After another week of reverses and confusion along with some gains in our pandemic odyssey, there is one truth that trumps all others.
Vaccines work against Covid-19, and the sooner we get them to people the sooner this crisis will pass. The job of politicians and health officials is to get as many people immunised as possible as quickly as possible.
The real-world evidence is there for any doubters. In Israel, with more than 60 per cent of the population vaccinated, the requirement to wear masks outdoors ends this weekend. The UK, well ahead of us in terms of doses delivered, opened up this week after cases and deaths fell to a six-month low.
Hospital Report
Ireland is behind overall but our early efforts have been concentrated in specific vulnerable groups, and these are starting to reap the benefits.
There were no outbreaks in long-term care facilities last week, for the first time since July. You have to go back to August for a time when case numbers among healthcare workers and over-85s were as low as they are now.
We have gone from a “glass half empty” to a “glass half full” situation in the space of a few weeks. Certainly, people’s willingness to continue limiting their social contacts has helped reduce case numbers, but wider vaccination is the factor that made the difference.
Yet the week was dominated by concerns about rare reported side effects of the AstraZeneca and Johnson & Johnson vaccines and the messy introduction of mandatory hotel quarantine.
Concerns about these rare clotting events are real, but decisions about what to do were made without due regard for the practical fallout. Despite supposedly singing off the same data-sheet, regulators in Europe managed to arrive at multiple different decisions about the AstraZeneca vaccine – some carried on as before, Denmark stopped its use completely, while other countries including Ireland imposed age thresholds, which themselves varied from country to country.
Strange science
Our experts decided to stop using AstraZeneca in people under 60, even though your average 25-year-old was more than three times more likely to die in a road collision than to suffer serious side effects from the vaccine.
Though it was not an easy decision make, it was surprising to hear acting chief medical officer Dr Ronan Glynn say the age threshold could just as easily have been lower than 60.
Where is the science in that, or in the “abundance of caution” espoused by the National Public Health Emergency Team (Nphet), when the threat posed by Covid-19 is so much greater for most of us?
The result is that AstraZeneca is now deemed fit for blanket use on the 60-69-year-old group alone, and many of in this group are sceptical. “Not old enough to be very vulnerable but not young enough to be very valuable,” said one doctor, describing the “reticence” felt by her family members about the vaccine.
The cautious approach advocated by Nphet has saved lives, while forcing the closure of large swathes of the economy for months. But a resistance to change has led us down some strange paths, such as tolerating the arrival of Italian rugby fans in Dublin at the start of the first wave, or delaying the use of masks to protect against the virus, or refusing to believe Covid-19 is an airborne disease.
Now, rapid antigen testing is being introduced in third-level colleges, but not until September, when hopefully it won’t be much needed.
The fiasco of mandatory hotel quarantine shows real life is more complicated than any theoretical model. People were happy enough forcing nameless foreigners into a hotel room for a fortnight but when those affected were Irish people with dying parents or surrogate children, things took on a different complexion.
Half-island
Prone to evasion and already chock-full of exemptions, the system shows how hard a real “zero-Covid” policy would be to implement on our half-island.
Was earlier talk of another surge warranted? Just a few weeks ago, unnamed Government Ministers were briefing journalists on the possibility of 1,000 cases a day, but this never materialised. Taoiseach Micheál Martin told us the UK variant (B117) was “significantly more dangerous”, but Irish figures and recent studies show it isn’t.
B117, which is more transmissible, hit us for six after Christmas but since then it has been crowding out other problematic variants, an upside that is often overlooked.
"Scariants", as they have been named by one US commentator, have become a media trope. Every day brings a new report of some hair-raising mutation, such as the "double mutation" variant from India, reported on Friday.
Ignore most of these reports. It is perfectly normal for a virus to change and for hundreds of variants to emerge. Only a handful of Covid-19 variants have been designated "variants of concern" – including those from the UK, South Africa and Brazil.
The fact is the vaccines protect greatly against the risk of contracting the virus and provide excellent protection against serious illness, regardless of variant. They also seem to reduce transmission.
Instead of feeding fear, we should be unwinding it. Rather than telling people what they cannot do, we should be planning for what they will be able to do. That means dates, risk stratification, clear targets and co-ordination with our neighbours.
We can start by allowing fully vaccinated people to enjoy the benefits of their status.
