Very radical change is needed over the six-week period of this tragic lockdown if Irish society is to survive socially, culturally and economically.
The National Public Health Emergency Team (Nphet) is, in effect, the Department of Health and the Health Service Executive rolled into one at senior level. It is the health establishment; it is not simply an expert body advising our health establishment. It is to our health system what the curia is to the Roman Catholic Church. And it suffers from all the same dangers and delusions. Its relationship with the tiny political superstructure of elected Ministers and their special advisers is completely unbalanced with predictable consequences.
Hospital Report
The first radical change for which I argue is the introduction of total transparency. By that I mean that all advice and every single piece of data upon which decisions are taken or advice is given is made public instantly so that it can be understood and evaluated. On Tuesday on the radio, most elected politicians sadly admitted that they had no access to Nphet’s data, raw or distilled, or to Nphet’s briefing or advice.
What is, for example, the exact benefit and cost of closing down most retail activity?
If decisions are to be taken by the Government on the basis of Nphet data, modelling, projections and advice, is there any case for one comma of it to be kept secret? Is there any justification for according Nphet the function of sole State advocate or editor or interpreter of unseen data or propagator of secret proposals?
Second, we need urgently an economic emergency sectoral team which can assess and minimise the disastrous side-effects of purely public health strategies, and estimate accurately the price we are exacting for accepting Nphet advice. What is, for example, the exact benefit and cost of closing down most retail activity? Are all factories vectors of community transmission?
Psychological damage
Third, we need another emergency team that researches, quantifies and advises on other health issues involved in lockdowns, such as mental health, non-Covid deaths, suicides, psychological damage of lockdowns and socio-cultural destruction.
We need press conferences where these different teams give us separate information and data with the same publicity as the Nphet events.
With Nphet allies being granted access to the airwaves to predict 20,000 or 30,000 deaths as has recently happened, surely we are entitled to know exactly what scenarios were painted by Nphet for the Government’s consideration - and in minute detail? We know that some of their advice around nursing homes has been wrong in the past. Likewise, we know that they have flip-flopped dramatically on the safety and utility of mask-wearing.
Exactly what were the proportions of the projected crisis that they outlined to the Government which persuaded Ministers including the sceptical Leo Varadkar to “come on board” the Nphet agenda?
Living with and minimising Covid must have at its heart a really strong testing and tracing system
Are we entitled now to know whether they really do predict that in six weeks the daily rate of infections will fall to 50, justifying a relaxation in the Level-5 lockdown in the run-up to Christmas? Has Nphet predicted that a further lockdown will probably be required immediately after Christmas? What are the probabilities of these events, according to Nphet? Are we entering an era of Groundhog Day lockdowns strongly condemned by the World Health Organisation?
Utter failure
What so often happens is that targets are fixed at a political level which the administrative organs of the State simply hope will happen rather than make happen. The utter failure of the test-and-trace plans of the HSE (or should that be the Department of Health or someone else?) is a case in point. Living with and minimising Covid must have at its heart a really strong testing and tracing system. The United Kingdom has been just as inept as we have been.
On September 3rd, RTÉ broadcast an item about an unfortunate young doctor who contracted Covid at the age of 23. The nation was informed in detail of the very serious effects and the dangers he encountered during his treatment. A month later, the same young doctor was presented by Nphet at its daily press conference to repeat his sorry tale. That demonstrates that Nphet does not consider itself to be a purely advisory body to the Government, but also accords itself an advocacy role.
If lockdowns, as WHO now states, are only defensible as temporary measures to buy time to mobilise and organise health resources, the next few weeks should be used to do that but also to reorganise the decision-making and accountability of our political control of the health sector. The alternative is sustained failure. Leading to social and economic disaster.