Covid-19: We're only half way at best and the road ahead looks like a long slog

Effective system for tracking virus will require results of tests available much quicker

The supply of personal protective equipment for healthcare workers remains a source of complaint for many on health’s front line. File photograph: The Irish Times
The supply of personal protective equipment for healthcare workers remains a source of complaint for many on health’s front line. File photograph: The Irish Times

The rule of marathon-running, it is said, is that the first half lasts 20 miles – and the second, six-and-a-bit.

It’s a little like that with the Covid-19 epidemic; having put in the hard yards over long stretches, we find we’re only halfway on at best and the road ahead looks like a long slog.

Ireland’s plan to escape the lockdown – described by officials who designed it as cautious and conservative – cleaves to the best international advice.

But it is also the product of the situation the country found itself in at the start of this month, with too many cases and deaths occurring each day, and too much of the virus circulating in ways we knew too little about.

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Moreover, it takes account of the frailties in the system that have hindered, and may continue to hinder, our effectiveness in hunting down remaining cases so the virus does not make a return.

These include the supply of personal protective equipment for healthcare workers, which is still a source of complaint for many on health’s front line.

Despite an increase in testing capacity, that system still does not inspire confidence, with reported average turnaround times in the community of three to four days and continuing anecdotal reports of much longer waits – 12 days, in the case of one person who contacted me yesterday. The hospital system, where samples from healthcare workers are tested, works faster, but here too delays are reported.

An effective system for tracking the virus will require the results of tests to be provided much quicker – at most 24 hours – so that cases can be identified and contacts put into isolation.

The same applies to contact tracing, where only a fraction of the number of staff trained for this work are being used. This is despite it taking an average of six days to complete contact tracing for each case.

In the run-up to the first loosening of restrictions on May 18th, some hard decisions will have to be made on travel into the country. We got it wrong on foreign travel; allowing Italian rugby fans into the State, and Cheltenham fans out of it, and failing to implement either a travel ban or a mandatory quarantine to help stop cases being imported.

These are harsh measures, but if they had been implemented earlier, we might be almost ready to lift them now, as other countries are.

Taoiseach Leo Varadkar told the Dáil during the week that making it mandatory for visitors to fill in forms to self-isolate for 14 days was "not good for tourism". Yet it is hard to see what tourism is likely to happen for months to come.

Tougher restrictions on travel might allow for a greater or an earlier loosening of internal restrictions, as scientists try to juggle the loosening of different measures in such a way as not to set off a second wave of the virus.

The challenge posed by unrestricted travel across the Border with Northern Ireland would remain, but at least the approaches for the two jurisdictions appear to be converging.

The lockdown was a one-size-fits-all response to an imminent crisis; what is needed now is greater nimbleness, flexibility and targeting.

Not all measures had the same impact in terms of curbing the virus, as a study published last week by the University of East Anglia suggested. Banning mass gatherings, closing pubs and restaurants and shutting schools had the most impact, while stay-at-home policies and blanket business closure were far less effective, it found.

After the initial restrictions, many of the measures we subsequently introduced effectively doubled down on the broad mass of people who were already adhering to the “new normal”.

As we went on to find out, a huge number of virus cases are concentrated in specific areas – healthcare workers, residential care settings, meat factories, marginalised groups. Up to now, the system has been slow to identify and target these areas with approaches tailored to the needs of those affected.