Not for the first time, the course of the pandemic in Ireland is being determined to a great extent by what happens across the Irish Sea.
Blessed with the best scientists yet cursed with some of the worst political decision-making during the pandemic, the UK continues its rollercoaster ride with Covid-19.
Slow initially to understand the threat posed by the virus, it suffered more deaths per head of population than almost any other country in Europe. Yet British researchers have led the world in genomic sequencing and vaccine development, and the speed of vaccine rollout this year has been impressive.
Predictably perhaps, national pride at these achievements came before a fall, as the Delta variant swept over from India and established a European foothold in northern English cities.
In the space of weeks it became the dominant variant in England, where it threatens to undo some of the progress made with the vaccine campaign. Now, it is spreading rapidly around the world, posing a threat that is inverse proportion to the rate of vaccination in a country.
Initially, the UK thought it was “out the gap” because its vaccination rollout was so advanced, only for a second flaw in its strategy to emerge. From early this year, it opted to maximise the interval between the administration of vaccine doses, so that as many people as possible could get at least one dose as quickly as possible.
Fair bet
The vaccine of choice was AstraZeneca, developed by its own scientists and touted constantly by nationalist politicians. That said, the move to a 12-week gap was backed by the UK's chief medical officers, and seemed like a fair bet at the time.
Too late, the scientists discovered AstraZeneca – and Pfizer – is only 33 per cent effective against infection with the Delta variant after one dose. The UK went from being the best protected country in Europe to a land filled with people at risk of dangerously overestimating their post-lockdown levels of protection.
Even after two doses, AstraZeneca offers only 60 per cent protection against being infected with the variant (Pfizer gives a respectable 88 per cent, according to early studies).
Meanwhile, the politicians were dithering again. Evidence of the risk posed by the Indian variant started accumulating from late March, but the UK government declined to put India on its "red list" for travel for another month, even though it added Pakistan.
Cancelled visit
British opposition parties have linked the delay to prime minister Boris Johnson’s plans to visit India in April, which ultimately had to be cancelled.
Curiously, Ireland held off on mandatory hotel quarantine for travellers from India for even longer, until early May, basing its decision partially on data from England.
Whereas we have managed to keep the lid on case numbers so far, infections in the UK have soared. Surges initially occurred in places like Bolton, with large Indian communities, but have since spread almost nationwide.
The World Health Organisation says the variant is "poised to take hold" across Europe, and already in the US it accounts for 6 per cent of cases.
The variant is at least 40 per cent more transmissible than the alpha (UK) variant that hit Ireland after Christmas, which itself was 40 per cent more infectious than previous types.
It may also increase the risk of hospitalisation and it does affect vaccine effectiveness. There are reports of new sets of symptoms more often linked with this variant, such as headaches, sore throats and runny noses.
Fresh restrictions
Understandably, countries want to keep the variant out for as long as possible; hence, the fresh restrictions on travel with the UK under consideration by Ireland and many other countries. That hardly addresses the problem, though, as data on variants, obtained by genetic sequencing, is patchy; the largest concentrations of variant cases may be in areas where little or no sequencing is carried out.
Mass vaccination and testing drives work, as Bolton has shown. British scientists have already found a way of identifying variant cases more quickly. They have also shown, in Bolton for example, that targeted vaccination and testing drives work.
Vaccination, though, remains the best defence against the variant. All the vaccines greatly reduce the risk of serious illness from any variant, with a new Public Health England study showing two doses of Pfizer and AstraZeneca give more than 90 per cent protection against being hospitalised.