Covid-19 outbreaks in Cork nursing homes more than tripled in the third wave of the pandemic, according to a new HIQA report.

The Health Information and Quality Authority (HIQA) and the Health Protection Surveillance Centre (HPSC) have published an analysis of the factors associated with outbreaks of Covid-19 in nursing homes, across three waves of the virus in spring of 2020, autumn/winter of 2020, and early 2021.

Building on a previous analysis that only examined the first two waves, this new analysis found that there were more nursing home outbreaks in the third wave than in the first two waves combined.

This was reflected in statistics for Cork nursing homes, where only 1 in 10 experienced an outbreak in the first two waves of the pandemic – 7% in wave one, and 10% in wave two. This jumped to 1 in 3 nursing homes, or 33%, having an outbreak in the third wave.

Tadgh Daly, Chief Executive of Nursing Homes Ireland, said that this was mainly down to the amount of Covid-19 circulating in the community during the third wave.

“In the third wave there was very high incidence in the community, which we've all said from the outset was the single biggest predictor of an outbreak. If you have high incidences of Covid-19 in the community, that’s going to impact on transmissibility,” he said.

“Like everything we have to take the learnings, but the report did say that if nursing homes had an outbreak previously, they were less likely to have another one, and I think that could be a measure of the work that staff did to be in a better position to minimise or mitigate subsequent outbreaks,” he added.

Analysis

In general, HIQA’s analysis found that the probability of a Covid-19 outbreak occurring in a nursing home increased with the number of beds in a home, and was strongly linked to levels of Covid-19 in the community, and proximity to other nursing homes.

It found that where there was more than one outbreak in a nursing home, subsequent outbreaks tended to be less extensive.

The type of nursing home, being public or private, had no significant effect on the probability of an outbreak.

Vaccination of nursing home residents, which began in January 2021, had a significant effect in reducing the probability of outbreaks, and decreased the extent of outbreaks when they occurred. The report said that this “unsurprising” finding illustrates the benefits of the vaccination programme and the prioritisation of nursing home residents for vaccination.

However it warned that uncertainty around the extent and duration of vaccine immunity should be carefully considered in the face of potential future waves of the pandemic.

Of the 595 nursing homes registered with HIQA during the three waves, there were 375 outbreaks of Covid-19 amongst residents, across 293 nursing homes.

71 nursing homes across the country had more than one outbreak across the three waves, while 275 homes registered throughout the whole period had no outbreaks at any point. A further 27 homes that were only registered for part of the study period had no outbreaks.