Thread by @gavreilly

NEW: Several patients treated in ICU in February were later diagnosed with #covid19 - meaning the coronavirus was present in Ireland two weeks before the first case was notified to authorities.

Story on @VirginMediaNews at 5:30

Internal HSE data seen by @VirginMediaNews reveals that four patients - admitted to ICU on several dates in the second half of February - were later confirmed to have #covid19.

Those patients were admitted to intensive care on February 17, 18, 25 and 28.

All of these admissions to ICU were before the Dept of Health and NPHET were made aware of a separate case on February 29, which was previously thought to be the State’s first.

HSE says the earlier cases were only confirmed as Covid-19 positive later - and Feb 29 was its first.

It is possible that those patients were treated for a separate condition in ICU, and were only swabbed after the fact.

However the HSE data I’ve seen suggests this is unlikely - the cases are included in a graphic showing the breakdown, by day, of Covid-19 admissions to ICU.

It is known that the health service was acutely aware of the prospect of Covid-19 appearing in Irish hospitals, so it is almost certain that - assuming these were suspected cases - PPE, social distancing and all the other protocols were being fully observed at the time.

But while there has often been a lag between cases been confirmed, and then notified to the HPSC (which in turn informs NPHET), it’s unclear how in multiple separate instances, notification might have taken so long to come through.

It’s also not clear when the HPSC was told that these previous ICU patients were tested positive, and therefore whether this might have resulted in any delays to contact tracing which could otherwise have been avoided.

Separately it is unclear if NPHET was ever told of the subsequent confirmation of Covid-19 in these cases - Dr Tony Holohan’s answer at this evening’s press conference suggests not.

Why might NPHET, when debating huge public policy, not be informed that older cases had emerged?

Remember the timing. On Feb 20, Simon Harris changed the law so that any new cases of Covid-19 had to be routinely notified to the HSE. At that time, authorities were largely watching out for the disease among people who’d returned from China.

That was also the week where there was fierce public debate around the Ireland-Italy rugby match, given Lombardy’s infection rate.

The Govt asked for the match to be called off on Feb 25, which now turns out to be the date of the third ICU admission of a Covid-19 patient.

This was also a time when authorities were alive to possible cases, and (as Holohan himself said this evening) were encouraging anyone with symptoms to be referred for testing, even if the chances of it being Covid-19 were remote.

So given all that, how could the delay in testing and notification potentially be so long? Especially for any patient who was so gravely ill as to require ICU - and who (if not being treated for something else by coincidence) were likely to be showing some symptoms first?

(And if the patients were being treated for something else entirely, and Covid-19 only came on the horizon afterward… questions would then arise about whether they might have caught the virus while still in hospital.)

So quite a few issues raised by this story - owing to patient confidentiality it will be near impossible to establish the circumstances of each.

But systematic issues, like whether key advisors on huge public policy were not informed of early and serious cases, need addressing.

Here’s a much more concise version, from the @VirginMediaNews at 5:30.