Skip to main content

COVID on the fringes of society - Dr Patrick O'Donnell

When the COVID-19 pandemic unfolded across the world at the start of 2020, it was clear to see that the virus had no regard for geography, class or distinction. Land borders were ignored as COVID freely travelled without limitations and from the affluent to the marginalised, everyone was susceptible to the illness.

Despite increasing pressures on the health system, most of those affected had access to the care they needed. However, there was a cohort of those on the fringes without the same access to supports. 

Dr Patrick O’Donnell is a general practitioner and a member of the Irish College of General Practitioners but is also a member of the Public and Patient Involvement Research Unit at University of Limerick with expertise in participatory health research with socially excluded communities.

With an interest in the delivery of primary care in areas of deprivation and to marginalised groups, Dr O’Donnell explains what it was like for people on the fringes of society who were dealing with COVID.   

“Mid-March 2020 was a time of huge uncertainty and fear for many people across the country with the arrival of the COVID-19 pandemic. The whole Irish population was asked to prepare for an unprecedented challenge, and most of the focus was on people being able to protect themselves by staying at home and staying informed.

For some people on the margins of society, those simple {public health] requests were not so easy to follow.

In terms of the health system response to this pandemic, GPs in their thousands across Ireland began attending weekly webinars to update them on topics such as infection control, COVID-19 testing and palliative care of people in the community. 

“Guidelines and referral pathways for people suspected of having COVID-19 were changing at an extraordinary rate in response to new knowledge gained on this virus at home and abroad. In the Mid-West, a CHO3 Area Crisis Management Team was established to plan and coordinate activities relating to the virus across the hospital and primary care services. 

“This management team was regularly updated by public health specialists on the evolving situation, and the likely pressures that would be felt across the health system, and it was then able to make decisions accordingly. 

“The response that was initiated to support the health of people who were homeless or otherwise marginalised in Limerick city during the COVID-19 pandemic was no less enthusiastic,” he adds. Dr O'Donnell explains that firstly, a rapid and flexible approach to COVID-19 testing was adopted. 

For cases where vulnerable people needed testing, we quickly went out in to the hostels, halting sites, clinics or other settings that they were familiar with. 

In addition, a multi-agency group of stakeholders was quickly convened to develop supported isolation facilities for vulnerable people in the city. 

“These were individuals who were awaiting testing, awaiting results or who had been diagnosed with COVID-19. Representatives of Limerick City Council, Safetynet Primary Care, Mid-West Simon and the Ana Liffey Drug Project came together with HSE Social Inclusion, Primary Care and Public Health staff to plan the response. In the months that followed, we supported many people who were rough sleeping, people with addiction, people who were undocumented migrants, people from direct provision and others to isolate in a supportive setting where their health could be effectively monitored. 

“Now more than six months on, both of these measures are still running and able to respond to the changing trends in the spread of COVID-19. The success of these measures is down to the collaboration across services and the pragmatic approach adopted by all in the face of this unprecedented challenge,” adds the Limerick native.  

Dr Patrick O’Donnell has been advising HSE Social Inclusion on the COVID-19 testing and supported isolation of people from marginalised groups across the Mid-West. He has also been acting as a member of the HSE CHO3 Area Crisis Management Team since the beginning of the Covid-19 Pandemic. 

The Clinical Fellowship in Social Inclusion post he holds at UL School of Medicine was developed by the Partnership for Health Equity which is led by Professor Anne MacFarlane of UL School of Medicine, Dr Austin O’Carroll GP of the North Dublin City GP Training scheme and the HSE Social Inclusion Unit. The aim of this partnership is to advocate for evidence based primary healthcare for all, with a focus on typically marginalised groups in society.

A graduate of UCD, Dr O’Donnell also holds a Masters Degree in Global Health from Trinity College. Patrick’s main research interests are in Health Equity, Primary Care for Marginalised Groups and Medical Student Electives. -  Andrew Carey