The first analysis of Ireland’s Covid-19 cases provides an interesting, somewhat encouraging, but ultimately incomplete picture of how we are faring in the fight against the disease.
These are early days to be crunching the numbers on cases, just three weeks after the first one occurred, it has to be stressed.
Yet the breakdown of cases by area, age and to some extent severity, provided by the National Public Health Emergency Team on Wednesday evening, offers some straws in the wind.
The number of cases recorded each day have been creeping up and, we have been warned, is set to surge over the coming weeks; 1,300 by the weekend and 15,000 by the end of the month, it has been predicted.
It will be tempting to rate our performance against these forecasts, but there is little point in doing this. This is because the more tests we carry out – and more testing is a good thing – the more Covid-19 we will find.
The UK, for example, lags behind Ireland and other European countries in the number of cases it has recorded simply because it is testing less; generally, patients are tested there only if they end up being hospitalised.
The analysis by the emergency team of the first 271 cases in the Republic show that almost one-third of people were hospitalised. Again, this tells us little, because in the early stages everyone who tested positive was being hospitalised, even if their symptoms were mild. We can expect this hospitalisation rate to roughly halve over time if the experiences of other countries is replicated.
It is encouraging that just six patients, or 2 per cent, have required intensive care so far. Translating this figure on to the forecast of 15,000 cases would mean a requirement for 300 intensive care beds by the end of the month.
At the start of this year, Ireland had about 250 such beds; we have about double this number by now as a result of measures taken to tackle the pandemic. That still leaves a shortfall, but not one that couldn’t be bridged with some more supplies and imaginative thinking – and more staff.
However, things play out differently in the middle of a pandemic-induced surge of cases, relative to our current “calm before the storm” period. Patient outcomes worsen as multiple cases arrive together and staff get infected or have to self-isolate.
Mortality rate
The two deaths so far give a case fatality rate of 0.7 per cent. This is good, but you can tell little from such low numbers.
The low numbers of deaths and intensive care cases are clearly influenced by the age cohorts affected; almost one-third of cases is among under-35s, and two-thirds among under-55s.
These figures could change hugely if the disease were to gain a foothold among older people, for example in a nursing home. Hence the need for social distancing and visitor restrictions.
There are other reasons to be hopeful. Our population is still relatively young – 14 per cent are over 65, compared with 23 per cent in Italy. We do not generally live "on top of each other" as in parts of China and Italy.
We have fewer multigenerational households in which the virus can be spread from children to vulnerable grandparents. For once, we can think of rural isolation as a positive.
All of these factors, plus a widespread adherence to social-distancing measures, should help to “bend the curve” in our favour, though by how much is not yet clear.
It remains the case, though, as I wrote as far back as February 1st, that it is the nature of outbreaks such as this for things to get worse before they get better. And this one certainly will.
We will know we are succeeding when we manage to keep as many possible out of intensive care and to minimise the number of deaths from this virus.