A PERSONNEL ABSENCE in April and the encoding of staff data lead to a delay in publishing 244 cases of Covid-19 at Dublin’s Mater Hospital, an internal HSE report has found.
It was widely reported in May that 244 positive cases among hospital staff dating back to March at The Mater were reported in one group rather than gradually each day, leading to an apparent increase in daily case figures released by The National Public Health Emergency Team (NPHET).
Despite assurances that all legal requirements were met by The Mater in reporting these cases, and that contact tracing was immediately carried out, HSE officials initiated an investigation into the anomaly.
Ireland’s Covid-19 case figures are uploaded from laboratories each day to what’s known as a Computerised Infectious Disease Reporting [CIDR] system. Uploaded cases include names and dates of birth for Covid-positive patients.
In The Mater, however, staff data is anonymised, according to the report, “to protect confidentiality and respect the dignity of the staff being tested”.
The Mater Hospital stated that this approach was introduced to encourage staff to seek a laboratory test.
Only The Mater’s Occupational Health Department had access to named healthcare worker data in this case.
The OHD removed names of staff samples which were then sent to its laboratory and gave these 244 cases “codes”, which meant it was not possible to include names and dates of birth when uploading them on to CIDR, as is required.
Discussions took place internally on 20 April regarding this anonymised data in an attempt to resolve the issue of uploading them to CIDR.
The Mater’s laboratory informed the PHD that uploading staff data using codes was creating problems, including duplication.
When PHD asked the Mater if could have the key to these codes it was told by the hospital this was not possible.
The Mater’s laboratory then uploaded a sample of 60 confirmed Covid-19 cases among Mater staff on to CIDR, which were included in that day’s daily figures.
The PHD then asked the Mater to not upload any more cases until the issue of anonymised data had been fully resolved.
However, a senior personnel absence from 21 April meant that the issue was not fully resolved for another three weeks.
‘Rapidly Escalated’
On 13 May, on instruction from HSE Public Health Department East all cases of Covid-19 amongst Mater Hospital staff since 13 March – 244 in total – were uploaded to CIDR, leading to a jump in daily figures reported by NPHET.
In its report, the HSE states that the circumstances occurred during a period when demand on hospitals and public health departments was at “an unprecedented level”.
According to the report, there was no delay in critical public health actions, like contact tracing, for these cases. All 244 cases were notified by The Mater’s Occupational Health Department (OHD) to The PHD so that contact tracing could be initiated.
Following the incident, HSE Chief Clinical Officer Dr Colm Henry “sought and received formal assurance from the HSE’s National Director Acute Operations that full Covid-19 information including for staff tested, is being uploaded onto the CIDR system by all hospitals,” the report states.
The HSE has recommended that its National Director Acute Operations write to all hospital groups to make sure there are no future barriers to uploading healthcare worker test results to CIDR.
It also recommends that any healthcare worker data entered into the HSE’s contact tracing system has also been uploaded to CIDR.
“If a problem is identified, the public health department must immediately contact the relevant hospital laboratory to resolve the reporting issue,” the report states.
“If it is not possible to resolve reporting difficulties this way, the issue should be rapidly escalated to the National Clinical Director, Health Protection by telephone and email,” the report concludes.
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