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HSE letter outlines Direct Provision strategy but warns accommodation may be 'insufficient or unsuitable' for self-isolation

There have been 171 cases of Covid-19 among people living in Direct Provision including 13 clusters.

Image: Shutterstock/totojang1977

THE HSE HAS outlined its strategy for Covid-19 in Direct Provision centres but warned that some accommodation may be “insufficient or unsuitable” for self-isolation, a letter obtained by TheJournal.ie shows. 

It comes as The Irish Refugee Council warns that as restrictions are lifted people living in congregated settings like Direct Provision “will always be vulnerable to outbreaks even when risk decreases in other parts of society,” said IRC CEO Nick Henderson. 

Nasc, migrant rights centre, meanwhile, has called for people living in the system to be prioritised for testing. 

In recent weeks, the HSE and Department of Justice & Equality’s handling of a Covid-19 outbreak at the Skellig Star Hotel in Caherciveen, Co Kerry has drawn criticism from migrant rights organisations. 

Last night, public health officials confirmed 171 cases of Covid-19 among people living in Direct Provision. This includes 13 clusters.

As the Department of Justice & Equality has come under pressure, questions have also been raised about the HSE’s response, its strategy for Covid-19 and how it affects asylum seekers.

In a letter to the Irish Refugee Council, seen by TheJournal.ie, the HSE – which leads the response to Covid-19 in Direct Provision – clearly lays out its response for the first time.  

In the case of congregated Direct Provision centres there may be a case for extensive testing including all residents and staff, the HSE said, with a decision to be made by Local Public Health Directorate. 

For less congregated Direct Provision centres, only close contacts of a Covid-positive person will be tested. 

For contact tracing, the HSE said it counts all residents and staff at Direct Provision centres as close contacts due to the congregated nature of centres. 

Although self-isolation can be provided on-site, the HSE said, there is at times “insufficient or unsuitable accommodation” at times in Direct Provision. 

In addition to 3 self-isolation facilities, the HSE said people living in Direct Provision, including people in Caherciveen, can request a transfer to City West under these circumstances.

Despite calls to shut down Skellig Star in Caherciveen, the HSE said residents should not be moved from the centre.

“HSE consider that Covid-19 outbreaks can be managed with advice of local Public Health and support from Social Inclusion team, DOJ and centre management,” a HSE spokesperson said.

“This is the approach taken in outbreak control and monitored.”

‘All But Inevitable’ 

So far, 1,600 out of 7,700 people in Direct Provision have been tested. 1,700 people are still sharing rooms, despite Chief Medical Officer Dr Tony Holohan saying it is not possible for people living in these settings to physically distance. 

On Friday, the HSE confirmed that a letter enforcing quarantine at Skellig Star Hotel for a further two weeks was sent by local HSE officials.

The letter said that residents had not been following self-isolation rules and, therefore, two more weeks of quarantine would be enforced. 

The Irish Refugee Council, meanwhile, had been calling on the HSE to give clarity on its strategy for testing in Direct Provision and for managing outbreaks. 

On Thursday, HSE CEO Paul Reid said the HSE aims to have a 90% end-to-end turnaround time of three days on testing and contact tracing for Covid-19 positive cases by this week. 

In its letter, the HSE says it will inform the Department and Direct Provision centre management if there is a positive case. 

However, it is more likely centre management will be aware of a Covid-19 case first, the HSE said. 

“Residents should feel safe to inform centre management if they are concerned about possible Covid-19 or have been diagnosed,” the letter adds. 

Testing, the letter states, has an important role to play in Covid-19 response for Vulnerable Groups, like asylum seekers. “However, it is but one tool in the response,” the HSE added. 

The emphasis, it said, was on “getting information” to centre managers and residents in Direct Provision in order to support prevention and hygiene measures. 

“Control depends on what people do both to protect themselves and others,” the HSE said. 

“This includes restricting movements, maintaining social distance in recreation…and complying with Government measures,” it added. 

In response to the HSE’s strategy, Fiona Finn, CEO of migrant rights centre Nasc, says it “is disappointing” that Direct Provision residents have not been prioritised for testing. 

“Residents in centres are acutely aware of the need to social distance and to take all possible precautions,” said Finn.

“However, the nature of living in a Direct Provision centre means that some close contact is all but inevitable.

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“Given the high risk of asymptomatic transmission, widespread testing is an essential tool to ensure that more clusters do not appear in centres,” said Finn.

“As the WHO director Dr Tedros Adhanom Ghebreyesus says: ‘You can’t fight a virus if you don’t know where it is’.”

Asked in the Dáil yesterday about prevention and testing in Direct Provision centres, HSE Chief Clinical Officer Dr Colm Henry said that widespread testing has been carried out in some Direct Provision centres, depending on size and the number of positive cases. 

“We leave this judgment of the Public Health Departments who are managing these outbreaks on each individual basis,” said Henry. 

Henderson of the Refugee Council said implementation of the HSE’s strategy will “obviously be crucial”. 

“We and other organisations will be monitoring this carefully,” he said. 

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