Subscriber OnlyHealth

Covid-19: Ireland on a knife edge as case numbers could go either way

Slow, painful gains have stalled, raising fears that we may soon lose control of the disease

Deputy chief medical officer Dr Ronan Glynn and Prof Philip Nolan, chair of the Nphet  Irish Epidemiological Modelling Advisory Group, at a Covid-19 update press conference at the Department of Health on Monday. Photograph:  Colin Keegan/Collins
Deputy chief medical officer Dr Ronan Glynn and Prof Philip Nolan, chair of the Nphet Irish Epidemiological Modelling Advisory Group, at a Covid-19 update press conference at the Department of Health on Monday. Photograph: Colin Keegan/Collins

A senior person involved in planning Ireland’s response to Covid-19 says that, in mountaineering terms, the country is at a “col” – travelling along a high ridge between two peaks.

Whether we descend, or shoot back up to dangerous altitudes, is all to play for.

The slow, painful gains made since Christmas have stalled, with case numbers over the last week raising fears that control over the disease may be on the verge of being lost.

Hospital Report

One Minister, who previously was happy to wait until the evening for the latest case numbers, admits to now poring over swab data and positivity rates as soon as they are published. Recent days have been more encouraging than last week, with 349 cases reported on Tuesday, and the five-day average number of cases dropping to 499.

READ SOME MORE

However, senior Coalition sources say that concern persists and much remains in the balance as the Government begins to plan for what restrictions can be eased early next month.

As Minister for Culture Catherine Martin told a virtual gathering of US tourism leaders on Tuesday, “the outlook will become clearer in the coming weeks.”

Some in Government believe it is now more likely than not that the construction sector will stay largely closed beyond April 5th. All agree on one thing: that the days and weeks ahead will be crucial to how Ireland experiences the next phase of the pandemic.

Stabilise

Either the numbers stabilise and resume their downward march, validating the State’s approach of incremental reopening, beginning with schools, or else they stagnate, or even worse, deteriorate. If the latter occurs, senior public health sources say, effectively they are out of ideas.

“If the slightest change in how we act pushes us back into early December growth rates, then you have to hang tight [extend the current lockdown] and wait for the vaccine, or engage in some kind of extreme suppression like a circuit breaker,” said one senior source.

In earlier phases, when numbers rose, it was sometimes possible to point to a culprit such as household visits, or meat plants. Surges have previously been arrested, in part, by targeting these settings or practices.

However, the National Public Health Emergency Team (Nphet) and the Government believe the B117 variant of the disease is proving to be a much more elusive and frustrating opponent.

Sources say analysis by Nphet shows that the more transmissible variant is having a “huge amplifying effect” once it gets into households, where on average one in three contacts is infected.

The virus, they say, is transmitting when households mix and in workplaces. When it is brought home, a higher level of infection is guaranteed as family members and housemates transmit it to each other.

Social gatherings

To get to 3,000 cases in a week, only a couple of hundred transmissions in social gatherings are needed. Give the B117 variant an inch, and it will take a mile.

Prof Pete Lunn, the ESRI behavioural economist, says this is why there is such danger inherent in relatively small slips in compliance, or higher levels of compliant social activities.

“What’s concerning me is we were making real progress and it looks like it may have stalled. And I find it hard not to link that with the modest increase in activity,” he said.

This partly explains the nervousness among policymakers. One senior source speaks of the period ahead as the “17+14” . The first number is a reference to Wednesday’s date, the second to the following two-week period when the impact of St Patrick’s Day celebrations becomes clear.

This combined with how transmission is impacted by the greater mobility associated with the reopening of schools will be a factor in whether, and how, the Government decide to ease restrictions on April 5th.

Senior sources say the Cabinet may meet later in the last week of March, to give time to consider the latest data, with decisions on what is to come communicated before Easter.

With uncertainty the only constant, Ireland is heading for yet another crunch period in its fight against Covid-19.

Jack Horgan-Jones

Jack Horgan-Jones

Jack Horgan-Jones is a Political Correspondent with The Irish Times