ve been investing significantly into research towards treatment. While Saoirse gave her name to the foundation, Liam’s name will live on in Liam’s Lodge which will be the first-ever National Children’s Respite Centre to cater for children with rare and genetic disorders and funded by the Saoirse Foundation. When it is built, it will be the country’s second only palliative care centre for children with life-limiting illnesses. Of course, in tandem with so many other charities who have seen their fundraising efforts badly hit by the advent of COVID-19, The Saoirse Foundation has also seen its coffers diminish over the past months making Liam’s Lodge (the third major initiative undertaken by the Foundation) a reality looks set to be delayed. “Irrespective of COVID-19, we will keep the fundraising going,” Tony declares emphatically. “Whatever happens from the point of view of the economy as a result of this virus is as yet unknowable. Fortunately, I think the philanthropists are still there and we will focus initially on maintaining our existing services. That is what we are concerned about at the moment; to fundraise as much as possible until things hopefully return to normal. Concluding Tony says: “We still aim to build Liam’s lodge later in the year even though construction costs have been going through the roof since we launched the project six years ago when completion costs were estimated to be five million euro. Liam’s Lodge is a fantastic project though. It will serve 22 families every week of the year. The design will have 22 lodges and a mix of eight two-bedroom lodges and the remainder of three-bedroom lodges - all connected in a single facility. Like a holiday village - all connected by common corridors and nursing stations and therapy rooms. We will also continue to push for a BUMBLEance expansion outside of the Republic.” BUMBLEance is a completely FREE service for families. For those who have a very sick child in their lives and wish to use the service there is a dedicated booking line on 0861451470 or email enquiries can be made to info@saoirsefoundation.com

Liam Heffernan

“Liam’s Lodge is a fantastic project. It will serve 22 families every week of the year. The design will have 22 lodges and a mix of eight two-bedroom lodges and the remainder of three-bedroom lodges - all connected in a single facility. Like a holiday village - all connected by common corridors and nursing stations and therapy rooms.” the Public Sector Magazine

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FCJ Sisters in Indonesia visiting their Muslim neighbours during Covid19.

FCJ SISTERS – IRELAND Thank You to all on the Frontline of Covid19 in Ireland from the FCJ Sisters and Companions in Mission

“Heartfelt thanks to all our frontline workers who risked their lives during the Corona Virus for all our service users”

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Fr. Joseph O’Reilly

Provincial Superior

Sr Alicia FCJ volunteering with a food bank in Manchester serving over 100 food parcels each day during Covid19.

from the Daughters of Charity of St. Vincent de Paul

The Faithful Companions of Jesus (FCJ Sisters) are a diverse group of Catholic women from many countries and cultures who are united in companionship with Jesus and others, sharing Christian Faith and Gospel values and living Ignatian spirituality. The Sisters share life, live in community and • offer spiritual accompaniment, discernment for decision making, and retreats • offer companionship to people in neighbourhoods and parishes • work with people who are poor, trafficked, and suffer injustice • are committed to care for the earth, our common home • are involved in the education of youth If you are considering a way of life as a Sister that would involve living companionship, serving others, living a spiritual life and caring for our earth and would like to talk,

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Call to Action Housing in Ireland has been mired in controversy for decades with the majority of Irish people believing that government is not doing enough to tackle homelessness.

The majority of Irish people remain unconvinced that enough is being done to tackle the housing crisis. A report from the Simon Community reveals that Irish people believe the government is not doing enough to address the problem even before you take into account additional pandemic issues. Seven in ten respondents expressed their concerns about the rate of homelessness in Ireland over the past number of years and a further 75% believe politicians are making a scant effort to make rents more affordable. Respondents were most exacerbated in relation to soaring rents and the prolonged homelessness crisis. “The survey shows public opinion to be ahead of political opinion and demonstrates the real urgency that exists on the ground,” Niamh Randall of Respond said. “This is particularly the case in relation to the private rented sector and homelessness, and what we found was that 75% of people believe the government is not doing enough to keep rent affordable while 72% are really concerned about the rates of homelessness increasing due to rising rents and reducing supply.” A further survey carried out by homeless charity the Peter McVerry Trust reveals that almost two-thirds of people would support a new tax on empty houses. 62% of respondents said they would support a tax being applied on houses which have been vacant for at least one year. The charity believes such a tax would dissuade people from stock-piling property while

waiting for the price to rise. It could also raise up to €54m a year in Dublin alone which could be allocated towards supporting the homeless.

Empty Nests For the last three years, the Peter McVerry Trust has been working hard to get empty buildings back into use as homes and during that time it has delivered over 50 homes for people exiting homelessness. “We have a pipeline of double that number over the next three years and we see enormous potential in these buildings,” said Pat Doyle, CEO of Peter McVerry Trust. “We can turn these empty homes around, quickly, cheaply and to very high standards. “We strongly believe in the merits of an empty homes tax because it will encourage the owners of empty homes to either take up existing grant schemes or place their properties on the market. Ultimately, an empty homes tax will result in an increased number of homes to rent, to buy and to be used for social housing.” The policy is strongly endorsed by the Simon Community which says that the number of vacant properties in Ireland could house our homeless population 27 times over and it is urging the government to make use of the estimated 200,000

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vacant properties which exist across the country. “When you look at these figures and then you look at the very stark contrast of people trapped in emergency accommodation families, children, single people who don’t have dependents in their care - it’s a very, very stark fact that we could meet their housing needs 27 times over,” a spokesperson said. The Simon Communities in Ireland say it is unacceptable that so many homes lie with almost 13% of total housing stock vacant which is twice the level expected in a functioning housing market. Respond’s Niamh Randall said the fact that we have so many people without homes and homes without people is shocking. “Clearly having more effective housing stock management across the country is a matter which must be addressed urgently. Access to decent, affordable homes is vital if we are to prevent any more people from becoming homeless and ensure that people have every opportunity to leave homelessness behind. The Simon Community opinion poll shows that thousands of people all around the country are hugely stressed and anxious about housing and homelessness for themselves, for their loved ones and for their friends. Three in four of us (75%) believe that the government is not doing enough to ensure the price of rent is affordable and seven in 10 (72%) expressed concern about the effect rising rents would have on homelessness.

The Simon Communities in Ireland say it is unacceptable that so many homes lie with

almost 13% of total housing stock vacant which is twice the level expected in a functioning housing market.

Cooperation & Collaboration Focus Ireland says one positive aspect of the coronavirus pandemic is that it has kept homeless figures low. The agency’s Southwest Regional Services Manager Ger Spillane says that the charity has seen a steady decline in the last few months in homeless numbers, however, this is coming from a very high base of over 10,000. Despite the lockdown and despite the pandemic, Focus Ireland was able to house over 500 households during this crisis

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period. “Covid was a crisis on top of a crisis,” he said, “but I think that there’s a lot of good work being done in dealing with the consequences of the virus and in dealing with homelessness.” CEO Pat Dennigan feels that Focus Ireland and their partners should be proud of what they have achieved and have shown the effectiveness of collaboration. “We are at a critical juncture which will decide how the homeless crisis goes not only for the rest of the year but for many years to come.” He believes that COVID-19 can be a turning point in the fight against homelessness. Other countries have used this crisis to rethink their approach shifting from short term responses towards building affordable homes. It presents today’s government with a clean slate and a chance to make a real impact, effecting measures to end this particular crisis once and for all. Commenting on the figures released on 31 July 2020, Minister for Housing, Local Government and Heritage, Darragh O’Brien, said, “Despite the increase in exits from homelessness and the reduction in the numbers accessing emergency accommodation, the number of people and families in homelessness is simply too high. One of my main priorities as Minister will be to accelerate the numbers of people exiting homelessness and to reduce the time that people spend in emergency accommodation.” He added that increasing social and affordable housing will be key and increasing the levels of supports to households with complex needs.


Making Makingaacomplaint complaintto to the the Ombudsman for Children’s Office Who we are:

The Ombudsman for Children’s Office (OCO) raises awareness of children’s rights and investigates complaints about services provided to children by public organisations. The service is free and independent.

What can you complain about?

Schools, hospitals, Government Departments, most public bodies or organisations that receive funding from the State.

Who can you complain about?

The actions of a public organisation that may have negatively affected a child.

Call us on Freephone 1800 20 20 40 Email us at oco@oco.ie Fill out an online complaint form at

How to complain?


Find everything you need to know about renting in Ireland The Residential Tenancies Board is home to the very best information and data on renting in Ireland, for both tenants and landlords alike.

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Homeless Support Caring for the homeless during COVID-19

Depaul’s Back Lane service in Dublin

Depaul exists to serve individuals or families caught in the spiral of homelessness. The charity provides 30 services across the island of Ireland and last year helped over 4,000 people experiencing homeless. David Carroll is the Chief Executive Officer for leading cross-border homeless charity Depaul. He previously worked as a care assistant and a social worker in North and West Belfast and Glasgow before entering management in homeless services in 2001. He joined Depaul in 2009 and was recently appointed CEO of the charity. Here we chat with David about the charity’s response to the COVID-19 crisis and the impact the crisis could have into the future. Depaul is a cross-border homeless charity in existence since 2002. When it was first established, it pioneered with innovative services for a specific group of people experiencing homelessness. Depaul set up its first service in Dublin, however, it soon became apparent that an approach to helping the most vulnerable was needed on a greater scale. In 2005 Depaul expanded and began delivering its first accommodation service in Belfast. The charity

now operates 30 services across the island of Ireland and help over 4,000 men, women and children each year. For David, working with Depaul is a chance to make a real difference: “Personally, I was delighted to become CEO as the charity has a particular focus on the most marginalised people in our society. This is what attracted me to Depaul when I first began working with the organisation in 2009. There is such an opportunity to make a difference in one of the most important issues of society.” Depaul is a refuge for people who often find themselves excluded or isolated due to a lack of support or assistance. “My main motivation is to make sure that people on the fringes of society get the assistance and help they need but maybe can’t get elsewhere,” explains David. Depaul offers specialist services to people with the most complex needs. These services help to support those with entrenched drug and alcohol issues. They also provide accommodation for women leaving the prison system, young people leaving the care system, rehabilitation services and

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Depaul CEO David Carroll

services for individuals with complex mental health issues. The charity has grown over the years to be a significant organisation on the island of Ireland in the delivery of homelessness services, particularly for people on the very margins of society. As an organisation, Depaul faces difficulties and challenges every day, even more so in the current climate. “The COVID-19 crisis has had a huge impact on the way we deliver services. It has also brought with it the need for extra services which, in line with our values as an organisation, we were more than happy to be involved with and lead on,” David explains. “In addition to the 30 services we deliver in both the Republic of Ireland and Northern Ireland, we set up an isolation unit and a 100-bed cocooning unit for the most vulnerable within the homeless population. “Across our accommodation-based settings, we reduced capacity by almost 15% to ensure social distancing guidelines were adhered to. We had to adjust to using a skeleton staff model within services and we reviewed our shift patterns to ensure movement within services was limited and the risk of exposure was reduced. In Derry we had to completely close our Foyle Haven Day Centre which we run for street drinkers and those experiencing homelessness where an average of 40 arrived every day. However, I am pleased to say that all of our other services remained operational throughout the crisis.” Asked whether he was happy with the Governments response to those experiencing homelessness during COVID-19 David gives a resounding yes. “There was an urgency to help the most vulnerable which was great to see and be part of. There was a real collective approach from various Government departments and statutory agencies, the likes of which I have not witnessed before. It was really heartening. I am also immensely proud to see the response from our staff too. Everybody is fully committed to doing what needs to be done to protect our service users. Our staff are very much on the frontline and deal with vulnerable people who have a

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high risk of contracting COVID-19. For many of those who we help, contracting the virus could be fatal. I am really proud to be part of an organisation that is so driven to deliver for those experiencing homelessness.” According to David, we must continue to provide the required health and accommodation supports for those experiencing homelessness once the COVID-19 crisis eases. He feels that the need for collaboration amongst the relevant departments has never been so important going forward. Even though the response to date has been impressive, he says that we must continue this approach and the plan to ensure people do not return to the streets or to crowded settings needs to be robust. “This crisis has shown in the most realist of ways, how damaging not having your own home can be. We also need to bear in mind that many people have lost their jobs. There is a real risk of people becoming homeless as a result of COVID-19 and we need to commit to ensuring this does not happen,” adds David. David encourages people to get involved with fundraising events or kindly donate to support the work of Depaul where possible to help the charity to care for the most fragile and vulnerable people in society. “Our work couldn’t happen without the generous support of others and we are so grateful,” he says. Musing on what the current crisis has brought home to him David comments: “It has taught me that solutions to ending homelessness do exist and that when we all work together for the common good, we can realise these solutions. The crisis has forced people to imagine a better way of supporting people experiencing homelessness, in particular around meeting their health needs. It is now imperative that we keep that momentum and togetherness alive.” ie.depaulcharity.org


CORONAVIRUS:

Depaul are on the frontline protecting the most vulnerable during Covid-19.

Help us do more. Call 01 453 7111 or visit ie.depaulcharity.org Charity Reg. No. 20048938 (CHY14753) Depaul, Holy Cross College, Clonliffe Road, Dublin 3


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ASK THE EXPERTS Businesses have taken a hit during the COVID-19 pandemic with many looking to outside consultants to recover and prepare for a post Covid world.

In the current economic environment, businesses must find ways to stand out, tighten their operations and maintain revenues while keeping outgoings low. As many businesses struggle to keep their heads above water, the day-to-day operations of the business are more than enough to keep management busy, especially in smaller businesses where owners or managers wear many hats. Problem-solving, investment and future planning are an important aspect of any business, particularly in light of the current pandemic, but many companies lack the in-house skillset required to focus on strategy and future direction. Hiring new employees to fill these gaps doesn’t always make sense either, seeing as many projects are one-offs. Whether it’s a cost reduction program requiring a dedicated team or implementing an IT strategy that requires a specialist for several months, outsourcing to a consultancy firm serves as access to temporary, highly skilled employees. Outsourcing to a consultancy firm allows businesses to plan ahead and be crisis ready rather than simply weathering the storm. Business consultants range from certified public

accountants, tax accountants, attorneys skilled in business law or consulting firms who offer services that apply to a range of activities such as management, sales, recruitment or marketing. The number one benefit that consultants can offer is that they provide high-level expertise exactly where you need it. Often clients have a perspective on how to solve a problem but they need to make sure that they are looking in the right direction; this is where consultancy pays dividends because consultants work with so many different companies, they will often have worked through the same issues in the past with someone else. They can provide a perspective based on what they’ve seen work (or not work) before and given this experience, they can often bring new and innovative ideas or challenges to the table that clients wouldn’t have been able to see on their own.

Value Add Having full-time employees provides its own benefits such as specific industry experience, the ability to perform varied

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organizational duties, a full-time presence on-site and a set salary. However, contrary to what many might think, outsourcing key projects provides significant value for money as consultants offer a higher level of business expertise than the average employee. They can develop strategies for growth or manage projects. They bring experience from a variety of industries which allows them to offer creative solutions and “out of the box� thinking. They can provide an objective viewpoint which allows for more diverse ideas than could be provided internally.

Managing Manpower A paradox of the coronavirus pandemic is that some industries and businesses suddenly find themselves requiring a lot more employees. Examples include the obvious one of healthcare and frontline workers as well as supermarkets, call centres, home delivery services, online shopping services, security workers and IT specialists to help with the big increase in the volume of employees working from home. The number one reason that companies often give for using a recruitment agency is to gain short term access to key strategic skills. In these difficult times, it is even more complex to gain access to skilled candidates so using a recruitment agency to identify talent, setup online interviews and negotiate terms can be very effective. The best recruiters will have their finger on the pulse of their specialist markets and can give the hiring team insight into what is happening. They should know the available talent, where they are and how to reach out to them, salary rates, career expectations, available skillsets etc despite current hiring complexities. If other businesses are also struggling to find the same people as you, they can advise on alternative solutions. The best will act as partners and collaborators and will be your eyes and ears in the market. In a practical sense, consultancy firms pull from their niche experience, industry knowledge and problemsolving abilities to offer valuable advice which is ultimately good value for money.

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Whether it’s a cost reduction program requiring a dedicated team or implementing an IT strategy that requires a specialist for several months, outsourcing serves as access to temporary, highly skilled employees.


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Silver Servisource Established twenty years ago by its current CEO Declan Murphy, Servisource Recruitment Agency continues to make its mark as one of the fastest growing recruitment agencies in Ireland.

The rapid ascension of Servisource Recruitment to the forefront of the hotly contested Irish recruitment sector has been an impressive feat. At its inception in 2000, Servisource had just two people on its books but now it boasts an 80-strong workforce which hold the fort at its bases in Dublin, Cork, Limerick, Galway, Manchester and London and at its headquarters at Quayside Business Park, 4 Mill St, Townparks, Dundalk. The supply of temporary and permanent labour is a potential minefield and from the outset, Murphy - Mayo-born and father of four adult children - avoided every tripwire laid down by the twin ravages of a turbulent economy and a highly competitive marketplace. Instead, he focussed on delivering on building trust and establishing strong relationships with clients and delivering a highly professional, responsive and innovative service. Initially, it began to make headway and carve out a reputation in the construction sector. Two decades on and the the company remains a leader in its field, offering a complete range of award-winning outsourced HR services from payroll to training, recruitment and selection. The company boasts a proud track record of exceptional service delivery in permanent, temporary and contract placements and training, across a range of sectors nationwide. It also specialises in permanent, temporary and contract placements and training across a range of sectors including Medical and Healthcare, Engineering and IT, Construction, Catering, Clerical and Customer Service, Accounting and Finance, Hospitality and Domestic, Logistics and Warehousing and Sales and Marketing. An unyielding commitment to servicing the needs of

Servisource Recruitment’s clients and giving them the best service possible has been and continues to be Murphy’s principal modus operandi. And the efficient service and smooth communication lines which form the backbone of Servisource Recruitment’s success is mirrored in the similar success enjoyed by the other strings Murphy has added to his bow. Among them, his entry into the healthcare industry. Murphy began making inroads into the rapidly expanding sector of healthcare staff recruitment a couple of years after establishing his recruitment agency. As the noughties gathered pace and Servisource’s revenue from the construction industry tapered off, the company’s healthcare activities began to gather pace. “We developed an acumen for hiring staff in general but more particularly in the healthcare industry back in the early noughties,” Murphy reveals. “And it wasn’t just within Ireland that we recruited well but from abroad also and that has served us well in all aspects of our business. “As time went on, we formed the view that hiring staff to third parties wasn’t a valued resource for clients and we found that in many cases they were looking to outsource activities, so we set up our workforce solutions division and within that healthcare division we have a homecare brand called Myhomecare.” These days, Myhomecare is probably the largest Irish owned homecare business. It provides a range of services from domiciliary care and companionship for older persons, right through to complex nursing care for everybody from young infants who are being discharged from hospitals around the

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These days, Myhomecare is probably the largest Irish owned homecare business. It provides a range of services from domiciliary care and companionship for older persons, right through to complex nursing care for everybody from young infants who are being discharged from hospitals around the country country and critically from, for instance, Crumlin Hospital where the patients often require intensive care at home and/or end of life care. Murphy is excited by the company’s launch of a brand-new app and the timing of its emergence also happens to be quite fortuitous. “The app allows families to establish a circle of care for a loved one or a service user,” he says. “They can allocate their time and take part in the delivery of care to that person through the app and it allows them to stay in touch and stay part of the whole care sector as well.” Under Murphy’s stewardship, Servisource Healthcare has become one of Ireland’s leading national and international suppliers of high quality and innovative temporary and permanent healthcare staffing solutions. The recruitment of permanent nursing staff is often a lengthy, precarious, time consuming and expensive process and with ever decreasing numbers of nurses applying for

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positions, Servisource Nurse Staffing Agency has had to rise to the challenge of helping its clients reduce their workload by providing a consistent supply of fully qualified, highly skilled nursing professionals from Ireland and abroad. In taking the risk out of procuring nurse staffing solutions by maintaining the highest standards of compliance, Servisource has become the go-to company for discerning employers who wish to avail of the services of a company that can provide professional, flexible and reliable staff at short notice. But Servisource’s home care service doesn’t restrict itself to just providing nurses or carers. Indeed, Myhomecare offers routine medical services such as vaccinations or pharmacy delivery in the comfort of the client’s own home. The company also works with medical practitioners and suppliers to provide a wide range of supportive solutions such as home adaptations and essential medical supplies. Servisource Healthcare’s tailor-made home care services


Frontline & Healthcare

“We do a lot of work with the educational training boards around the country and we deliver online training. I’m proud to report that we’ve trained over 120 people over recent weeks in Infection Prevention and Control online, and we’ve done that free of charge as well. We have staff who are part of the frontline and who put themselves in harm’s way and that is something I am keen to point out and acknowledge.” and packages cover a wide range of services from basic home help and befriending to advanced nursing care and supported hospital discharge. Murphy and Co. also provide cost effective solutions which help its longstanding clients manage budgets, reduce workloads, maintain staffing levels, and deliver premium patient care. Little wonder that Servisource is the official partner to the HSE, supporting the Ireland-on-Call campaign! “We’re running the ‘On-Call for Ireland’ campaign for the HSE and nursing homes Ireland,” Murphy explains,” having approached them at the start of the campaign. “So far, we’ve put over 400 applicants in touch with nursing homes around the country and we don’t charge them for that as it was part of our commitment to support the service during the current pandemic.” Servisource’s social conscience at national level in helping to tackle COVID-19 is mirrored by its commitment to the various parties operating at grass roots level in the healthcare industry. In that respect, the company’s local, dedicated teams bring to life its own catchphrase ‘local presence/national reach’ by providing healthcare staffing solutions to clients with regular, timely updates. Pointedly, Servisource has significantly enhanced the delivery of high client fill rates by providing local, highly skilled, compliant healthcare staff ensuring continuity in service at all times. Included on its roll call is a client relationship manager, booking coordinator and recruitment administrator; a line up which ensures all client requirements are dealt with in a timely and professional manner at a local level be it in relation to home care support services; paediatric care, palliative care, prenatal and postnatal help, reablement; tracheostomy homecare, respite care; pharmacy medication services, oncology care, mental health care or chronic illness management. In addition, Servisource Healthcare Training provides a complete portfolio of nationwide healthcare training services to both private organisations and individual members of the workforce, making it Ireland’s leading healthcare training provider. Servisource enjoys a peerless reputation in the provision of tailor-made training packages to its clients, equipping front-line staff with the repertoire of skills required in the modern healthcare practice. This service is a consistent, quality approved formula, which not only ensures best practice to HIQA standards, but realises real results at ground level. Bringing together the knowledge and experience of experts

within the health sector and sharing their skills and know-how to drive positive change in Ireland’s health system is a core trait of the company. With the advent of the coronavirus, company chief Murphy explains that his company’s on-line database which is integrated with a broad range of social media channels facilitating access to the largest candidate databases in the world in seconds - is a much more significant driver in the company than heretofore. “Circumstances this year with the onset of COVID-19 has helped change our business model to a more online presence,” says Murphy. “For instance, we do a lot of work with the educational training boards around the country and we deliver online training. “I’m proud to report that we’ve trained over 120 people over recent weeks in Infection Prevention and Control online, and we’ve done that free of charge as well. “We have staff who are part of the frontline and who put themselves in harm’s way and that is something I am keen to point out and acknowledge. We run the assisted admission service on behalf of the HSE where we manage our involuntary psychiatric admissions to the country’s mental health facilities. “ The success of the Murphy-led firm is also fuelled by Servisource Managed Services Solutions; a unit which removes the heavy administrative elements of rostering, recruitment, training and compliance by delivering ‘all inclusive’ and robust staffing solutions, thus saving the customer time and lots of money. Servisource is the favourite of a growing number of bluechip firms because it removes the risk out of procuring staff by maintaining the highest standards of compliance while training them to the client’s specification. The company’s inhouse training division includes a mobile training unit which can bring training to the client’s facility at a time and place convenient to them. “It pleases me that we are able to consistently demonstrate to our clients, like the HSE and other service users, that we’re a very robust and responsible business to work with,” CEO Murphy adds. “We are a very strong service provider and implementing the best technology solutions available and ensuring quality of service are the two areas that we’re really zoning in on at present in order to give us a differential and an edge when we emerge from this Covid crisis. An even greater edge, dare we say!”

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Pandemic Preparedness Justine McCarthy, Head of Healthcare, EY Ireland and two senior colleagues Michelle Mulcahy and Sarah Reade unravel the wide-ranging impacts that the pandemic has had on society and assess how we might best curtail its ongoing effects and whether there are any critical lessons to be learned to date.

Six months into the COVID-19 pandemic and the world remains uncertain as to when we might finally be rid of the most rampant and indiscriminate virus in a century and permitted to return to our normal lives. The disruption wrought by the pandemic has been so pervasive and wide-reaching that many commentators are questioning whether a return to life as it existed pre-COVID-19 is realistic or even desirable. Justine McCarthy, who leads EY Ireland’s healthcare practice believes it is premature to evaluate the legacy of COVID-19 while its impact continues to unfold and the final chapter is yet to be written. McCarthy and her team have been front and centre of the multi-faceted, national COVID-19 response; busy advising commercial clients and state bodies, including the HSE, on how to best plan, prepare and implement the strategies necessary to respond effectively to the new realities wrought by the pandemic. “At the moment, Covid is the single biggest and most challenging event we have ever had to deal with, and we are not out of the woods yet,” she says. “At this stage, it’s too early to comment on its defining legacy but we do have some idea of its likely repercussions in a broader sense, with society reassessing

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its attitude to life in general and becoming far more conscious about specific issues such as hygiene. “It is also likely to lead to a far more considered and responsible approach in terms of how we care for the elderly and more vulnerable in our community. Unfortunately, we are yet to see the real impact and the longer-term health implications of COVID-19. If you talk to a cardiologist or respiratory physician, it is pretty bad news in terms of the post Covid rehabilitation and its lasting effects. We also know that enforced isolation and other measures will have ramifications in terms of an increase in mental health issues.’ A highly accomplished strategic thinker and adept at managing complex transformation programmes, McCarthy is a management consultant of some 20 years standing and works exclusively in healthcare. Her expertise ranges from operational and capacity planning to performance optimisation, organisation design and governance and strategy development. She has developed over 20 strategies for health service providers and completed numerous governance and organisation design reviews and service reviews in the north


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and south of Ireland. McCarthy recalls her initial feelings of trepidation when Covid began to sweep unrelentingly across Europe in early March of this year. The speed at which it took hold was unprecedented and she shared the concerns expressed by many health experts that COVID-19 had the capacity to overrun our health services, resulting in catastrophic loss of life and a seismic and potentially irreversible shock to business. Thankfully the worst scenario did not come to pass. While the impact has been undoubtedly traumatic, McCarthy has been largely impressed by the national response and the manner in which the HSE and Government together with business and wider society have adapted to the crisis and curtailed the severity of its Justine McCarthy, Head of Healthcare, impact. Complacency, however, remains a EY Ireland real danger, she says, citing the cautionary tale of Melbourne which was lauded as a model of pandemic preparedness, just days before it was forced into a second lockdown. “Events can change so rapidly; just look at Melbourne,” she warns. “Just before the second wave hit, I was listening to an excellent podcast from a panel in the city who were reflecting on their Covid experience, their success in managing the first wave and how best to avoid and prepare for a second surge.’’ “In Ireland, we have adopted a cautious and measured approach. There are challenges around that, and it has been exceptionally difficult for some businesses. The service economy, in particular, has been decimated and it has been terribly sad to see the numbers of Covid cases and deaths. Of course, it goes without saying that our frontline staff have been exceptional.” “Given the scale of the challenge everything was never going to be perfect but by and large, I think the public feel that it was managed well and the overall response has been relatively successful to date. The Government showed strong leadership while Tony Houlihan, and more recently Ronan Glynn have done a phenomenal job.” “The HSE took every opportunity to speak directly to the public, calling for unity and a genuine request for us all to stick on the green jersey and play our part, protecting the elderly and supporting our frontline workers. It was about recognising that we are all in this together and that the response requires a team effort. It was very

You have to

be agile with

a governance

structure that allows you to

make decisions quickly. These

are the starting points, the must haves. You have to have your

surveillance;

you have to have adequate lab

capacity and

you have to have your workforce configured for

rapid deployment.

effective and an impressive demonstration of great leadership.”

Standing Side by Side McCarthy was also impressed with how all the relevant data was assimilated and communicated. This was a new departure for the HSE and the EY team played a significant role in that aspect of the response - gathering the relevant data, standing up the architecture, developing dashboards to present the data and trends, and using sophisticated modelling techniques to interpret the flood of daily information, keep abreast of the virus’s ongoing status and identify and prepare for likely scenarios. “It brought transparency to the process and helped create a sense of ownership within the community. It encouraged people to ask how they can play their part,” McCarthy says. “Showcasing and displaying the real live facts as depicted by the data modelling and analytics was an important aspect of the communications strategy and they did that very well.” In recent weeks a number of commentators have emerged to question the cautious posture adopted by Government. Instead, they advocate a more aggressive approach with the ultimate aim of eradicating COVID-19 in its entirety from this island. This would almost certainly require a second lengthy lockdown which opponents argue would decimate the economy. While welcoming diverse views McCarthy views this latest proposition as probably unrealistic. “Rarely do scientists or public health experts talk about the eradication as a response or as a management approach. It is all about anticipation, early intervention and then ensuring that you have the basic building blocks in place to manage the pandemic,” she says. “Internationally the reality is that those countries that dealt with this successfully as the pandemic broke were those that learned from SARS and had the necessary preparations in place. They were ready. Science is informing policy and our scientists and our public health experts are standing side-byside with the decision-makers, which is just as it ought to be.” Germany is a prime example of a country which has learned from SARS and it should come as little surprise that it sits

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top of the EU leader board in terms of preparedness. This has been a critical factor in the success it has had in limiting the impact of Covid on Germany’s health services and wider economy. At the outset of the pandemic, Germany ordered 20,000 ventilators but this was merely to maintain supply levels, according to McCarthy. “They already had a sufficient number of ventilators to meet any additional needs arising from COVID-19,” she explains. “Germany took the lessons learned from SARS really seriously and they made sure they had their surveillance systems up-andrunning and their testing and supply chains in place. They buy the bulk of their equipment from local manufacturers, so they do not have to depend on international suppliers. They had everything in place and were ready to act quickly. “You have to be agile with a governance structure that allows you to make decisions quickly. These are the starting points, the must haves. You have to have your surveillance; you have to have adequate lab capacity and you have to have your workforce configured for rapid deployment. A proper preparedness system must be in place which can be readily activated, and scientists need to be front and centre in this. We need to think along these lines because it’s going to happen again, and it is going to be part of health services planning into the future.” “In Ireland, our level of preparedness could have been better but we rose to the challenge and did really well. There are learnings and we all agree there are always areas for improvement, but some things can never be prepared for. Remaining flexible in our response and acknowledging that our assumptions for managing pandemics, such as not shutting borders, may change is important.

Co-Ordinated Global Approach The ability to better withstand future outbreaks will require a more integrated and coordinated global approach, particularly in terms of developing improved early detection and rapid response capabilities. In particular, McCarthy argues that greater support should be provided to low-income nations to assist in developing more robust and effective response mechanisms to cope with emerging outbreaks. McCarthy says it is incumbent on us to assist low-income countries to improve their preparedness against future threats. “The first thing is to be able to recognise and detect any potential virus and to ensure that our health services have the requisite capabilities to do so effectively. “After that, it’s about having the ability to stand-up and respond quickly and ensuring that you have the testing and contract tracing model and the necessary surveillance apparatus at the ready. These are the key building blocks. The need to secure your own supply chain, particularly with regards to access to PPE is also vital. Our health system needs to be able to react quickly in terms of capacity. The rising numbers in ICU and the pressure on our acute beds in Ireland were very scary at one point and we called on the private sector to support our efforts. It is crucial to have that contingency plan in place and to be able to ramp up hospital capacity at short notice. We need flexibility and the capacity to rapidly turn up capacity according to peaking demands and surges” The need to remain on guard and in an advanced state of

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preparedness is particularly acute as winter draws closer. In the months to come, the strain on our health services caused by the standard seasonal flu is likely to be greatly exacerbated by renewed outbreaks of COVID-19. Put starkly, we are potentially facing an even more calamitous phase of the virus which might once again threaten to overwhelm our health services. “This is a very serious concern and certainly the biggest worry for our health service. This is now the time of the year where we typically plan for the winter and ensure that we are putting the right interventions in place. But it needs to go way beyond the normal winter planning. “We are already operating at occupancy levels that are above what they should be. Going into a winter where we are already at over 100% occupancy on occasions in some hospitals and while our capacity is potentially down 20% because of all the implications of the pandemic and social distancing, is certainly a significant concern. Trying to manage the normal winter in a Covid environment needs a significant amount of investment. We need interventions put in place in primary care and the community to prevent people from attending an A&E in the first place. We are too reliant on our hospitals. Prominent in Covid’s firing line are elderly and more vulnerable citizens. The cruel reality of the disproportionate impact on older people was laid bare by the COVID-19 Nursing Homes Expert Panel report which reveals that up to 80% of all notified deaths from COVID-19 were among people aged over 75. This has called into question the model of care which is in place for older and more vulnerable citizens and highlighted the need to consider alternative options, including community living models and greater support to assist elderly citizens to remain in their home. “COVID-19 has highlighted the importance of communitybased service delivery in order to reduce the number of people in congregated settings. There should be a home first approach,” says McCarthy. “This means living in the home or in the community with the necessary supports and avoiding large residential settings. We need to look at smaller settings and how we can provide patients and service users with more community-oriented rehabilitation services. It’s about providing solutions which enable people to continue to live in the community. With over 300,000 employees operating in more than 150 countries worldwide, EY enjoys a vast global footprint which has been invaluable to the EY Health team in Ireland in terms of being able to access crucial data and the latest information on how other nations are faring with respect to COVID-19. “Our team were able to access current trends and interventions from around the world quickly, which is helpful when faced with the mammoth challenge of planning and reacting to a pandemic. We’re a small country and we need to be able to quickly access information and learn from elsewhere. It’s been challenging but we have been able to do that and as a firm, we were delighted to be in a position to help out.” “One of the first questions from any health system when seeking advice is what are other countries doing. The people that we’re working with don’t have time to be reading lots of material and it’s important to be able to mobilize information rapidly in a user-friendly way. We brought that learning and expertise quickly into play.


Frontline & Healthcare

Now, Next & Beyond Now, Next and Beyond is a framework developed by EY which provides a detailed response strategy for society and businesses trying to navigate their way through the pandemic. It advises clients on how to organise their planning and how to prepare for recovery. Clients are challenged to assess how they can capitalise on the experience in order to transform their service offering and advised on how to navigate the shift back towards broader service delivery in the face of COVID-19. “We are unfortunately still on this pandemic journey and it is unclear when and how it will end. As a result, we have anxious patients, pent up demand for certain services, workforce challenges, capacity deficits, ongoing supply challenges and a very different landscape for healthcare delivery” says McCarthy. “While managing the pandemic, our health service is trying to restart services safely, but at the same time trying to implement the Slaintecare reforms, and address some of the key long-standing issues such as overcrowded A&Es and waiting lists. Driving through real change and service transformation in the midst of a pandemic is exceptionally challenging but it is necessary and doable. I believe the pandemic has proven again that Ireland can achieve great things when we are up against it, and although it won’t be easy, with the support of the public and our great healthcare staff I think we will come out of this pandemic with a better health service.

Digitisation On the face of it, the first phase of the COVID-19 response which entailed the virtual lockdown of an entire population would appear the most challenging. However, six months into the pandemic and it is the unwinding of the restrictions and the effort to navigate a slow return to normality which seems to be proving a difficult course to chart. The sheer magnitude of the upheaval caused by COVID-19 presents an unprecedented challenge to policymakers and no country has emerged unscathed, according to Sarah Reade, Senior Manager, Government and Healthcare Consulting, EY Ireland, who specialises in health

Sarah Reade, Senior Manager, Government and Healthcare Consulting, EY Ireland

Healthcare data needs to follow the patient. An important consideration here is patient consent and making sure that the patient is happy with their data being shared. That needs to be factored in from the start and we must do it safely and securely in a manner that protects the privacy of the patient while ensuring they receive the best care available.

transformation and data analytics. EY recently won ‘Data Analytics Partner of the Year’ at the Microsoft Ireland Partner Awards and has been instrumental in assisting the health services to deploy the most effective technological and digital resources available in the fight against Covid. In the main, Reade believes the health authorities deserve high praise for their performance to date. The decisive actions and careful and deliberate strategic approach allied to the cultivation of a collective sense of responsibility which characterised the initial response to the pandemic will be equally important as we chart a path forward and ‘learn to live’ with the virus. “We were doing exceptionally well through the lockdown period when everything was closed down and I think those measures were essential in terms of minimising the spread of the virus,” she says. “The collaborative effort between the government health authorities and the National Public Health Emergency Team together with the health service itself and the private hospitals in dealing with COVID-19 has been absolutely commendable.” “The rapid and early announcement of the public health restrictions and that decisive action combined with daily reporting and the focus on contact tracing all contributed significantly to our ability to navigate through the pandemic. In comparison to many other countries, we have been doing well. However, we are not out of the woods. Things are turning around and we now have to steer our way through the current stage of the crisis while carefully opening back up the economy and wider healthcare services. We’ve now surpassed 28,000 confirmed cases, so it’s definitely challenging.”

Long Term Repercussions There is a general consensus that Covid is likely to have long-term repercussions which will endure long after the pandemic itself has passed. But the legacy written by COVID-19 does not necessarily have to be entirely destructive and Reade is hopeful that it can have a positive impact in terms of better enabling the important work of further digitising Ireland’s health services. COVID-19 has already accelerated

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important elements of health digitisation which have the potential to transform the health service and generate significantly improved efficiencies. Reade was particularly impressed by the HSE Covid Tracker App and the extent to which the wider public has engaged with and utilised the device. “The HSE Covid tracker app was a really positive initiative and I’d love to see everyone have it on their phones as it provides an instant means of tracking how many people have been exposed to the virus. It is a really effective way for us to track exposure to COVID-19 on a person-by-person level.” “The HSE is investing €1bn in PPE and similar amounts on testing and contact tracing. It’s a very significant investment towards meeting the challenges presented by COVID-19. More than 1.7m people have now downloaded the app and it has become a vital component in our arsenal against the pandemic. I also commend the HSE on making the app available globally so other countries can leverage the technology. This is very much a global problem also.” In 2013, the E-health Ireland strategy was published which provides an outline of eHealth and demonstrates how individual citizens, as well as the Irish healthcare delivery systems - both public and private - and the economy as a whole, can benefit from eHealth. Recognising the importance of ICT investment for healthcare, Sláintecare sets out clear goals for the eHealth agenda to both digitally connect the health service and digitally connect the citizen. Describing the strategy as an “ambitious program to bring technology-enabled solutions to the health service in Ireland”, Reade says that considerable progress has been made against all the targeted objectives. “This strategy highlighted the potential of digital health and provided a platform at a policy level which I think has been really positive. Two key elements of the strategy are the implementation of national electronic healthcare records (EHR) and Individual Health Identifiers (IHI) are vital for us to make progress on our eHealth journey. We need EHRs but we also need the data from these systems to be joined up with datasets from other healthcare systems across healthcare services. We need to have systems that are interoperable and ensure that the data is not contained within silos, so we don’t simply move from paper-based to electronic silos. “Healthcare data needs to follow the patient. An important consideration here is patient consent and making sure that the patient is happy with their data being shared. That absolutely needs to be factored in from the start but if we are upfront about it and do it safely and securely and in a manner that protects the privacy of the patient while ensuring they receive the best care available. Then we will receive the public support and acceptance needed.” For the moment, Ireland continues to lag behind exemplar nations such as Estonia where almost the entirety of the health service is fully digitised. Although we have yet to reach those dizzying heights, significant strides have been made in recent years, particularly in the primary healthcare network, whereas many as 95% of GP’s services now fully digitally enabled. Nonetheless, there is still a way to go in our acute and secondary care settings. Health outcomes can be improved through the provision of reliable cradle-to-grave healthcare

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records leveraged by the different entities/services that a patient engages with throughout their life. “Estonia as an example often highlighted because they’ve got around 95% of the data generated by hospitals and doctors digitised.” “What benefits does that bring?” Reade points out “this means citizens have access to their own records. They don’t need to go to a doctor for a repeat prescription. They can simply call the GP and that repeat prescription can be sent directly from the doctor to the pharmacist”. “Without Covid that facility would have taken a long time to implement in Ireland, but it is now widely in place and it is of considerable benefit. The point to note about Estonia is that the move to digitisation of healthcare has supported them hugely in the transition from curative medicine to preventative care. Having all of the data available to them in order to be able to look at the trends and forecast forward rather than just looking back has been very beneficial. “Other countries such as Norway and Sweden also have permission-driven consumer and clinical access to healthcare records. Regardless of where the patient is attending, their care records can come with them.” Britain’s Salford Royal NHS Foundation Trust has deployed an EHR and open EHR clinical data repository, alongside their core patient record system in order to meet the challenges presented by data access. By joining up their social care and clinical care data they have a broader picture of the patients’ conditions and needs. According to Reade, access to individualised data also supports the important task of providing personalised treatment for patients. “For example, each patient is treated individually from an oncology perspective with a personalised therapeutic regime,” Reade states. “Genetic sequencing can be used to understand all of the aspects of their condition, we can then come up with really good personalised medicine and therapies which are tailored specifically to the individual and which have been shown to lead to better outcomes.” From an investment perspective, full digitisation will require significant financial and human resources. The Ireland 2040 economic development plan has earmarked €500m in funding to support disruptive innovations in the health service. Not all the funding is focused on digitalisation and Reade says it will also have a big impact in terms of research into advanced technologies such as AI. “From 2019 to 2020 the NHS has spent £305 million on digital health so there is a financial requirement involved,” she acknowledges. “We in Ireland, work in a complex system and we have multi-stakeholder environments, so we need multiple groupings together on the journey.” “The resources that we need include the IT specialists that understand and can leverage the technologies. We also need healthcare service providers and staff to engage in the process. They understand the business and they understand how the health service works. It’s about collaboration, bringing these parties together. The size of the investment required depends on the size of the project and the level of complexity involved. If we’re talking about a national scale, we are going to need stakeholders at a national, regional and local level which is inevitably more complicated. “The total return on investment will be achieved in the


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medium to longer term. Whilst there are some quick wins, it’s going to take time. If we look at other industries that have experienced significant technological disruption, it takes time.” Promisingly Reade believes that the capacity constraints which are evident in Irish hospitals every winter can be considerably alleviated by digital solutions. Many treatments provided on-site before COVID-19 were carried out digitally through the pandemic in order to control the number of patients presenting at the hospital. “The use of solutions like telehealth has increased hugely during the Covid pandemic,” she says. “Telehealth has been around for a long time, literally years in the making, but its adoption at scale has Michelle Mulcahy, Senior Manager, really just happened over the last four Government and Healthcare Consulting, EY Ireland months. It’s driven by the demand for safety and patients’ willingness to social distance and the fact that the resources to deliver telemedicine and all the technologies required are readily available. If we can keep that going as we move into the winter period, that will definitely help our hospitals.” As Ireland’s health providers embrace the benefits of digitisation, Reade believes that it will also encourage progress in other key innovations which have the potential to dramatically enhance healthcare provision. “There is the whole area of wearables and sensors and the help that they can provide in supporting the management and monitoring of treatments for patients,” she enthuses. “There are also great opportunities from leveraging other technologies like fifth generation, wireless communications and the whole era of AI and data analytics. “All these instruments and innovations will continue to expand and be further enhanced. AI and wearable technologies will help us move to more preventative care models rather than reactive healthcare. I also think genetics and genetic sequencing has a huge role to play. “These are the technologies that are out there which, when applied to the healthcare service, can deliver great benefits. it is about empowering patients and ensuring they are better informed and it is about providing more personalised, individually tailored treatment. The way we treat patients will change dramatically in the coming years. There is a rise in

the patient population with comorbid conditions and chronic diseases and we need to look at new ways of treating them. “Across those morbidities, having holistic, comprehensive data available around the whole of the patient will make a big difference in how we treat patients. As we get more data, it will enable further research beyond where we’ve been so far, and this will in turn lead to everimproving treatment and outcomes. “Necessity is a great thing, because it forces change and how we look at things. It adds impetus. I do think Covid has driven us to deliver new ways of working and some real benefits. I don’t think we would have got e-prescribing across the line as quickly without the COVID-19 crisis. It has also highlighted to the public and to our healthcare system the possibilities that exist and the potential to transform healthcare provision in Ireland. Of course, these solutions do not come without their own particular challenges, but the benefits are great.”

Businesses face numerous

challenges. They

Healthcare Consulting

have had to move their workforce to a different

environment, they have seen their supply chains

disrupted and

many businesses have had to completely

reexamine their

working models

and reshape their businesses. We are helping them to do that.

Michelle Mulcahy, Senior Manager in Government and Healthcare Consulting, EY Ireland, believes that globally, everyone has been impacted by this pandemic and EY are no different. Here she discusses these changes and how EY help their clients to adapt and innovate. We have had to change how we work with our clients. Ordinarily, we work side-by-side with a client and we embed ourselves within the organisations and the projects we’re involved in. Typically, a lot of our time is spent at the client site rather than in our own offices. Since Covid started, we have been doing everything remotely. I have completed two projects in the last couple of months and they were 100% remote. It means having to build relationships and communicate in different ways. We have also had to use technology differently because some organisations are better set up than others. We have had to be a lot more explicit with our clients and explain from the outset what we’re doing, how we’re going to do it and how it’s going to benefit them. A lot of that set-up work which might previously have been done on a much more informal basis now needs to be done in a more formal and structured fashion. It

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makes relationship building a little trickier and clients do miss the normal face-to-face contact. That said, our experience to date has been very positive. Our team has always been highly mobile. From a work-life balance perspective, the fact that people aren’t having to commute daily provides a few additional hours each day which have been put to good use. We have kept on track from a deliverables perspective and productivity has not been an issue. The team has been very focused, very deliberate and determined to make this new reality work. We have found that in many cases, staff can be more productive when taking virtual meetings from home. You’re very targeted with the meetings you put in your diary and very little time is wasted on non-essentials. So, overall, it has been a positive experience. Running workshops, and collaborating is challenging but there are ways and means to get around it. We ran a virtual workshop recently with 45 people involved which we hadn’t done to that extent before. But we managed it very well. Are we able to provide as good as a product as we do when everyone is in the same room? Nothing replaces face to face but it’s much better than if we were to try and do everything via email, it allows for engagement between different groups in a live setting to get instant input and feedback.

Adapt & Innovate In terms of workshops and group events, there are efficiencies gained from people not having to travel and in the aforementioned project, we would have had people coming from all around the country, so it has some benefits in that regard. Of course, there is still a lot of planning and preparation involved and I wouldn’t take away from the importance of faceto face-collaboration. It’s easier to challenge people face-to-face and ideally, you want to be able to better observe and gauge people’s facial expressions. When you are communicating in person, you get a better indication of their reaction and whether they’re pleased or disappointed. It is much harder to read people in the virtual environment and you must take different cues. However, it’s a case of needs must and having to adapting

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to the new world we live in. Working from home is part of that. Covid has up-ended industries and impacted the nature of the work we carry out across most of the different sectors in which we operate. We are involved in helping organisations across multiple sectors and all of them are trying to mitigate the risk of Covid. A lot of organisations, including the health field, are not digitally enabled to the extent they need to be, and they have had to acquire these skills virtually overnight. Businesses face numerous challenges. They have had to move their workforce to a different environment, they have seen their supply chains disrupted and many businesses have had to completely reexamine their working models and reshape their businesses. We are helping them to do that. The world is being reshaped and while that presents opportunities, it also means that those organisations that don’t change will get left behind. Our role is to apply our health offering to the unique needs of the client and support clients in adapting to the new reality and targeting those facets of their operations which need to be improved. We bring in specialists’ resources from across the various EY departments to help them, depending on the kind of support they need. Looking to the future Michelle feels that EY Healthcare will maintain some of the new working models beyond the Covid crisis. Overall, the experience of flexible working has been positive. There is now far greater confidence that employees can work productively from home and clients have also been reassured that the quality of the service they receive is not compromised by the fact that people are now teleworking. Just because you can’t see people doesn’t mean they’re not working. What’s important is that they’re still delivering the same high-quality product. I think we’re likely to see a blend of people working both from home and in the office. It’s still very important to maintain the human factor and that won’t change but I do think there will be greater flexibility going forward and that is a positive thing. This is likely to have an impact in terms of companies and organisations reconsidering the extent of the capital they’re prepared to commit to their office facilities going forward. We know globally that several of the big tech firms have said that they expect working from home to continue for at least another


Frontline & Healthcare

year. Our own offices have started to open subject to significant restriction and the vast majority of EY employees continue to work from home. In general, there isn’t an appetite to go back into the office unless you really need to be there, and I expect there will be a change in the amount of real estate that organisations will choose to continue with.

Crisis Map Some companies have done well from Covid and have been lucky as a result of being in the right position and being able to optimise that. We have seen many examples of the entrepreneurial spirit and companies in the food and hospitality sector which has been severely affected responding by launching good takeaway services and things like virtual wine tasting. Some of these initiatives have done really well. Other organisations have been adversely impacted because they are not set up in a way that enables them to diversify and respond in the necessary manner. They may have had to close their physical doors for an extended period and they don’t have the technological infrastructure or capacity to operate outside of the normal. By and large, it has been a mixed bag. Those businesses with a front door dependent on footfall and without an established online presence have been impacted most severely. They are constrained in how they can react because they are dependent on numbers coming into their premises. EY’s global footprint is hard to match. It is a significant resource and we have been putting it to good use. A lot of what we have learned is as a result of the SARS epidemic a few years back. We carried out a lot of work with a variety of countries around that period and assisted them in developing their response and in preparing a ‘Crisis Map’ to defend against the threat of future pandemics. We have people working on the development of different modes of response in countries across the globe. We have a direct route to global experts in all the relevant subject matter expertise necessary to address this pandemic and we leverage all that knowledge and information in assisting the HSE and many of our other clients. We have what we call a global knowledge hub and we can get up-to-date, pertinent information from any country in the world. We have linked in with different government departments to discuss their issues and we are actively sharing our knowledge and expertise. In terms of advising clients and health organisations to use this period of destruction to meet their future needs, first and foremost, we’re advising people to plan. Companies need to undertake a root and branch examination of their operation and identify what worked well during the crisis and which of the changes it makes sense to hold on to. That kind of thinking has been in play since the very beginning and most managers and business leaders can see by now where the opportunities lie. They can see how people have adapted, not just in relation to the adoption of technology but also in terms of employees having to change their roles somewhat in order to adapt to the new conditions. How do we foster that going forward in order to make sure that we are prepared the next time because the plan is hopefully never to

have to go into a full lockdown again and to be able to manage with public safety advice the level of infections until a viable vaccine is available. The way most jurisdictions are managing the crisis is by paying close attention to the Rt factor, which is essentially the reproduction number and other key measurements indicating how fast the virus is growing and impact on hospital services. Government have an escalation protocol in place which determines the course of action to be followed in the event of a certain threshold being reached. If it continues to increase beyond a certain level, there is an escalating measure of restrictions ready to be put in place. It’s about managing any outbreaks that arise in a measured, methodical manner as has been the case to date. We have seen several countries exercise a semi-lockdown on a regional basis to address localised outbreaks, including Australia, Spain and Germany and this option seems to be a bit more palatable as we have seen recently in some counties here in Ireland. Of course, we can never be certain given the different parameters that can impact the spread of the virus, again, it goes back to the simple things, taking personal responsibility, wash your hands regularly and keeping your distance from people. Protecting yourself and protecting others, it’s just something that everyone needs to take responsibility for going forward. In terms of key lessons to take away from the current crisis from a health perspective, Covid may act as a spur for data and digital innovation in our healthcare services. It can help accelerate the move towards personalised care which is one of the key trends at present. It’s really centred around determining patient needs and how we can best meet those needs. The traditional model is face to face and it still predominates. But it is recognised now that we can have more virtual consultations and greater use of telemedicine. We are moving towards a more virtual environment where not all healthcare will be delivered face-to-face. More healthcare providers are moving into that space using telemedicine, tele-physio, and sending text messages with your result. They are all simple things that are creeping into society. There is an opportunity now to promote the use of simple devices to help patients to self-manage and take more controls while still providing the care they need. There are simple things like using your fitness tracker and health applications to monitor and manage health conditions and there are a lot more applications available now for people with relatively common chronic disease such as diabetes and heart conditions. There is so much more that can be done and there are lots of innovators out there looking at how you can manage long term conditions which put a lot of demand on the health system. There’s also a great deal of innovation happening in terms of using technology to monitor and care for the elderly and use of medical devices and applications that you can identify warning signs and flag risk factors which might arise. There is no shortage of solutions coming on stream, but the difficulty lies in bringing in this new technology and applying it systemically across the system. That is the challenging part. It’s about delivering what the patient wants or needs and working towards making the response unique to each patient. Disruption always heralds opportunity and we see a lot of opportunities arising from the reconfiguration of long-established systems and practices in the health field.

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YOU’RE IN SAFE HANDS.

you’re in safe hands

At Airmedica, we are committed to helping keep Ireland’s frontline staff safe. Our HSE-approved hand sanitiser contains 70% alcohol and is specially formulated using over 80% Irish ingredients to be soft on skin. For a 10% discount on hand sanitiser orders, email us at info@airmedica.ie and use the discount code Frontline10. www.airmedica.ie | +353 94 937 1570

@airmedica


Frontline & Healthcare

Deep Clean The outbreak of coronavirus has instilled an unprecedented level of germ phobia in our populations. People are now demanding the highest standard of hygiene in public places to offset the chances of picking up the disease. The implementation of hygiene controls are vital if we are to return to any kind of normal at home and in the workplace.

The virus that causes COVID-19 spreads in the same way as a cold. Breathing, talking, coughing, sneezing all create bioaerosols, which are tiny droplets in the air. Experts claim that these bio-aerosols can travel over two metres from their source and settle on surfaces after around 15 minutes. Some reports claim that there are exceptions to these figures, however, they provide a good frame of reference for creating a safe workspace. Reports suggest that droplets in the air produced by a contagious person can persist on both porous and non-porous hard surfaces. The type of surface defines how long the droplet remains contagious; in some cases just minutes, but on certain surfaces, the virus can potentially still be active for hours or even days. While the virus is active, it is easily transferred from person to surface and then from a surface to another person, who may touch their face and risk infection. However, we do know that employing good hand hygiene and sanitising surfaces can disrupt the defences of the virus and stop it in its tracks – in effect, good hygiene kills it off. Simple and straightforward handwashing with soap and water is more effective at reducing the incidence of a handtransmitted viral infection than using an alcohol rub/gel. This might come as a surprise, but there are two reasons why soap

and warm water are so effective. Soap can dissolve the thin sticky layer of oil on the surface of the hands (sebum), which is then washed away by running water. Because the viral particles are mostly attached to this sticky layer, they are rinsed away too. Secondly, the chemical structure of soap can disrupt the outer cover of the coronavirus. Once this cover is disrupted, the virus can no longer function effectively. Although hand washing is an essential part of antiviral hygiene, it is often impossible to wash hands at all times. After using the petrol pump at the filling station, when alighting from public transport or every time we come into contact with a common touch surface while outside, we cannot always scrub up immediately. In these cases, disinfection is the best option and this is where a chemical substance such as hand sanitiser is effective on the hands and/or the touch surface to break down the viral particles.

Chemical Warfare To remove pathogens in high volume environments such as workplaces, more stringent hygienic measures are necessary. Chemical disinfectants can significantly reduce contamination

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Coronavirus is changing the world in diverse and unforeseen ways and is impacting dramatically the world of hygiene and cleaning. on surfaces and are an essential first step in any process of eliminating potentially harmful micro-organisms. While cleaning with water, soap or a neutral detergent removes dirt, debris and other organic matter such as blood, secretions and excretions, it does not kill micro-organisms. There is also the consideration that the concentration and contact time for a disinfectant to be effective on surfaces are critical. Therefore, in addition, a chemical disinfectant such as chlorine or alcohol should be applied to kill any remaining microorganisms following a general clean. While there is no evidence for equating the risk of transmission of the COVID-19 virus in the hospital setting to any environment outside of hospitals, it is still extremely important to reduce the potential for COVID-19 virus contamination in non-healthcare settings such as in the home, office, schools, gyms or restaurants. High-touch surfaces in these non-healthcare settings should be identified for priority disinfection. These include door and window handles, kitchen and food preparation areas, countertops, bathroom surfaces, toilets and taps, touchscreen personal devices, personal computer keyboards and work surfaces.

Innovation Challenge Coronavirus is changing the world in diverse and unforeseen ways and is impacting dramatically the world of hygiene and cleaning. As is so often the case, necessity becomes the mother of invention. Robot vacuums have been on both the commercial and domestic market for some time. Now, new high-tech cleaning options are emerging including some that make surfaces clean

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themselves. One company working in this ground-breaking field is the Danish company ACT Global. They are already selling a transparent coating that can be sprayed on surfaces which breaks down microbes. It becomes active when illuminated and it works under normal indoor light. In other areas of research, companies are studying how ultraviolet (UV) radiation could be a valuable resource in the battle to destroy viruses. In particular, they are focusing on the shortest wavelength of ultraviolet light, UVC, which they have discovered scrambles the DNA of organisms, ultimately killing it off. Lucid Drone Technologies, based in Charlotte, North Carolina is taking on the challenge of cleaning huge areas such as sports stadiums. Lucid has adapted its drones to spray disinfectant over an area of up to 2,140 square metres in one hour. They have built a dozen sanitation drones and currently can build 10 drones per week. The potential growth for this type of innovative product is evident and the company says it is already in talks with NFL teams. CEO Andrew Ashur added that they have had enquiries for drones to work on dust suppression, maintaining windmill turbines and water towers and oddly enough, as a vulture repellent. The turning point has not yet been reached in the ongoing battle with coronavirus. The maintenance of stringent and diligent hygienic standards must spearhead our strategy for keeping ourselves and our communities safe. It is worth bearing in mind also that COVID-19 is not the only germ in town. Seasonal influenza, the common cold and a plethora of other viruses continue to pass our way. Good hand hygiene and proper disinfection practices at home and work are habits that never go out of season.


Frontline & Healthcare

Absolute Hygiene While the importance of quality assurance and cleaning standards are as critical as ever within the healthcare sector, understanding the importance of absolute hygiene, cleanliness and traceability are paramount to preventing the spread of Coronavirus in all sectors during these unprecedented times.

Derrycourt Cleaning Specialists has proven its capabilities at undertaking the surge in quality cleaning needed to combat COVID-19. The knowledge and understanding of the necessary services stem from 30 years’ experience within numerous industries and 15+ years within healthcare, pharmaceutical and cleanroom sectors. This experience has enabled them to consistently improve their services, products and techniques. Throughout this pandemic, the company has been able to provide specified cleaning services such as decontamination cleaning, hydrogen peroxide fogging services, ecostatic disinfectant spraying along with an emergency response service specifically dedicated to COVID-19. “Our depth of experience has prepared us to undertake this additional work with minimal disruption to the daily running of Derrycourt,” explains General Manager Avril McCarthy. “It has allowed us to create contingency plans for emergencies through the knowledge and strong community of staff that we have in place. “Our staff undertake rigorous training in quality assurance regardless of the sector in which they work. The level of assistance and advice Derrycourt are providing to our clients is what they value most in us. We have created COVID-19 specific training courses for all our staff to complete to provide them with the correct knowledge and procedures to provide the required level of cleaning and sanitising.” Derrycourt is an award-winning company and has recently been awarded Cleanest Healthcare Premises in the UK & Ireland at the 2020 Golden Service Awards. The company’s dedication to training is evident with its ‘Commitment & Investment in Training Award’ at the European Cleaning & Hygiene Awards

for the past two consecutive years. “It is vital that we live up to these accreditations and continue to provide the highest standard of services,” McCarthy adds. Being frontline workers, Derrycourt employees have played an integral part in ensuring that frontline workers are kept safe and clean throughout COVID-19. “The impact and strain COVID-19 has had on our cleaning staff has been difficult, however, members of our healthcare team have noted that it has brought them closer together as a team and they feel more appreciated for their role as a frontline staff worker and that the importance of their job has been seen by all,” McCarthy says. “Their commitment and hard work over the past number of weeks have been incredible and they have made it possible for many sectors to return to work since restrictions have been lifted.” According to McCarthy, the next challenge for Derrycourt is to safely get the education sector operational, having already assisted creches, playschools, offices and many other types of business in returning to work. “Our experience tells us that a realistic and carefully constructed plan is critical in enabling a safe return,” she says. “Derrycourt has been working closely with schools, advising them how they can prepare for the return of students and have provided a comprehensive range of services and solutions that can assist them in this. These services are provided by Derrycourt’s fully trained and experienced personnel who provide much-needed assurance of a clean environment for students and staff preparing for a new academic year. Regardless of your industry, we have the specific cleaning knowledge, experience and skill set to get you safely back to work.”

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In Safe Hands As Ireland enters each new phase of the easing of lockdown restrictions, good hand hygiene remains essential in the fight against COVID-19. According to Breffney O’Dowling-Keane, Brand Development Manager at Airmedica, soap and water aren’t always readily available, so hand sanitiser is a vital tool for those on the frontline and working with the public. Demand has increased exponentially in recent months, with UK market research firm Kantar reporting a year-on-year sales increase of 255% in February alone. However, not all hand sanitisers are created equal. With more and more brands entering the market, you need to be sure the products you are buying are effective and meet the stringent Irish and European quality standards. All the relevant information should be clearly marked on the label of the hand sanitiser. It’s important that you and your team

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are educated about what to look out for when buying, using and storing hand sanitiser so you can carry out your work safe in the knowledge that your hands are protected.

PCS & EN Number A PCS number, given out by the Department of Agriculture and the Marine, is confirmation that the product you are using meets the biocidal criteria claimed on the bottle. All hand sanitisers should contain a PCS number visible on the bottle. Airmedica’s PCS number is 100302. You should also always check your hand sanitiser has an EN


Frontline & Healthcare

Not all hand sanitisers are created equal. With more and more brands entering the market, you need to be sure that the products you are buying are effective and meet the stringent Irish and European quality standards. number. If there is an EN number clearly indicated on a label, it means that the product meets all European quality standards. Airmedica hand sanitiser has been tested under EN1276 and EN1500, the European Standards which evaluate the efficacy of sanitisers in killing bacteria.Â

Effective Protection To be fully effective, the Center for Disease Control recommends using an alcohol-based hand sanitiser that contains at least 60% alcohol. This should be clearly marked on the bottle. Airmedica hand sanitiser contains 70% alcohol and also contains nourishing ingredients to ensure it is soft on your hands. To apply correctly, take off any rings or jewellery and apply a pea-sized amount on to clean, dry hands. Rub into and around the entire surface of your hands for 60 seconds, including between your fingers to get full coverage. Continue rubbing until your skin is fully dry. Because of its high alcohol content, it is important to keep hand sanitiser out of direct sunlight. Store in a cool dry place, out of the reach of children.

ABOUT AIRMEDICA: Airmedica is committed to keeping Irish frontline staff safe so they can keep our communities safe. As the leading Irish brand in personal protective cosmetics, Airmedica has seen the essential work being done across the country first-hand. Since launching in March 2020, they have partnered with local hospices, hospitals and charities nationwide, including Marymount Hospice, Crumlin Children’s Hospital, Mayo Roscommon Hospice and Cork Penny Dinners, donating 10,000 units of hand sanitiser to date so responders have what they need to continue their work. With over 30 years’ experience, expert teams in Mayo and Cork are passionate about using the best ingredients possible to deliver the best products for you, your hygiene and your health. Using over 80% Irish ingredients, all Airmedica products are cruelty-free and vegan. For more on Airmedica products and how they can help keep your teams safe, visit airmedica.ie or email info@airmedica.ie.

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USES OF NATURAL HERBAL CREAMS AND WASHES The Botanica Products are all Antiseptic, Anti-Fungal, Anti- Bacterial, Anti-Inflammatory, Antihistamine and Insect Repellent. • • • • • • • • • • •

Acne After Shaving Balm After Sun Athletes Foot Blackheads Body Lotion Burns Cleanses, Tones & Exfoliates Cold Sores Cracked Lips Cuts & Grazes

Wash the affected area with the Botanica Cleansing Wash (needs to be diluted-one capful to a 1/2 litre of water) and then apply the Botanica Natural Herbal Cream. (Do not rinse the wash off)

BEFORE

• • • • • • • • • • •

Deodorant Dermatitis Eczema Fungal Nail Infections Hives Insect Bites Mouth Ulcers/ Lichen Planus Nappy Rash Psoriasis Rosacea Scars

AFTER

BEFORE

AFTER

Natural Herbal Cream Botanica’s Natural Herbal Cream is a unique combination of herbal ingredients carefully selected and blended to repair blemishes and skin complaints. The antiseptic properties of Tea Tree Oil along with soothing Aloe Vera, plus the additional beneficial value of Comfrey and Lavender, provides an all purpose natural herbal cream to help support and maintain healthy skin. Directions: For best results cleanse area first using Botanica’s antiseptic cleansing wash. One capful per ½ litre of warm water. To feel forever young and beautiful - use the Eternal Youth Cream morning and night on eyes, forehead, face and neck.

Botanica International Ltd

Units 12-13 Warrenpoint Enterprise Centre, Newry Road, Warrenpoint, BT34 3LA Tel: 0044 (0) 28 4173 9151 E-mail: enquiries@botanica.ie

www.botanica.ie

Botanica International Ltd


Frontline & Healthcare

Herbal Healing “I believe the natural world has a solution for all conditions,” - Sean Cooney MD, Botanica International Ltd. His company, based in Warrenpoint, Co. Down, utilises only natural ingredients in the manufacture of their products. Botanica was established in 2005 to cater for the growing awareness of natural products and to utilize the wonders of nature’s healing energy. Their herbal range was developed to treat common skin conditions. It contains a combination of natural ingredients, all of which have proven beneficial properties. Botanica’s herbal system works to promote healthy cell growth and complete recovery without scarring. Traditionally, creams are used to form a barrier on a cut, but in fact a heavy thick cream can slow down the healing process on two levels. It can hold dirt around the affected area and it can prevent infection from getting out. Botanica’s wash cleanses the area and helps to remove any dirt or scabbing which may have formed. The wash is followed by Botanica’s Herbal Cream which is readily absorbed into the skin. It activates the healthy cells and the powerful properties of the natural oils get to work on a swift, complete recovery. Daily washings and cream application will reduce the affected area while continuing to liberate any infection. All of the Botanica products have been tested by the worldrenowned LCH Laboratory in Paris to prove they are all free from chemicals, toxins, parabens and lanolin. There is a large and growing interest in natural products, and Botanica is called upon regularly to speak at various events about the healing properties of their products. The team also keep up to date on industry developments by attending various lectures in local universities. Botanica are no stranger to awards, having collected many accolades and prizes for their company and products over the years including a 2020 award for “Ireland’s Best for Natural Medical Remedies”. Their products have gained cult-like status among horse and dog trainers, breeders and animal owners alike. Some of the most popular products are the Botanica Cleansing Wash, the Natural

Herbal Skincare Cream, the Fly Spray and the Anti-Itch Cream. Botanica are currently working on their upcoming show calendar to promote and sell their products in Ireland, and also their talk and lecture series to increase awareness of the Botanica range. Although Botanica sell their products worldwide and products can be purchased directly from their website, Botanica International has also recently taken on a new distributor in Ireland to improve the availability of the product in more physical locations and to ensure it is available nationwide. The team at Botanica are enthusiastic about the future of the company: “When it comes to all skin conditions, natural products are the way to go; therefore, Botanica is the obvious answer. Botanica gets results where all others have failed!”

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PUBLIC SECTOR SUPERANNUATION EXPERTS We are a team of Experienced Tax Advisors, Certified Financial Planners (CFP) and Qualified Financial Advisors (QFA) specialising in Financial advice for all Public Sector superannuation schemes

Key Personnel in the Company

Over 20 years’ experience Nationwide coverage with Head Office in Galway Multi agency Mortgage and Insurance Brokerage SERVICES AND ADVICE THAT WE PROVIDE Pre Retirement Planning Advice • Pensions calculations • How to maximise your tax-free entitlements • How to retire in the most tax efficient way possible

DiarmaiD Blake

Managing Director Master’s degree in Accounting and Finance (MBA) Qualified Financial Advisor (QFA)

Post Retirement Planning Advice • How to manage your money and make it last longer in retirement • How to implement tax efficient methods to reduce your tax liability on your retirement income Public Sector AVCs AVCs specifically tailored to maximise tax-free retirement lump sums Public Sector Mortgages Mortgages specifically for the public sector only Allows public sector employees to qualify for a larger mortgage than offered by banks Quick and easy process Types of mortgages on offer • First time buyer Mortgages • Remortgages • Equity Release Mortgages • Loan Consolidation Mortgages • Residential Property Investments Public Sector Income Protection Individual Income Protection specifically tailored for the public sector Tax Advise Inheritance Tax Planning For more information please call (091) 393125 168 the Public Sector Magazine www.mmadvisors.ie

lorna egan

Director Certified Financial Planner (CFP) Qualified Financial Advisor (QFA)

Clive Slattery

Senior Tax and Pensions Consultant Former Principal Officer of the Revenues Financial Services Pensions Unit for 20 years Produced the Revenues Pensions Manual Lectures administrators on all Public Sector Pension schemes


Frontline & Healthcare

Money Matters These are unprecedented times with the current situation impacting on us all socially, mentally and financially. While it is important to implement the various healthcare guidelines, we should equally take care of our financial wellbeing.

Two-thirds of Irish adults are worried about their finances as COVID-19 wreaks havoc on the economy, with people aged between 45 and 54 living outside Dublin standing out as the most concerned, according to a survey carried out by research firm Behaviour & Attitudes for financial services firm BlackBee Investments with one in six adults “very worried” about their finances. COVID-19 has seen over 1 million people reliant on state support, some via the wage subsidy scheme (70-85% net wages) and some claiming the Pandemic Unemployment Benefit, with many receiving state support for the first time. Everyone is experiencing this pandemic differently, mentally and financially. Consumer research from N26, the European mobile bank reveals the impact the virus is having not only on Irish health and day-to-day lives but also on finances. The survey, which asked 10,000 adults across Europe and the US to share how their financial lives are being impacted by the pandemic, reveals money worries are now the second biggest concern after health for people across the globe. These money concerns have led 77% of Irish people surveyed, equivalent to 1.5 million Irish adults, to say that they

have changed their financial priorities as a result. Fears over the economy were cited as the biggest worry weighing on the minds of Irish people, with over a third (35%) concerned about increases in the cost of living, with a significant difference between men and women – 34% men and 43% women. 39% of those surveyed were found to be anxious about job security, highest amongst those aged between 25 –34. With this financial uncertainty, 73% of Irish people surveyed said they were now attempting to put away more money than before the crisis. People working from home rather than commuting to work make savings on travel and things like lunches and coffees. Reviewing regular subscriptions like gym memberships and credit card bills can identify subscriptions and other expenses that can be cut to free up cash for an emergency fund. Of those surveyed, the majority were putting aside on average 164 euros extra a month. The survey also shows emerging changes in consumer spending habits. 82% of Irish people admitted they had also changed the types of items they buy each month. While grocery shopping remained the biggest spend before and during the pandemic, meals out, takeaways and fashion, previously

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second, third and fourth, had been replaced with subscription services, whilst takeaways remain a top choice for consumer spending in Ireland.

No Contact It’s not solely what people are spending their money on that has changed, but the way they are spending it. 54% of Irish people said they were “definitely opting” for contactless payments and moving away from using cash due to health concerns. Cash use has all but evaporated, something that will leave the likes of Visa and Mastercard as gatekeepers of spending. In Britain, cash use halved in a handful of days last month as stores were shuttered and people fretted notes and coins could be transmitting the virus, the U.K.’s largest ATM operator reported. Stores around the world, including some supermarket and grocery store chains, have opted to go card only, refusing cash. It’s a change they say is only during the coronavirus crisis but seems unlikely to ever go back to how it was before. There are plans to create a digital dollar, up until recently a distant dream, and France is moving ahead with trials for a digital euro. In a world suffering a pandemic, cash is no longer king. General Manager of Greater Europe at N26, Sarunas Legackas said, “While some of the financial trends emerging may only last the length of this pandemic, many will stay. People are starting to experience first-hand the benefits of digital banking from an app or desktop at home. Having their money at their fingertips as well as some of the cool and innovative features to budget, save and transfer funds.”

The most common rhetoric during the

coronavirus is that life will not be the same as before, and recent research

has found the pandemic has forced

people to think about their finances

Subsistence Existence While there are many options available to process payment, the sad fact is that many people are living hand to mouth worried about how they will survive from one payday to the next. A survey carried out by Willis Towers Watson, a leading global advisory and brokering solutions company found that two in every five workers in Ireland (40%) are living from payday to payday, despite believing their financial wellbeing is at its highest level since 2015. Financial concerns are impacting on employee health, relationships and causing worries about their future. David Glennon, Director in the Health & Benefits practice at Willis Towers Watson, said “Although we have recently seen salaries rise for workers in Ireland many are still struggling to meet their financial obligations. Nearly two fifths (40%) of struggling employees are earning €65,000 or more, so the issue is not necessarily one of income, but rather a need for them to better understand how to manage their finances.” The research was undertaken before the COVID-19 crisis

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differently. which is, unfortunately, bringing some of the findings into stark reality and fundamentally people are going to struggle financially. 40% of those surveyed do not have enough savings to meet household bills for six months if they took a significant hit to their income, and sadly for many, this scenario may well become a reality in the current crisis.

Pension Pots One emergency fund that some are looking to as a solution is the pension pot. People furloughed from their work or made redundant may need additional income and could see this as a quick-fix solution. As a result, there has been a rapid rise in the number of people seeking access to their pensions or enquiring about doing so, according to separate findings by Unbiased and HMRC. And although many are wisely seeking advice on doing so, many more are not, and may be risking their long-term security as a result. Everyone needs financial advice at some point in their lives. When times are good and confidence is high this might be for retirement or establishing trusts for children, however, in times such as those we are currently experiencing, having the support of a trusted adviser you can rely upon to help, guide and advise you is more important than ever. The clear message is, seek advice, then make a decision. It is important to equip yourself with all of the information so you can be sure to strike a balance between what benefits you in the short term and what you will need in the future.


Frontline & Healthcare

Public Sector AVCs – Am I creating a tax Liability at retirement Additional Voluntary Contributions (AVCs) are contributions you make to your pension scheme to build up an additional retirement fund. When you retire, this AVC fund can be used to top up your employer pension benefit. Diarmaid Blake, CEO at Money Maximising Advisers gives us the benefit of his experience in the area. If you have an AVC or are planning to contribute into an AVC, it is imperative that you take time to fully understand the main functions and benefits of an AVC and how it is going to improve your retirement plan. From our experience in dealing with AVC and retirement queries over the past 20 years, this is not the case with the majority of public sector employees. It is important to know where you stand with your AVC, whether you should stop-start or restart your AVC and if you have an AVC, whether you are overfunded or underfunded. AVCs are basically a long-term savings plan that qualifies for tax relief at your marginal rate (20% or 40%). Access is restricted to your retirement date. However, public servants across the country have a misunderstanding of AVCs and how to use them as a vehicle to reduce their tax bill and increase their tax-free lump sums at retirement. The two main functions of an AVC are as follows-

To maximise tax-free lump sum entitlements on retirement All public sector employees can use an AVC to max out their tax-free lump sum entitlement. It is very tax efficient and is highly recommended as all contributions qualify for tax relief at

your higher income tax rate (usually 40%) on entry and can also be withdrawn tax-free on retirement. The optimal amount of money required to contribute into an AVC to max out your tax-free lump sum depends on your shortfall on retirement. This calculation is usually directly correlated to your years of service at retirement and your final pensionable salary. It is very important for all public sector employees to know their shortfall and use an AVC to bridge the gap. However, any AVC funds above this amount will create a tax liability. The funds are treated as income and liable to income tax, USC and PRSI. The liability can be as high as 52% for many retirees.

Buy back Years of Service AVC money can also be used to buy back years of actual/ notional service. However, in our experience, the cost of buying back service can be very expensive and rarely makes financial sense. Nevertheless, it is important to check to see how much it costs to buy back a year of service and how much additional pension income will be incurred in retirement for this. After you draw down your tax-free AVC funds and/or buy back any years of service, any additional funds are taxable. These surplus funds are then transferred into another pension

AVC Funds @Retirement

Withdraw Tax Free portion

Figure 1

Buy Back Years

Excess funds (Taxable)

Transfer to an ARF

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Income €

Public Sector Pension Income illustration Tax Free Lump Sum

Cashflow difficulties

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vehicle called an Approved Retirement fund (ARF). Funds are withdrawn each year from your ARF for as long as they last. They are however taxable at your marginal rate of tax. Please see Figure 1 below a diagram to illustrate this

How much should I contribute into an AVC? As stated above, the optimal amount that is required in your AVC is your tax-free lump shortfall. It is important that all public sector employees know this number. There are some very clever ways to increase this figure so it is important to chat with experienced advisors on how to achieve this. Your shortfall can be made up by contributing on a monthly basis over a long term period or alternatively, a last-minute AVC can be used closer to your retirement age.

Already have an AVC? If you have a tax free lump sum shortfall and have less than this amount in your AVC, you are what we called Underfunded. It is advisable to start or restart your existing AVC to make up this shortfall prior to your retirement. If you currently have an AVC and have excess funds over your tax-free lump sum shortfall, you are what we call Overfunded. These excess funds could be liable to up to 52% tax, (income tax, USC and PRSI) on retirement. From our experience, many public sector employees are actually overfunded and will have a significant tax liability on retirement. In these circumstances, we recommend that you stop paying into your AVC, analyse where your existing AVC funds are invested and the charging structure this AVC provider is charging you etc. While you may be overfunded, by effectively managing your paid up AVC funds and obtaining very competitive annual management charges, you can make significant gains on these funds which can somewhat be offset against the tax you will pay on exit.

Cashflow problems and State pension’s deferred entitlement If you started working in the public sector post-1995, You

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It is very important to be aware of the thresholds and rules in retirement in order to draw down any excess funds from your AVC as taxefficiently as possible. are an A1 PRSI payer/employee. This entitles you to a state pension. However, this portion of your pension is not payable until age 67/68. The cashflow issue arises if you retire at say age 60, as you will have to wait for 7 to 8 years until you are entitled to draw down your state pension portion of your Pubic Sector pension. This can leave many retired civil servants with cashflow problems from retirement age to state pension age. Although you may be entitled to a supplementary pension, this is not guaranteed and is not available if you have any other income, no matter how small this is. If you are overfunded, ie, if you have excess funds in your AVC, on retirement you will usually be transferring these into an Approved Retirement Fund. It may be tax efficient to draw these down in the years prior to receiving your State Pension entitlement at (67/68). This will bump up your income in your 60s as well as having more scope to draw down your taxable ARF income in the lower income tax rate band. The state pension entitlement of €12,912 usually pushes many civil servants into the higher income tax rate band of 40%. It is very important to be aware of the thresholds and rules in retirement in order to draw down any excess funds from your AVC as tax-efficiently as possible. For example, from age 65 onwards, there are tax-free income thresholds once you don’t exceed these you pay zero tax. The threshold for a single person is €18,000 per annum and €36,000 per annum for a married couple. From age 66 onwards you don’t pay any PRSI. From our experience, many retired employees ignore many of these thresholds and tax-efficient strategies and end up paying way more tax on their income than they should.


Frontline & Healthcare

HSSCU - Caring for their Members Health Services Staffs Credit Union (HSSCU) is one of the largest and strongest credit unions in Ireland with branches in Dublin, Galway, Cork, Limerick and Louth.

Health Services Staffs Credit Union would like to thank their inspiring healthcare workers and other employees in the public sector for the amazing work that they have been doing throughout the COVID-19 crisis. HSSCU has been here to support its members and is honoured to be able to help Ireland’s heroes at this time. As many of you know, HSSCU is Ireland’s nationwide credit union caring for those working in healthcare, Irish Rail, CIE, Bus Éireann, An Post Employees (in Munster) to name but a few and the union has always prided itself on providing for the public sector. With the emergence of the COVID-19 pandemic, HSSCU has put its efforts into being as accessible to members as possible. They have banded together to continue offering a fantastic service to members while also supporting frontline healthcare workers in numerous ways. In recent months, HSSCU pooled their sponsorship funds to help as many healthcare charities and initiatives as possible.

Projects HSSCU has helped include, but are not limited to: n Social distance digital relay for Pieta House n Providing lunch to staff at the Mater Misericordiae University Hospital by sponsoring Doyle’s Corner n Sponsoring #Comfort4COVID where hundreds of tablets were provided to hospitals and nursing homes around the country to connect patients with loved ones n Funding for PPE for face mask clips and face shields n Providing goody bags to Covid testing centres Further than sponsoring the community, HSSCU is also in the midst of directly taking care of members. They are currently accepting applications from members for their annual bursaries and scholarships. In the coming months, there are plans to give out €120,000 in bursaries to members and €50,000 in scholarships. They are delighted to offer these free bonuses to HSSCU members.

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Pádraig Power Marketing Manager

Stay Safe, Stay Home Not only have HSSCU put their money where their mouth is with regards to sponsoring their community, they have also made things as easy as possible for members to do business with them. HSSCU always allowed members to do their business from home, but with the COVID-19 crisis at hand, this has been enhanced via increased staff manning telephones and responding to emails as well as making access to the free mobile app CUAnywhere easier as new PINs can now be received by text. Mindful of the need to help those in the healthcare industry HSSCU has introduced a ‘Stay at Home’ loan at a discounted loan rate. The credit union has seen great interest in this innovative product from current and new members who are turning to their credit union during this pandemic. Though some financial institutions postponed the joining of new members during the COVID-19 crisis, HSSCU has remained fully operational helping new members come on board. For almost two years now HSSCU has allowed members to join the credit union via online applications on their website. Equally, for members-to-be who prefer more traditional media, an application form can be printed from the HSSCU’s website, completed and posted by FREEPOST directly to them. It is with open arms that HSSCU accepts all eligible new members at this time and early recent graduates. Perhaps the most exciting addition to HSSCU’s portfolio in these times in the introduction of their new current accounts. Current accounts are something that HSSCU members have been interested in for some time and the credit union is delighted to now offer this facility. With a HSSCU current account, members can take advantage of a globally accepted debit card, ATM withdrawals, tap payments, an overdraft

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(subject to approval) and more. Speaking of the introduction of HSSCU’s current account, HSSCU’s marketing manager, Pádraig Power, stated: “We are elated to bring this product to our members, especially at a time when it can help them more than ever. Many people have traditionally seen credit unions as a place where it can be difficult to access their funds. This is certainly not the case at HSSCU and with the introduction of our current account we are giving our members the ability to have their HSSCU funds with them wherever they go. We wanted to make sure that we brought a great current account to our members and with our debit card, overdraft option and more, we are proud to now be the primary financial services provider for many of our members.”

Everyday Heroes HSSCU would like to thank members on the frontline for their amazing and brave work during the COVID-19 pandemic. Mr. Power continues: “On behalf of HSSCU, we would like to extend our gratitude to all of our members for their bravery and fantastic efforts during the COVID-19 crisis. We are well aware that our healthcare workers on the frontline have been Ireland’s heroes throughout this entire experience and we are honoured to be able to help in any way we can. Equally, we would like to thank our transport and An Post members for helping to keep the country running at this time. We appreciate each and every one of our members and we are inspired by the work of those in the public sector every single day.” Should you be a member of HSSCU and you think there is a cause they could support, please fill out a sponsorship application form on their website: www.hsscu.ie


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Analyse This Benefacts is a unique social enterprise that punches way above its weight when it comes to open data re-use, data sharing and an exhaustive evidence base for policy and grant-making to Ireland’s nonprofit sector.

A specialist in data on Ireland’s 32,000+ nonprofits (including 11,171 charities), Benefacts has transformed the public transparency and accessibility of an entire sector ranging from small local clubs and societies through social enterprises to prominent charities active in the arts, education, health and social care, housing, homelessness, local development, philanthropy and sport.

Director Patricia Quinn. In this regard, Benefacts is in line with best practice in statistical data gathering. “Joined-up Government needs joinedup data”, to quote the National Statistics Board.

Data Origins

Benefacts data includes not just baseline regulatory information but hundreds of fields of detailed financial, governance, employment, payroll and compliance data harvested manually from the financial statements of 10,000 larger non-profit charter bodies, companies, friendly societies, trusts, political parties and trade unions. “Benefacts definition of civil society is inclusive, not exclusive”, says Patricia Quinn. “We include every organisation that isn’t part of Government or part of the private sector”.

Thanks to Ireland’s leading role in driving wide adoption of open data principles, Benefacts has been able to find and re-use data from more than forty different public sources to build an inventory of the sector that is updated daily. “Public sector bodies continuously publish open data about the nonprofits they register, regulate or fund. Benefacts harvests, cleans and aggregates the data and republishes extracts on its free public website”, says Benefacts founder and Managing

The sources of data in Benefacts database of Irish nonprofits

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Who uses the data? Benefacts unique database is deployed in various ways. The CSO gets a quarterly dataset which is integrated into its comprehensive statistical overview of the entire economy and forms part of the CSO’s regular returns to Eurostat. Another dataset is published daily to Ireland’s open data portal, Data. Gov.ie and Benefacts is also linked into the analysis screens used in Revenue. Benefacts data analytics application, developed in cooperation with a group of departments, agencies and local authorities, provides public sector grant-makers with structured access to their own portfolio of grant-aided organisations, giving them a five-year view of trended data including grants from all sources, employee numbers, governance profile and financial trends. This registered service – Benefacts Analytics has proved a powerful source of data supporting due diligence, risk analysis, grant compliance and accountability reporting. Bespoke analysis reports have been generated for a myriad of uses, from preparing for an Oireachtas Committee hearing to providing a due diligence report for a number of leading charities considering a merger. Nonprofits and their stakeholders in government aren’t the only users – Benefacts gets queries from philanthropists and asset management funds looking to see where they can make a useful contribution to the sector of their choice. The main beneficiary of the data is the public – other than Benefacts free searchable website (benefacts.ie) there’s no other place where the public can find information about a nonprofit’s charity tax status, its government funders and its status with all of its regulators. This has attracted recognition from all kinds of users, including nonprofits themselves.

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“Benefacts definition of civil society is inclusive, not exclusive, we include every organisation that isn’t part of Government or part of the private sector”. says Patricia Quinn. “

What’s the data telling us? Each year, Benefacts produces a report drawing together all of the data from the full population of nonprofits and provides an analysis of the sector, published as a microsite on https://www. benefacts.ie/insights/reports/ “This analysis is based on every return by every nonprofit company and charity which makes it unique,” says Managing Director Patricia Quinn. Most reports draw on survey data which rely on samples and usually cannot be compared like with like. Benefacts reporting tracks the same trends – turnover, sources of revenue, profile of regulation, state funding, governance, employment numbers and higher remuneration year on year and they report on them sub-sector by sub-sector. Benefacts’ fourth annual report on the sector was released in May. Key findings were:


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n there are at least 32,841 registered nonprofits in Ireland – including charities, trusts, civil society organisations, professional bodies, sports and cultural organisations n Nonprofits are a sector of extremes with only 150 big organisations (turning over more than €12m), 10,000 small or micro-entities and 20,000 unincorporated local clubs or societies n Government funding to the sector – which includes fees for the provision of services, as well as grants – grew by 13% from €5.2 billion to €5.9 billion between 2017 and 2018 n Aggregate turnover within the sector grew by 9.5% from €13bn to €14.2bn year-on-year, mainly within a handful of larger organisations n Total employment in the sector rose to 165,075 n Nonprofit start-ups including social enterprises outnumbered wind-ups nearly 2:1, with 540 new startups in 2018 n More than 86,000 people from all walks of life are serving as board members

What’s next for Benefacts data? As the consequences of the COVID-19 pandemic cut a swathe through the Irish social economy, Benefacts found that its data was much in demand. Nonprofit organisations got in touch with Benefacts data analysts to look for benchmark data derived from accounts filed in 2019 to model the prospective costs of a loss in fundraising or earned revenues. Boards of larger charities contemplating radical business decisions including mergers have asked for small benchmark reports, giving them business intelligence on norms in their part of the sector such as social housing, local development, the arts. State agencies and philanthropists have asked for data to support rapid response initiative to get emergency funding to vulnerable organisations. “Because they routinely receive and process a large body of data derived from applications and reports provided by grantees, it’s easy for public servants to forget that nonprofits themselves have very limited access to current business intelligence on their own sector”, says Quinn. “Network bodies such as the Council for Social Housing, or the Charities Institute of Ireland or the Disability Federation of Ireland do a lot to survey their members and share insights on best practice, regulation and so forth,” she added. “But there is no substitute for hard data derived from the audited accounts of the full population of entities in scope. In the private sector, decisionmakers take it for granted that industry data will inform

business decisions at the level of the individual enterprise – why should nonprofits be different? In some ways, it’s even more critical for organisations whose work goes to the heart of the wellness of our communities.”

Public Policy Context The Department for Public Expenditure and Reform initiated this infrastructural resource in 2014 in a partnership agreement with the Atlantic Philanthropies and the Ireland Funds. Besides assisting the public in seeing where money is being spent in their name, the founding vision was for “a shared resource that would provide funders, policy-makers and other external stakeholders with an accessible source of high-quality financial and governance data on the sector to reduce oversight costs and to support more effective decision-making.” It would also assist government in designing and delivering better services that support the goal of achieving the best possible outcomes for services users. “So much of this is in line with later reform initiatives, including the Open Data revolution, Digital First, and “Build to Share,” says Quinn. “We know that hundreds of public servants use the free website every day, and we have plans to enhance our web-based search and service solutions in line with some of the feedback we have been receiving.” The groundwork has all been done, the data sources identified, the unique IDs assigned, the data cleaning and amalgamation processes established and tested. For Benefacts, the next steps include discovering how they can best engage with the 265 Public Sector Bodies that provide grants to up to 15,000 nonprofit entities, both nationally and locally. Once engaged Benefacts will work with them to assist them in the delivery of integrated services and aid in simplifying the decision making processes which will in turn help to improve the transparency of their work.

BENEFACTS ANALYSIS 2020 32,841 Organizations 165,075 Employees 86,481 Directors/charity trustees €14.2bn Turnover €5.9bn State funding

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Backing Healthcare The pandemic impacted the healthcare sector in many ways and arguably has reunited the sector with increased collaboration. Mary-Clare Roche-Nagle, Healthcare Director and Cathal O’Connor, Head of Business Unit, AIB Corporate Banking explain how AIB worked hand in hand with customers and the healthcare sector during this pandemic.

We are still going through a surreal and challenging time. At the end of February, the first confirmed case of COVID-19, a new unknown and dangerous virus had arrived in Ireland. Little did we know that this would soon develop into a devastating worldwide pandemic. The repercussions of this virus have impacted and will continue to impact everyday life, our health and the country’s economy. Like all businesses and organizations, in AIB the daily routine and normal work practices necessitated a complete transformation over a short space of time. As a result of the abrupt lockdown due to the dramatic spread of the virus, our people were mobilized from an office environment to working from home and, in a lot of cases, in the company of their children. From the outset, the Government has been to the forefront in leading the fight against this virus, providing excellent

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advice and clear guidelines on testing, contact tracing, social distancing, hand hygiene and cough/sneeze etiquette to flatten the curve of disease incidence. The HSE and National Public Health Emergency Team (NPHET) have been tirelessly professional in their daily advice to the public. Acute hospital environments have changed dramatically to allow for all seriously ill patients suffering from COVID-19 to be prioritized and treated urgently. The HSE and 19 private hospitals across the state reached a unique agreement between them to combine resources to battle the virus. The nursing home sector, with some vulnerable residents, suffered most. The effects of COVID-19 caused ongoing stress for the staff and care workers while they did their best to contain the virus. At the same time, they tried to provide every support for the residents who were unable to see their families


Frontline & Healthcare

throughout a challenging time. The general practitioners, practice nurses and staff in primary care were the first point of contact and provided advice and reassurance to worried patients. They triaged calls, referred patients for Covid testing while looking after the general public’s health. Many general practitioners, in Pictured from L-R; Provost Patrick Prendergast, Prof. Aideen Long, Prof. Luke O’Neill, Minister Simon Harris, Prof. Kingston Mills, AIB CEO Colin Hunt, in Trinity Biomedical Sciences Institute’s Immunology Lab order to control the spread of the n We donated to a start-up technology firm that is deploying virus in the confines of their surgeries, installed online video virtual ward technology to healthcare providers. This consultations with their patients. technology assists in the treatment of Covid patients who In line with our customer first approach at AIB, we are isolating in their homes. undertook proactive customer and market engagement so n The AIB Together Fund was set up to support our local we could position ourselves to support the sector. Having communities and charities. Our people across Ireland have a dedicated healthcare team helps us to have a better been fundraising and donating to an AIB Together Fund for understanding of the challenges facing our customers. In order a range of charities. These charities include our community to provide support and ongoing advice, we quickly put in place investment partners FoodCloud (organizes the redistribution streamlined structures and procedures to enable us to assist the of surplus food from the food industry to the charity sector) sector efficiently and quickly in every way possible. We devised and Soar (supports teenagers and young adults) amongst a series of credit solutions along with simplified processes and others. We will match that fund from the business - for every fulfillment steps to ensure these supports could be secured for cent donated from our people the bank will match it. customers as quickly as possible. Some of the financial supports COVID-19 is expected to be a feature of our lives for the and credit solutions we provided to healthcare customers foreseeable future, with social distancing, continued testing, included 3-6 month payment breaks on interest and principal contact tracing, hand hygiene and cough/sneeze etiquette loan repayments, amendments to loan terms and conditions, becoming the norm. As the economy begins to open, social additional debt financing and short term working capital distancing rules will affect every business, reducing capacity, funding options. volumes and work practices. The economic outlook remains We worked hand in hand with customers during this phase to uncertain, with rising unemployment and falling GDP. While alleviate, in some way, their worries during these uncertain times. the Central Bank of Ireland has pointed towards some early For those businesses and individuals concerned about their financial position, we encourage them to engage early with their signs of recovery due to restrictions being lifted, it advises that Ireland’s economic future remains uncertain. bank. There are a host of supports and packages available to One thing we all know is that healthcare is a necessity and assist them through the pandemic. while challenged on multiple fronts as a result of COVID-19, Despite the pandemic, we have shown our firm support for it is also clear that there will remain growth opportunities for the sector by providing more than €150m of new lending across various sub sectors of healthcare including primary care, elderly healthcare customers. We expect to see aspects of Sláintecare accelerated under the new Programme for Government and we care and mental health. will continue to support delivery of much needed healthcare In addition to providing support for customers, we have infrastructure for the system and our communities nationally. been involved in other initiatives in the fight against COVID-19. We are passionate about healthcare and strive to provide every These included: support for our customers. n Our pledge of €2.4m for the establishment of a dedicated Research Hub at Trinity College Dublin to urgently Allied Irish Banks p.l.c. is regulated by the Central Bank of Ireland. Lending accelerate the college’s immunology project to tackle the Criteria, terms and conditions apply. Credit facilities are subject to repayvirus. The AIB COVID-19 Research Hub will play a critical ment capacity and financial status and are not available to persons under role in the delivery of the Trinity COVID-19 Immunology 18 years of age. Security may be required. For information on supports Project. The hub will involve immunologists and infectious available please contact your local AIB branch, or visit www.aib.ie/covid19 disease clinicians from St James’s Hospital in Dublin.

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Managing your finances in the “new normal”

Cornmarket’s National Financial Planning Manager, Derek Delany, discusses why now is a good time to get organised and make the most of your money. you over the phone too. If you have health insurance, compare your current plan across over 325 plans in the market online at Cornmarket.ie to ensure it is good value for money and, more importantly, identify if you’re overpaying on your policy or find an alternative plan with similar cover and benefits.

There’s no doubt that Covid-19 has changed all our lives. Most of us are spending more time at home trying to figure out our “new normal”. It is a challenging time for everyone, especially those on the frontline of this crisis, and there is a lot of uncertainty in terms of our health and, for some, their finances.

Protecting your money

We understand the concerns that people have at the moment. While we cannot be sure of the overall impact that this will have on the wider economy, now is a good time to focus our attention to what we can control; like making the most of our personal finances. Here are some key things to consider.

Ensuring your family is financially protected is so important right now. Salary Protection helps keep your finances healthy if you can’t work because of an illness or injury.† To ensure as many Public Sector employees as possible have this peace of mind and important cover in place, we have negotiated a 6 Months Free offer* for a limited time only (see opposite for details).

Start with your tax Have you had a drop in household income? Reallocating unused tax credits and rate bands can increase your net take home pay. We recommend you review prior year tax payments and claim for medical, flat rate expenses and other tax reliefs which require application to Revenue for relief. Revenue allow claims for the last 4 years. Also, if you or your spouse is in receipt of the “Pandemic Unemployment Payment” or a “Wage Subsidy Payment”, you will need to complete a tax return for 2020.

Mortgages & loans If you feel the need to take a mortgage or loan break for 3-6 months, it’s important to thoroughly read the terms and conditions from your provider and to understand that it could result in either higher repayments or an increased term. However, this break is there for those who need it, so if you meet the eligibility criteria and are happy with the terms and conditions, it could be a way to free up cash flow into your home.

General Insurance Policies As always, shopping around each year to get a new quote is important. You can get a car and home quote online in just a few minutes and our team is always happy to do the work for

Life cover review You might be able to save money on your life cover or mortgage protection by changing providers. Like any insurance, you should review your policy regularly; particularly if you have had any big life changes like getting married, having children or buying a home. Firstly, to make sure you have adequate cover in place and, secondly, to make sure you are not over paying.

Planning for life after work Calculating your Superannuation Benefits will give you a real look at the money you will have and the age at which you can retire. Envisage what kind of life you would have with that amount of money in retirement. If you’re not happy with how the picture looks, there is no better time than now to do something about it.

In Cornmarket, we’re here to help you. We provide a complimentary Financial Planning Service for all Public Sector employees. Although we can’t meet face-to-face right now, you can get the same expert, free advice via video call or over the phone. Simply call (01) 408 6277 or go to cornmarket.ie/financial-planning-service.

†Subject to a claim being accepted, terms, conditions and exclusions apply. Cornmarket Group Financial Services Ltd. is regulated by the Central Bank of Ireland. A member of the Irish Life Group Ltd. which is part of the Great-West Lifeco Group of companies. Telephone calls may be recorded for quality control and training purposes. 15749 FPS Editorial 06-20


Protecting the Public Sector We’re doing our part to protect your financial wellbeing!

6 Months’ Free Salary Protection*

€80 Car insurance discount

for eligible members of the following groups who apply to join for the first time before 31st July:

when you buy a new policy online up until 31st August** (subject to a minimum premium of €399.76)

ASTI

INTO

Fire Brigade

MLSA

Fórsa Civil Service (in Professional, Technical and Service Grades)

NFVSP

Fórsa Health & Welfare (Local Government & Local Services and Education Divisions)

SIPTU Health Professionals

PNA POA SIPTU HCA

SIPTU Nurses

GRA

SIPTU National Ambulance Service Sector Grades

INMO

TUI

€100 Cashback when you purchase or renew a car, home or health insurance policy up until 31st August and also purchase a new Life product within the following 2 months

Free Financial Advice on video chat or phone we’ll help you make the most of your money & advise you if you’re experiencing financial difficulty

Talk to us – we’re here to help with all areas of your finances Call (01) 408 6277 For the full terms, conditions and exclusions of all offers go to cornmarket.ie/covid-special-offers *Offer available to eligible members of the above groups. You must fulfill the eligibility criteria of the scheme. This offer is not available to existing or past members of any Salary Protection Schemes administered by Cornmarket. Premiums will commence 6 months after the date you are accepted into the scheme. This cannot be claimed in conjunction with any other offer (e.g. Rewards/Free Period). Terms, conditions & exclusions apply. Irish Life Assurance plc is regulated by the Central Bank of Ireland. New Ireland Assurance Company plc is regulated by the Central Bank of Ireland. A member of Bank of Ireland Group. Aviva Life & Pensions Ireland Designated Activity Company, trading as Aviva Life & Pensions Ireland and Friends First, is regulated by the Central Bank of Ireland. **The Public Sector Car Insurance Scheme is underwritten by Allianz. Allianz plc is regulated by the Central Bank of Ireland. Cornmarket Group Financial Services Ltd. is regulated by the Central Bank of Ireland. A member of the Irish Life Group Ltd. which is part of the Great-West Lifeco Group of companies. Telephone calls may be recorded for quality control and training purposes.


Public Sector Magazine

Want some good advice? Get some good advice! Pensions, savings, investments, life insurance - all vitally important for you and your family’s financial well-being. The good news is there’s a huge range of options out there - the hard part is figuring out which one is right for you. Your local Financial Broker is an expert adviser who will assess your needs and is then legally obliged to recommend the most suitable product for your circumstances. At Aviva we know how complex this can be so we strongly recommend you get professional advice before making any decision.

To find an accredited broker in your area go to www.brokersireland.ie

For financial advice, you’re safe in the hands of your local broker! Aviva Life & Pensions Ireland Designated Activity Company, a private company limited by shares. Registered in Ireland No. 165970. Registered office at One Park Place, Hatch Street, Dublin 2, D02 E651. Aviva Life & Pensions Ireland Designated Activity Company, trading as Aviva Life & Pensions Ireland and Friends First, is regulated by the Central Bank of Ireland.

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Tel (01) 898 7950 www.aviva.ie


Frontline & Healthcare

Your Life, Your Choice Aviva promotes road safety amongst young drivers throughout the country with an innovative campaign to save lives.

Michael Bannon, Motor Underwriting Manager, Aviva General Insurance Aviva Insurance Ireland hopes to create awareness amongst younger drivers of the dangers of speeding, using mobile and the potential horrific impact on their lives and those of their loved ones in the unfortunate event of experiencing a serious accident. Following the success of a pilot program in schools around Cork run by the local county council and An Garda Siochana, Aviva recently announced the nationwide roll-out of their virtual reality headsets campaign. The virtual reality headsets provide a unique seven-minute simulation experience of a road traffic accident, with the user being fully immersed as a front-seat passenger in the crash scenario, bringing to life the trauma and consequence of same. The simulated crash highlights the impact of driver distraction, speed, mobile phone use and shows why wearing seat belts is so important for all passengers. Commenting Michael Bannon, Motor Underwriting Manager, Aviva General Insurance said: “Using the campaign title ‘Your Life – Your Choice’, the students will witness many of the dangerous behaviours and factors that are present when young drivers are involved in serious road accidents. More importantly, they also witness, from the front passenger seat, the immediate aftermath of a serious incident from when first responders arrive on the scene. “We are delighted to be supporting this hugely important campaign which we hope will drive awareness of the importance of driver safety and protect young lives on our roads. We hope that by using virtual reality technology,

students will be more inclined to engage with the campaign and will better learn the important road safety message that is inherent in the simulated crash. Whilst the experience may not be a comfortable one for the students, we would hope that it will ingrain in them the vital messages around road safety and protect them and other road users lives. Were we to save even one life as a result of our investment, it will have been worthwhile”, concluded Michael Bannon. Some 4,200 students from 30 schools participated in the pilot program which was led by Cork County Council’s Safety Officer, Caroline Casey and ably supported by An Garda Siochana. Initial feedback was hugely positive with students acknowledging that everyone should see the video as part of their driving test and that it held their attention throughout. Other comments from students included an acknowledgement that they should put their mobile phones away when driving the car. As part of the campaign, the road safety officers, supported by members of the Gardai talk to students about the most depressing element of the jobs when they attend the scene of serious road accidents. They also acknowledge that the worst task of all is calling to a parents’ home to inform them that their loved one has died in a road traffic accident. They know that that knock on the door is going to change those lives forever. This is the first time that Road Safety Officers in every county in Ireland will have the use of virtual reality headsets as a road safety training tool.

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Restart Ireland The Irish economy is both small and globalised and as a result, is more sensitive to developments around the world. It is considerably more volatile than its peers across a range of macro-financial variables and we are more prone to structural macroeconomic shocks. But our openness and connectedness is a source of strength.

Ireland’s highly-globalised nature can be seen in its reliance on the activity of foreign-owned multinational corporations who make a significant contribution to the Irish economy in terms of jobs, exports, fiscal revenue and value-added. The IMF’s latest update for the global outlook makes for sobering reading. It comes as no surprise that the report says that the global economy faces a sharp slowdown which is projected to be worse than the global financial crisis. The IMF expects a recession in 2020, with the global economy set to contract by 3 per cent. If the pandemic can be brought under control in the coming months, the IMF suggests we would experience a strong rebound next year. Of course, these estimates are surrounded by huge uncertainty as the pandemic unfolds. Worse outcomes are certainly possible: if the virus persists, so too does the economic disruption. At home, COVID-19 is having a severe impact on the economy. Activity and employment have dropped sharply and this will continue for some time. Business closures and lay-offs have taken place across the country. The retail, hospitality and construction sectors have been particularly badly affected. In this regard, the recent Central Bank Quarterly points out of these sectors “where close to 650,000 people are employed, the

number of job losses could exceed 500,000 during the current quarter” and the combined rate of unemployment may rise to around 25 per cent in coming months.” The Irish government, in cooperation with European counterparts, has implemented a range of measures to contain the depth and duration of the downturn. Fiscal measures implemented include additional healthcare spending, income support measures and support for businesses. The Eurogroup of Finance Ministers has also come out with a stimulus package of €500 billion. One of the main aims of these measures is to reduce the amount of ‘scarring’ inflicted on the economy during this slowdown. This includes the number of jobs lost and the number of firms that go out of business permanently. The crisis will have longer-lasting effects on the Irish and European economies if otherwise viable firms go to the wall due to the pandemic. Likewise, if people lose their jobs permanently, they cannot return to work when the recovery eventually takes hold. The government’s response has been quick, with the introduction of a range of measures in the health, jobs and business sectors. The emphasis has been to protect the health and safety of people from the spread of the virus while trying to support business.

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Frontline & Healthcare

The Nike Swoosh The next big challenge will be to design public policies to manage the reopening of the economy after the virus has been contained. The big question remains, when can Ireland reopen for business? The short answer is nobody knows. It depends on the containment of coronavirus both at home and abroad. Two letters of the alphabet are being used to suggest the rate of recovery, namely the letter ‘V’ and the letter ‘U’. Using the former letter, the suggestion is that there will be a V-shaped recovery, where the economy suffers a sharp but brief period of decline followed by an equally rapid bounce back. That seems overly optimistic. By contrast, the letter ‘U’ suggests a somewhat slower pace of recovery and one that is not very strong. In addressing an IIEA group meeting on 22 April 2020, Robert Watt, Secretary-General of the Department of Public Expenditure and Reform, described a third possibility, called ‘Nike Swoosh’ which suggests a longer and slower recovery.

The path of the Irish economy out of this crisis will depend on the path of the virus both domestically and globally. How well the world as a whole manages the pandemic matters to Ireland.

If the re-opening of the Irish economy happens at this end of this year it will coincide with the full impact of Brexit. There have been calls for the UK government to do the responsible thing and extend the Brexit transition period, as coronavirus plays havoc with the timetable for an EUUK deal but there are no suggestions that such calls on the UK government are being headed. The potential negative impacts of a ‘double whammy’ were referred to in the Department of Finance’s recent ‘Draft Stability Programme Update 2020’. It pointed out that “the interplay between a prolonged pandemic induced recession and a possible UK exit without a future partnership agreement in place would have severe implications for the Irish economy and public finances”. The lockdown for COVID-19 cannot be lifted in one fell swoop. This will pose a range of challenges for government as it will ultimately have to start by phasing-out the income supports and other sectoral supports that were introduced during lockdown. At the same time, it will have to consider

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what initiatives are needed to support companies as they restart their businesses and to stimulate investment in areas like housing and infrastructure. The cost of COVID-19 to the exchequer must also be managed. It is already considerable and will increase further. A recent estimate puts it as high as €30 billion or almost 10% of GDP. However, Donal de Buitléir, Chairman of the Chartered Accountants Regulatory Board in a recent policy paper concludes that “the costs of the additional borrowing necessitated by the crisis are affordable. Notwithstanding this, it is desirable that additional borrowing has extended maturity dates and that the funds are spent in a targeted and efficient way.”

Ireland’s highly-

the majority of the 260,000 employees laid off or on short-time.” Echoing these sentiments Ingrid Cherfis, President of the European Civil Aviation Conference (ECAC) highlighted the fact that “Europe, like the rest of the world, is at a complete standstill with almost no traffic except for cargo, repatriation and medical flights. The entire aviation system is deeply impacted by the crisis with layoffs and unemployment increasing day by day”. In addressing an IIEA group meeting, Robert Watt, Secretary-General of the Department of Public Expenditure and Reform, referred to a range of public policy responses that will have to be planned for the recovery of the Irish economy after COVID-19. He mentioned, in particular, the unwinding of the current emergency measures, the need to avoid pro-cyclical responses when it comes to fiscal policy and the policy responses required in areas such the labour market, public housing and infrastructure. The path of the Irish economy out of this crisis will depend on the path of the virus both domestically and globally. How well the world as a whole manages the pandemic matters to Ireland. Given the severity of the shock we are facing, there may be some persistent effects on the economy but we should look to minimise these and allow the recovery to take hold. Time is of the essence. Ultimately businesses must be able to restart their operations, workers must be able to regain their incomes, households and firms must be able to begin spending and investing again, and only then our economy can return to a positive place.

globalised nature can be seen in

its reliance on the activity of

foreign-owned multinational

corporations who make a significant contribution to

The Challenges Ahead

the Irish economy

The challenges facing businesses are considerable, particularly if a vaccine for COVID-19 is not found in the immediate future. The hospitality sector has been particularly badly affected and there is a real risk that many businesses in that sector may never reopen. In the case of pubs, the Licensed Vintners’ Association (LVA) and the Vintners’ Federation of Ireland (VFI) is pressing government to allow reopening. Recognising the challenge of maintaining social distancing in a hospitality environment, these organisations are putting in place radical changes to their normal operations to protect public health and to save what remains of their business. The Irish Hotel Federation recently pointed out that “the industry has been decimated with over 85% of hotels closed and

in terms of jobs, exports, fiscal revenue and

value-added.

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Changing Lanes Automobile manufacturers are currently facing very strong headwinds in the aftermath of the coronavirus crisis, which has hit the sector with an unprecedented force.

The European Automobile Manufacturers’ Association (ACEA) has published its annual Pocket Guide that provides an overview of the EU auto industry, including the latest sectorspecific data on employment, vehicle production and sales, road safety, R&D, the environment and trade flows. New data in this flagship publication confirm that the automobile industry is a key pillar of the European economy and as such, is vital to the wider post-COVID-19 recovery of the continent. Indeed, the turnover generated by the auto industry represents over 7% of total EU GDP. According to the 2020-2021 edition of the Pocket Guide, the automotive ecosystem provides work to 14.6 million Europeans, representing 6.7% of total employment in the European Union. With 2.7 million people working on the manufacturing of vehicles at 226 factories in the EU, the auto industry accounts for 8.5% of total manufacturing jobs in the region. Almost 18 million vehicles were ‘made in Europe’ in 2019, representing 20% of global vehicle production with 5.6 million of these vehicles being exported around the world, generating a trade surplus of €74 billion for the EU last year. The auto industry is by far the biggest spender on R&D in

the EU, investing an impressive €60.9 billion annually (+6.1% on the previous year), or 29% of the region’s total spending. Europe also leads the world when it comes to self-driving vehicles, responsible for a third of all global patent applications. There are 313 million vehicles in circulation on Europe’s roads today. Apart from ensuring that people and goods can move freely across the continent, these vehicles are a major source of government revenue, bringing in over €440.4 billion in taxes each year. Today, however, the European automobile industry finds itself in a difficult situation. Indeed, vehicle manufacturers had to shutter their development centres and production sites in the EU for an average of 30 working days during the lockdown period leading to production losses of more than 2.4 million motor vehicles so far with car sales expected to contract by a recordbreaking 25% in 2020. New car sales in Ireland are down by 29% compared to this time last year. New car registrations for August were down 4.2 per cent (4,875) when compared to August 2019 (5,088), according to figures released by the Society of the Irish Motor Industry (SIMI) while registrations this year are down by 28.6 per cent (78,920) on the same period last year (110,527).

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Safety & Sustainability Any way you look at it, this is a buyer’s market for cars and buyers are looking for safety and sustainability as well as value for money. A YouGov European survey highlights safety and sustainability as the key considerations for a car purchase with 47% of respondents said that safety was the most important feature. In terms of driving innovations, respondents agree that a top-selling point is for the car to anticipate hazards and other road dangers. Europeans also appreciate the benefits of the connected car, which shares information with its environment to find spaces in busy car parks and adapt its route based on real-time traffic. The survey indicates that attitudes towards driverless cars are divided. Currently, 28% of respondents expressed a clear positive attitude towards self-driving cars, Italy being at the forefront with 46% in favour compared with less than a quarter of those questioned in the UK. Anticipating dangers on the road, alerting the emergency services in the event of an accident, parking unassisted and performing manoeuvres so the driver doesn’t have to - the response from Europeans is clear: the car of the future is all about improved safety. However, these aspirations seem to suggest a lack of knowledge about the driver-assist systems already available on the market. For example, when we talk about the autonomous car of the future, we perhaps tend to forget about the safety features already available at lower levels of autonomy. The movement towards autonomous vehicles, however, will be gradual. In fact, rather than talking about a car revolution, the industry is busy working on its evolution – the technology deployed is only of any value if it is known about, understood, accepted and used. It takes time to build a sustainable future.

Environmental Impact The study confirms Europeans are environmentally conscious around cars. 24% of respondents felt that the most important characteristic of the car of the future is its environmental impact. This issue is even more important for younger generations: UK respondents aged between 18 and 24 rated eco-friendliness almost as important as safety, with 32% of respondents aged 18-24 listing environmental impact and 33% safety as the most important features of the car of the future. In terms of in-car comfort, the survey found that the comfort offered to passengers should be an increasingly important factor. Society is looking for comfort and personalised experiences, and that evolution in people’s requirements, together with technological advances, will lead to the development of a new kind of car interior. Bearing in mind that the car is more than 100 years old, the interior of the future will therefore require time to take shape. The last major change concerns the industry itself which has had to make major adjustments throughout 2020. With

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There are 313 million vehicles in circulation on Europe’s roads today. Apart from ensuring that people and goods can move freely across the continent, these vehicles are a major source of government revenue, bringing in over €440.4 billion in taxes each year. perspex screens, floor markings, a showroom with plentiful hand sanitiser and a COVID-19 set of guidelines in place for test drives, car dealerships are in a far different place in the wake of the pandemic. Despite the difficulties, however, dealers are reporting a high level of interest, particularly in second-hand cars to avoid having to use public transport. Manufacturers are tempting new buys with 202 offers, car deals and flexible finance options so those with the means to buy a new car will find that dealers have their arms and pockets wide open to sweeten the deal. Policymakers are being urged to urgently step up their political, economic and practical support to the automotive industry that will help manufacturers and dealerships weather the storm. While it is too early to draw broad conclusions, the unexpectedly high levels of interest in car buying generally may reflect tenuous confidence based on the practical necessities of needing a new or newer car to get on with the new normal.


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Refreshed Family & Small Car Range for Fiat Fiat has refreshed its range of small and family cars for July 2020, incorporating affordable hybrid technology, new engines and safety features with the modern and fresh styling customers have come to expect from the Italian brand.

New Fiat 500 Lounge Hybrid

In the small car segment, the iconic 500 is now available with a petrol hybrid engine that combines the latest Fiat 3-cylinder FireFly 1.0-litre unit with a 12-volt Belt-integrated Starter Generator (BSG) electric motor and a lithium battery that delivers 70hp (51kW). The Fiat Panda hybrid will be available later in the year. Amongst the benefits of this hybrid technology is that it includes lower emissions and increased fuel economy over previous petrol variants – 500 Mild Hybrid has CO2 emissions as low as 88g/km (NEDC2) with the Panda at 89g/km (NEDC2). Fuel economy for the 500 stands at 18.8km/l (WLTP Combined), while the Panda returns 17.5/km (WLTP Combined). A secondary benefit of the BSG system is that it ensures a very high standard of driving comfort allowing for a quiet, vibration-free restart of the internal combustion engine in Stop&Start mode. The clever system recovers energy during braking and deceleration storing it in a lithium battery and uses

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it to restart the engine and assist it during acceleration. The mild-hybrid unit used in the Panda and 500 receives a 6-gear manual transmission with front-wheel drive aimed at improving fuel economy in out-of-town driving. The new system also involves lowering the entire power unit by 45mm so the car behaves better on the road thanks to the lower centre of gravity. As standard, the updated 500 Pop receives Uconnect Radio with AM/FM tuner including DAB, USB/AUX inputs and steering wheel controls, LED daytime running lights, electric windows, chrome door handles and seven airbags. Building on the Pop specification, 500 Lounge receives a panoramic fixed glass sunroof to take the interior outside, leather steering wheel, 15-inch alloy wheels, air conditioning, Uconnect radio with a 7-inch touchscreen which is compatible with Apple CarPlay and Android Auto and rear parking sensors. Over and above the Lounge trim, the all new Star trim adds automatic climate control, 7 inch TFT instrument cluster, 3D


Frontline & Healthcare

navigation and 16-inch alloy wheels. In the family car segment, the Fiat 500X crossover has recently had the 500X Sport join the ranks of its range. More aggressive sporty styling has combined with greater performance with the inclusion of tuned suspension settings for lowered ride height, steering system calibration and 19-inch wheels. The addition of high-performance tyres also leads to improved agility and greater driving pleasure. This 13mm reduction in ride height results in a more aggressive exterior style, with better ground adherence and dynamism. The new 500X Sport can be equipped with a choice of two petrol engines, a 1.0 with 120hp and six-speed manual gearbox, and a 1.3 with 150hp and six-speed DCT dual-clutch automatic transmission, complete with steering wheel controls. For greater road-holding without compromise to passenger comfort, the 500X Sport also uses Frequency Selective Damping (FSD) on the front and rear suspension and adjusted shock absorbers. The steering system calibration has also been adjusted to return more precise and reactive feedback to the driver. The new Sport model asserts its credentials with a host of exterior styling cues including body coloured side skirts and wheel arches, diffuser-style rear bumper, dual chrome exhaust and full LED headlights and fog lamps. Continuing the assertive theme, Sport Red paint is available exclusively on the Sport model, while titanium grey details on the handles, front bumper inserts, front moulding, mirror caps and a Myron “500” logo on the boot-lid add to its premium feel. The sporty style of the exterior continues inside with aluminium and titanium grey highlights alongside a leather flat-based sports steering wheel with alcantara inserts. Exclusive new black fabric with techno-leather upholstery, with a grey “500” logo on the seats, a Myron steering wheel bezel, aluminium pedals and ambient interior lighting complete the 500X Sport’s unique interior. The new 500X is packed with a host of innovative driving assistance systems as standard including Traffic Sign Recognition and Lane Assist. Fiat’s Uconnect 7-inch infotainment system with satellite navigation which is compatible with Apple CarPlay and Android Auto, automatic climate control, rear parking sensors and Cruise Control are also standard on the Sport. The family car from Fiat, the Tipo range which is available in hatchback, saloon and station wagon has also been refreshed. The Fiat Tipo embodies the time-honoured concepts synonymous with Fiat – functionality, simplicity and personality – and the new Mirror version continues this concept and is focused on connectivity. The Tipo Mirror is a non-compromising mid-range offering with a balance of technology and style. Connectivity is standard with UconnectTM 7-inch HD LIVE touchscreen, which is Apple CarPlay and Android AutoTM compatible. Tipo Mirror also has its own distinctive style with exclusive new Mirror Blue livery setting off a host of chrome details including door handles, lower window line, lower grille surround, fog light bezels, mirror caps and a “Mirror” badge on the pillar. Diamond cut 16-inch alloy wheels complete the look. The Fiat Tipo Mirror is available with a choice of petrol and diesel engines, including the 1.4-litre 95hp and 1.6-litre MultiJet 120hp diesel engines, all paired with a six-speed manual gearbox.

Hybrid Detailing on New 500

500 Lounge Hybrid

New 500 X Sport

Newly available on the Tipo range is the Safety Pack. Alongside features such as six airbags and electronic stability control (ESC) with Hill Holder, it has anti-lock brakes (ABS) complete with electronic brakeforce distribution (EBD) and tyre pressure monitoring system (TPMS). The Safety Pack adds Speed Limiter Full Brake Control which detects potential collisions and activates the braking system accordingly. The Fiat retailer network is now reopen across Ireland and is adhering to government guidelines to protect the health of its customers and staff. For further information on the range and special offers available please contact your local dealer or visit Fiat.ie.

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Renault Group Ireland In the Driving Seat with Paddy Magee, Country Operations Director, Renault Group Ireland

Paddy Magee, Country Operations Director Renault Group Ireland

The motor sector welcomed the news that showrooms could reopen on the 18th May, however, reigniting sales at a time of uncertainty calls for innovative thinking. It has been, and continues to be, a difficult few months for the country, and the motor industry is weathering its own crisis. We spoke with Paddy Magee, the Country Operations Director of Renault Group In Ireland to get his view on the second key registration period in the sales calendar, July, and to see how Renault Group and its network have been reacting to the pandemic crisis. In response to the COVID-19 crisis and the overall impact on the Irish motor industry, Magee proposed a short term VRT reduction on new and used vehicles for the month of July, which would give a much needed boost to the already challenged motor sector. “A VRT reduction of say €3,000 in July ( 55% of the average VRT on new vehicles) would see the customer getting something back, reduce CO2 levels across the current carparc, and the process would work from a revenue level, with the tax take for the Government increased” explains Paddy Magee. “There are over 50,000 people employed in the motor sector in Ireland and with July a crucial month for us, this proposed short-term incentive is really needed to protect the industry

from dramatic job losses and to give customers support”. Renault Group themselves launched a real and transparent offer with real deferral periods and no penalties for personal and business customers looking to buy a new car or van, understanding that people have been hit financially over the past few months.

Buy Now Pay Later Renault’s 202 Buy Now, Pay Later 3+2+1 Offer is valid on all current stock across the Renault car range and includes - 3 Months Deferred Payments, 2.02% APR (saving customers €2,500 on interest payments compared to high street banks), and €1,000 Cashback. This offer is available on the 100% electric Renault ZOE, All-New Clio, All-New Captur, KADJAR, Mégane, Scenic and Koleos models and applies to all orders taken from now until the 31st July and registered on or before the 31st July 2020. Those looking to buy a quality used car will be happy to hear that Renault’s real payment deferral offer is also applicable on a number of RENAULT SELECTION used cars at Renault dealerships. Customers can Buy Now, Pay Later on 191 and 192 models and this offer includes - 3 Months Deferred Payments, 4

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Doireann Garrihy Renault Brand Ambassador Years Warranty + 4 Years Roadside Assistance, 3% APR HP over 3 years and 2 Years’ Servicing. On the award-winning Dacia range, the brand is continuing with a shockingly affordable offer for 202 registration plates on the Duster SUV, compact Sandero, Sandero Stepway SUV and Logan MCV. The Dacia Buy Now, Pay Later offer includes 3 Months Deferred Payments, 4.9% APR with prices from €99 RRP per month, for orders before 31st July. There is also a 48hour test-drive campaign for Duster for customers looking to get behind the wheel for themselves. “As we see COVID-19 restrictions lifting, fleet customers will be eager to resume operations to generate revenue and cashflow as quickly as possible. Our 3-month deferred payment offer for LCVs is a market leading offer which allows customers the potential to earn revenue for 3 months whilst not having any payments on their vans. This will give companies the opportunity to claw back earnings lost over the past few months due to COVID-19 restrictions. It is a real payment deferral with no increase in the monthly payments after the 3-month period, to support small businesses to get back up and running. The low rate APR means more savings in interest and lower monthly payment for customers, helping with the cost of change on new models and getting customers back on the road”. The Buy Now, Pay Later offer for vans is applicable on the award-winning Kangoo, New Master and New Trafic. Renault Pro+ customers can benefit from savings of €3,000 or more in interest payments through Renault Bank with 3 Months Deferred Payments, 3.9 % APR HP over 5 years (savings of €3,000 or more compared to the high street banks), 5 Years Warranty + 5 Years Roadside Assistance.

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New Guidelines With Renault’s 29 dealerships reopened for business, Magee explained that the network has adapted very well to implementing strict new guidelines for customers and staff to give assurance and confidence when visiting a Renault or Dacia dealership. “These in-depth guidelines include dedicated hand sanitising areas, number of customer entries to dealerships restricted, a “Drop & Go” key process for aftersales customers arriving for scheduled service, strict service scheduling for customers to minimise busy periods and also appointment only servicing. Customer test drives will be unaccompanied; cars will be sanitised on delivery and when dropped back and customers will receive personalised sales videos to help reduce visits. All these measures are in place across our network of dealers and they are all open for business”.

COVID Car Cover Mindful of the needs of frontline workers during the pandemic, over the past few months Renault Group Ireland joined forces with AXA Insurance Ireland to help returning Irish medics get on the road. Renault provided over 100 complimentary cars complete with complimentary AXA motor insurance for 2 months for doctors and nurses returning home to support the HSE during the COVID-19 crisis. Paddy Magee: “We as a nation are so grateful to all those working on the frontline treating patients and helping to combat the horrors of COVID-19. It shows real courage to come home from overseas to help us fight the battle and we really appreciated what these returning doctors and nurses were


Frontline & Healthcare

in-use model praised for its range and refinement. This follows further prestigious wins from WhatCar? and Driving Electric, recognising New ZOE’s all-round credentials.

The Future

doing. We hope that by supplying cars to these frontline medical staff helped to make their commutes to and from work a little easier and less stressful, and we and our dealer network were delighted to be of assistance in some small way”.

New ZOE So, back to 202 and the hugely important July market. Renault has a diverse range of new car models including All-new Captur, All-new Clio, the Mégane range, Kadjar and Koleos and the new fully electric ZOE, which arrived in Ireland just before lockdown! ZOE has been the best-selling electric car in Europe since its launch and the New Renault ZOE Z.E. 50 now has an extended range of 395km, greater performance, a completely redesigned interior, a fresh new exterior look and the most flexible charging on the market, priced from €26,990 including SEAI grant. With three generous trim levels, starting with entry-level Play, Iconic and GT Line, New ZOE is the most affordable electric car in Ireland with a 395km range – saving customers €9,000 versus other long-range electric cars. New ZOE comes with a more powerful 52kWh battery, a new R135 (135 hp) motor alongside the current R110 (108 hp) motor, a completely redesigned interior with premium materials and customisable 10-inch TFT instrument cluster as standard, Apple CarPlay™ and Android Auto™, new front-end treatment with revised bumpers, more sculpted bonnet, chrome grille inserts and ‘holographic’-effect Renault diamond logo, and full LED headlamps as standard across the range. The new model can avail of 50kW Direct Current (DC) charging for the first time - 50 kW fast charging can add around 145km of range in as little as half an hour. ZOE remains the only car with standard 22kWh AC charging capability through the Chameleon Charger™ - making ZOE by far the most suitable electric car for Ireland’s public charging network. Awarded the Best Supermini Award by TopGear magazine in its latest dedicated Electric Awards issue, this most recent prize marks the eighth award win for the newest version of Renault’s all-electric model despite only being launched since the beginning of the year. It follows Renault’s win as Best Manufacturer, and the New ZOE being crowned City Car of the Year in the annual TopGear.com awards, with the zero-emissions-

Looking to the immediate future Paddy Magee acknowledges the challenging times ahead: “We are in very unusual and uncertain times with the COVID-19 crisis affecting each and every one of us in a different way. The market is down understandably, and we are entering a difficult economic period globally and at home, which will impact us all. 202 is the second key selling period for us and we have to rise to the challenge and keep on motoring hence our VRT reduction proposal for July, and a real and transparent customer offer. We want to assure customers that our new deferred payments are real with no penalties after the three months and offering real savings so that they can be back on the road when restrictions are lifted and business resumes again. Our network is ready to work with customers on their individual needs for 202, be it business or consumer, and we believe this offer is market-leading and transparent to help customers make their decisions easier in tough times”. www.renault.ie www.dacia.ie

Dr Sara Kyne

COVIDCARCOVER Having returned from Melbourne via Malaysia on the 24th March, paediatric doctor Sarah Kyne is happy to be back home and working on the frontline supporting the HSE during the COVID-19 pandemic. 27-year old Sarah from Newbridge, County Kildare is now able to commute easily from her home to her new job in a Dublin Hospital having applied for the CovidCarCover initiative with Renault Ireland and Axa Insurance. This joint initiative between Axa and Renault acknowledged the exceptional contribution being made by returning medics to support the national response to the pandemic and over 100 cars were supplied with insurance. Sarah is photographed at a social- distance with Richard Murphy of Renault Belgard collecting her Renault Mégane.

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www.siac.ie siacbp@siac.ie PH: 01 459 3194 200

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Building for the Future Engineering and construction companies have a vital role to play in the post-pandemic recovery of communities and economies.

COVID-19 has affected communities globally, with more than 2.9 million reported cases to date - a number that is still rising. And while governments and companies globally are responding fast, much remains to be done. In this difficult time, construction matters more than ever. From building hospitals in just a few days to donating lifesaving equipment, the industry has played a critical role in responding to the crisis and in the recovery. The construction industry represents 13% of global GDP and unlocking currently constrained labour availability could help drive recovery while addressing our most pressing construction-related needs. But the industry has also suffered; construction sites in many countries have shut down and most sites that are open have faced disrupted supply chains and operational restrictions. Construction is typically much more volatile than the overall economy. Reduced economic activity results in less demand for new commercial or industrial facilities and ambiguity further dampen investment. Loss of income and lack of consumer confidence negatively affect demand for housing construction or refurbishment. According to PwC’s latest COVID-19 Pulse survey, things are likely to get worse before they get better. The survey found that 81%

of CFOs are considering cost reductions in response to the current crisis and 60% say they are planning to defer or cancel investments, particularly in areas such as facilities and capex, operations and workforce. On the upside, however, unprecedented public-relief packages could not only support a rapid recovery but also be followed by public-investment programs.

Smart Technology Organisations across the industry are shifting to remote ways of working. Designers and engineers are relying more heavily on digital collaboration tools such as building information modelling (BIM) which enables projects to continue in a digital and virtual environment even when participants are unable to meet in person. This collaborative approach allows data to be shared across professional disciplines and facilitates smarter construction. Smart technologies including artificial intelligence (AI) can further enhance the design process. They use big data and complex algorithms to create standardized designs at pace. The resulting designs can then be tested on a virtual platform in terms of their viability and cost, the local environment, and the developer’s specific ideas and

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Frontline & Healthcare

requirements. This means decisions and commitments can be made at an early stage, which speeds up the whole process. Leading engineers and contractors are using 4D and 5D simulation to replan projects and reoptimize schedules. Integrated digital-twin solutions are being developed to be used end to end, from project concept to commissioning and contractors are looking to online channels for monitoring their employees’ wellbeing through apps, ordering construction materials, managing scarce resources more accurately and maintaining cash flow. Other emerging digital technologies include GPS-enabled devices that monitor people’s movements around building sites and alert individuals if they come too close to others, or accidentally mix with those outside their working bubble.

New Practices The industry faced a shortage of skilled labour before the covid crisis. With the prospect of rolling physical-distancing measures and restrictions on cross-border movement, skilled labour shortages will become even more acute in the immediate future. Building in controlled environments makes even more sense in a world that requires close management of the movement and interaction of workforces. Such rationale further strengthens the case for off-site construction, beyond the existing quality and speed benefits. In response, contractors will likely see the benefit of more fabrication off-site and manufacturers, in turn, will expand their range of prefabricated subassemblies. In line with EU directives, governments are likely to stimulate the economy by encouraging measures to meet carbon reduction targets, for example, by retrofitting housing stock to improve energy efficiency. Such incentives might come in the shape of a combination of policy change and direct public investment. A parallel shift in demand toward more sustainable buildings and communities that promote healthier lifestyles (such as access to local amenities and outdoor space, higher standards on air quality, and recycled and sustainable materials) is also a potential benefit of post covid development. When the pandemic ends, engineering and construction companies will face a new world. The marketplace will change, as some national governments will be eager to invest in infrastructure to jump-start their recovery, and others may face new resource limitations. Portfolios will also change, with

In this difficult time, construction

matters more than ever. From building

hospitals in just a few days to donating lifesaving equipment, the industry has

played a critical role in responding to the crisis and in the recovery. both public and private-sector project owners placing a new emphasis on sustainability and resilience. Cities will need to serve more residents who work from home, likely leading to greater investments in connectivity and smart city initiatives. With change comes opportunity. American politician Rahm Emanuel said after the 2008 financial crash: “you should never let a serious crisis go to waste. And what I mean by that is it’s an opportunity to do things you think you could not do before.” Companies that emerge from this crisis with the capacity to adapt will be well-placed to pivot and seize new opportunities.

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Public Sector Magazine

Well Workspaces While most people have heard of sick building syndrome (SBS), not many have considered how it might be affecting their productivity and ultimately profits, or what they can do about it.

In a post-COVID world, how we work and how we assess the suitability of our workplaces has completely changed. The common challenges that filled boardroom meetings prior to the pandemic have been replaced by increased time spent worrying about employee safety, wellbeing and how teams might once again be able to work together in one location safely. Sick building syndrome (SBS) is the name of a condition that is believed to be caused by people being in a certain building or other type of enclosed space. It is often attributed to poor indoor air quality (IAQ) however; the precise cause is unknown. Dr Joe Allen and John Macomber, co-authors of the book, Healthy Buildings: How Indoor Spaces Drive Performance and Productivity, asked why are we ignoring the 90%? Referring to the fact that people are an indoor species that spend 90% of their time indoors, Allen and Macomber cited a double-blind study they conducted (#TheCOGfxStudy) to measure the impact of green buildings on the cognitive function of occupants. For their research, workers spent six days over two weeks in an office setting in which three variables in air quality were changed: fresh air, CO2, and common chemical levels. The study concluded that people perform better even when measured against themselves in various cognitive areas such as activity, focus, task, crisis, info seeking, etc. when they were exposed to high levels of fresh air and lower levels of the other variants. Through their research, Allen and Macomber identified nine foundations of a healthy building, namely air quality, thermal health, moisture, dust & pests, safety & security, water quality, noise, lighting and views and ventilation. While the study was conducted before the coronavirus pandemic, the authors conclude that buildings can not only affect cognitive function, but also disease transmission. Allen and Macomber concluded that “what gets measured, gets done.” These are sentiments echoed by Laura Doyle of Farrell Doyle Conservation. “At the heart of everything we do is this

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idea that blending traditional building methods with new conservation technologies ensures the longevity of historic buildings while also allowing the building, and the people working in them, to breathe. “Moisture and dampness hinder that and create a toxic work environment. We eliminate sick building syndrome while respecting the integrity of the original building and we work to maintain the building’s integrity while bringing it up to modern, safe working standards.” While the pandemic has undoubtedly brought many harms to our lives in 2020, it may bring some improvements in the long term. While the world is on pause, many businesses are looking to optimise the air quality of their workspaces, ensuring that their employees remain safe from COVID-19 once they get back to work. Respiratory diseases like COVID-19, are especially connected to air quality. Preliminary data show that people with pre-existing conditions like heart disease and asthma may be at a higher risk of contracting serious symptoms with COVID-19, and the majority of hospitalised cases have underlying health conditions. These conditions are exacerbated or even created by air pollution, and a symptom flare-up could make someone more vulnerable. Dry air reduces the body’s natural defenses against viral contagions, and viruses can travel easily in dry air. The combination of recirculated, dry air would make the office uncomfortable under normal circumstances but may make it deadly during this pandemic. Outside of COVID-19, we are all exposed to respiratory illnesses such as the flu and various colds, over the course of the year. In the 2018-2019 flu season alone, over 35 million people were infected. We can use the measures in place to control COVID-19 to change the built environment for the better, improving everyone’s health in the process.


Frontline & Healthcare

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Record 4 Week Turnaround For HTM Compliant Modular Bathrooms LMC Modular is proud to have provided two new fast track hospital projects for Ireland’s Health Service Executive (HSE) at University Hospital Limerickand Croom Hospital in County Limerick to help in the fight against COVID-19. The LMC Modular team worked night and day to deliver HTM Compliant bathroom pods to the project in record time. From the initial date of the order to the first pod delivery, we managed to reduce the design and procurement process from a normal duration of 16 weeks to an incredible 4 weeks. Our bathroom pods are delivered to site fully finished, mechanically and electrically tested and certified for easy connection to the site infrastructure. Our in-house BIM capabilities, design protocols and quality controlled manufacturing processes guaranteed standards of excellence for all elements of each individual pod. We would like to congratulate everyone involved in this worthwhile project and we hope that it goes a long way in the fight against COVID-19 - both now and in to the future. website: www.lmcgroup.ie email: info@lmcgroup.ie


Frontline & Healthcare

Modular Solutions LMC Modular was founded by Martin Lydon and Stephen McConnell in June 2017 under the banner of LMC Group. Between the two of them, Martin and Stephen have more than 40 years of experience in the industry.

The purpose of LMC Modular was to fill a clearly defined market gap. The need for high quality and affordable bathroom and kitchen PODs simply was not being met. LMC Modular PODs have since been used in the residential, leisure and healthcare sectors where quality standards, first-class service and production efficiency has resulted in phenomenal growth and success for such a young company. LMC Modular initially commenced operation in Birdhill, County Tipperary. However, due to its accelerated growth and thanks to ever-growing demand, the company rapidly expanded moving to a larger facility in Nenagh, County Tipperary, capable of handling the increase in orders. This facility measures more than 12,000 square metres and can produce more than 100 PODs per week, employing a workforce of almost 200. In addition, LMC Group is accredited to the highest ISO Quality, Environmental and Safety Standards. All LMC PODs are created in-house by a specialist team of BIM designers. “We are very proud of our ability to tailor our concepts and designs to meet each of our client’s unique requirements,” explains Stephen McConnell, Managing Director. “Once designs are signed off by both parties, a sample POD is produced and presented to the client for visual inspection and final sign off before manufacturing begins. Our production process has been developed with quality, reliability, durability and ease of installation as key priorities.” There are several stages that the POD goes through during the manufacturing process. However, once a POD has undergone

all of these phases, it is a completely finished and ready to use bathroom. No additional work needs to be carried out on-site other than to position the PODs and connect to the main electrical and plumbing lines. LMC can design, manufacture and deliver hundreds of ready to use bathrooms, kitchens or residential plant rooms before the building they are destined to go in to is even off the ground. Pre-fabricated bathrooms and kitchens save a construction project huge costs in terms of money, time and labour. Not only that, but the consistency and quality of LMC’s products could not be matched by onsite construction using the same budget and time constraints that LMC operates within. LMC has pushed the boundaries on what can be produced offsite and has completed recent notable projects for numerous luxury hotels and the health care sector. The work that LMC has carried out for leading hotels has allowed them to show exactly what can be achieved when opportunities to pursue luxury are afforded. This is evident in the company’s recent work with the Dean Hotel Bathroom POD. Equally important in current times with the health sector in drastic need of increased bed capacity due to the COVID-19 pandemic, LMC was able to perform an incredible feat and turned a 16-week start to finish procedure for POD production into a four-week turnaround – an amazing achievement and a huge tribute to their hard-working team. With such high demand today for a quick turnaround in housing and the ever-increasing needs of the healthcare and hospitality sector, business is rapidly expanding for Lydon and McConnell and the future looks very bright for LMC.

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