Nphet records 48 further deaths and 1,254 confirmed Covid-19 cases

Zero-Covid strategy not a ‘false hope’, says public health specialist

Public health officials have rejected as impractical and risky the "zero-Covid" strategy increasingly advocated by Opposition politicians. Video: RTÉ

A further 48 deaths of Covid-19 patients have been reported by the National Public Health Emergency Team, 45 of which occurred in January.

This brings to 3,214 the total number of deaths in the pandemic.

The median age of those who died is 82 years and they ranged in age from 30 to 99 .

Hospital Report

Nphet also reported 1,254 confirmed cases of the disease, bringing to 193,892 the total number of cases in the Republic.

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Of the new cases, 437 are in Dublin, 146 in Cork, 76 in Meath, 69 in Wexford and 62 in Kildare, with the remaining 464 cases are spread across all other counties

The median age of cases is 42 years and 54 per cent are under 45 years.

The 14-day incidence of the disease has fallen to 575 cases per 100,000 people nationally. Monaghan has the highest county incidence, followed by Louth and Waterford. Leitrim has the lowest incidence.

The five-day moving average is 1,269 cases per day.

On Friday afternoon, 1,518 Covid-19 patients were hospitalised, down 49 on the previous day. This included 211 patients in ICU, down five. There were 51 additional hospitalisations in the previous 24 hours.

Public health restrictions to curb the spread of Covid-19 will continue to be needed even after the more vulnerable members of society have been vaccinated, the chief medical officer has said.

Dr Tony Holohan said the high level of compliance to public health restrictions currently being observed must be kept up as further groups of people await their vaccines.

He told RTÉ’s Six One News that although a number of vaccines have been proven to prevent serious illness in people infected with the coronavirus there is not yet enough evidence to show it prevents transmission.

He warned that people who have been vaccinated must not relax their compliance with public health measures.

“We know that we don’t have to have a vaccine to prevent people from picking up this infection. We know that these measures that are in place, and if we follow them, can drive down the levels of transmission,” he said.

The reproductive number, which is now between 0.4 and 0.7, is “probably lower than we might have expected even with the introduction of these measures”, he added.

People of all ages are vulnerable to the virus, and there are many young people without any underlying conditions currently in hospitals and intensive care units being treated for Covid-19, he said.

“When this virus spreads at the kind of rate we have seen in recent weeks, even people who were in low risk groups pick up this infection in significant numbers,” he said.

Dr Holohan said he is “hopeful” that evidence will emerge over the coming weeks and months to show some of the vaccines will be able to prevent transmission. “If we get that evidence we will be able to contemplate opening up wider aspects of society.”

Hospitalisations, admissions to intensive care units, and mortality are the “unfortunate inevitable consequences” of such high transmission of the virus seen in the State at the end of 2020.

There has been a very large level of mortality in recent weeks, but there will be a drop in the number of Covid-19 related deaths over the coming weeks, he said. For every 1,000 cases of Covid-19 in Ireland, five to six people lose their lives, he said.

“The encouraging thing is that the good work we have done over the last number of weeks as a society is now beginning to feed into a slowing down of that level of mortality,” he added.

While the rate of the disease is now “significantly better” than it was two weeks ago, Dr Holohan said, the trajectory can change “very quickly”. If the measures are followed to a high degree over the next few weeks, considerations will be given to resuming important public services such as childcare provision, the reopening of schools, and the resumption of other essential health services.

Meanwhile, public health specialist Prof Anthony Staines said earlier that the Government has not got a long-term strategy to tackle Covid-19 while the first four weeks of the year have been "wasted" fighting about "zero-Covid", Prof Staines is among those calling for zero-Covid and said the Government's current approach to the virus will lead to "reoccurring lockdowns before the vaccines kick in".

Prof Staines is professor of public health systems at Dublin City University (DCU) and a member of the Independent Scientific Advocacy Group (ISAG) recommending a zero-Covid strategy.

“We’ve wasted the first four weeks of this lockdown, we could have used that time to bring in resources, to build and improve systems. Instead we’ve used it fighting about zero-Covid. We could have had it done and under way by now,” he told The Irish Times.

“The Government hasn’t got a long-term strategy, it is respond, respond, respond. The virus is ahead of us all the time. I was talking about playing whack-a-ball with the virus in March last year. We’re still playing whack-a-ball with the virus and we’re losing.”

Zero-Covid is the point where Covid-19 has been driven down as close as possible to zero through strict control measures.

Prof Philip Nolan, chair of Nphet's epidemiological modelling advisory group, said on Thursday "it is an utterly false promise to say we can go to Level 0 or 1 in the space of weeks or months".

“That won’t happen, and it would be an incredibly risky thing to do because we will inevitably be a leaky country and get reintroduction of disease, and that could easily be new variants,” he said.

Prof Nolan said he shared the aim of reducing community transmission of the virus to “as close as practicable” to zero, stopping non-essential travel and doing “everything we can” through testing and isolation to limit the risk of reintroducing infection.

“But we have to accept in the circumstances of this country that no such system will be perfect and can guarantee the complete exclusion of any new disease or variant.”

Dr Tony Holohan, chief medical officer, said zero-Covid would be very difficult to apply “in a realistic way in an environment like ours”.

Ireland is a small economy dependent on its links with Europe and "we simply couldn't realistically seal the borders of this country and stop people moving in and out", he said.

Responding to Prof Nolan’s remarks, Prof Staines said “it is not false hope”.

“The worst thing that could happen with zero-Covid is we try it and fail. We would not be one iota worse off if we did it and we might be better off because we might be able to control cases within our community,” he said.

“Even if we got that right and nothing else, it wouldn’t get our lives back to normal but it would reduce the number of cases.”

Prof Staines said that zero-Covid wouldn’t require “sealing the border” but that travel between the North and South would have to be limited.

“What you do for the border is you manage it, border communities can still go backwards and forwards...you make arrangements for air crew, for sailors, lorry drivers,” he added.

“What is much harder, but unfortunately deeply necessary, is people not coming home for funerals, for weddings. The hard bit is the people who really have a good reason to come home and can’t. I’m not trying to minimise the burden of those people, it’s horrendous but this is a horrendous infection.”

Prof Tomás Ryan, a neuroscientist at Trinity College Dublin, said zero-Covid has never been "formally considered by the Government or by Nphet".

"There's no documentation to say they have, it's just rejected at press conferences and they just reject it in the Oireachtas. That's not formally considering what it would look like," he said.

Prof Ryan said all of the justifications given by Nphet for rejecting a zero-Covid strategy were “non-medical, non-scientific reasons”.

“I thought it was bizarre, you had Prof Nolan and Dr Holohan rejecting a strategy while not offering another one and more than that, rejecting a strategy based on economic reasons, based on political reasons,” he said.

Paul Reid, chief executive of the HSE has said debate about a zero Covid strategy was frustrating and he attributed it to displaced anger

Mr Reid told Newstalk Breakfast that anger and frustration about the virus and restrictions was being shifted “to something else” – it had been focused on young people, meat plants, international travel, but ultimately it was all about behaviour.

“I don’t believe it’s possible to lock it [Covid] out,” he said.

A full range of measures would be necessary to suppress the virus, he added. “It’s not about closing the island. I wish it were that simple.”

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.

Sarah Burns

Sarah Burns

Sarah Burns is a reporter for The Irish Times

Ellen O'Riordan

Ellen O'Riordan

Ellen O'Riordan is High Court Reporter with The Irish Times