An all-island plan is now "the only way" to tackle the high number of Covid-19 cases occurring on both sides of the Border, public health expert Dr Gabriel Scally has said.

Calling for an emergency summit of Dublin and Stormont ministers, Mr Scally declared: “Sit in a room and hammer out an agreement about how we’re going to control this virus,” he said.

A “unified approach” should have been taken from the beginning, he complained. “We’re paying the price for the failure, and particularly the Border counties are obviously paying the price for that.”

Hospital Report

He said he "did not know of any benefits" that had resulted from the Memorandum of Understanding which was signed between the Republic and Northern Ireland.

Coronavirus search: How is Covid-19 spreading in your locality?

---

Covid-19: Nphet advises against travel from abroad as 395 cases and one death recorded

---

Crackdown on outdoor drinking in Blackrock after street furniture attracts crowds

---

Irish people abroad should not book flights home for Christmas yet, Varadkar says

---

“Certainly, I can see no harmonisation that has taken place as a result, and very limited if any integrated working, whereas we should have had an agreed approach across the whole island,” Dr Scally said.

‘Porous’

Asked why the Covid-19 figures in Donegal continue to remain so high, despite falls elsewhere in the State, Dr Scally said: "The Irish border has always been porous and people have always moved across it," he said.

"It's 310 miles of the most permeable border in Europe, probably . . . which is why it has always been a nonsense to have different approaches to responding to the virus between Northern Ireland and the Republic."

Donegal’s case numbers are now twice the national average, according to the Health Protection Surveillance Centre (HPSC). It has had 479 cases in the last 14 days – equivalent to 300.9 cases per 100,000 there.

Dr Denis McCauley, a GP based in Stranorlar, Co Donegal and chair of the Irish Medical Organisation's GP committee, blamed 25 cases in the county on a wake that took place close to the Border.

“Generally speaking, in the south and west of the county, it is generally quiet. The east remains busy probably because of cross-border transfer,” Dr McCauley told The Irish Times.

Letterkenny University Hospital has cancelled planned surgeries as it struggles to cope with the numbers. All but one bed in the hospital has been filled in the last 48 hours. Currently, it is treating 25 Covid-19 patients.

Garda checkpoints have not been as visible as previously, said Dr McCauley: “Our incidence rate is reflective of being beside a part of Northern Ireland that has the highest incidence, that’s Tyrone and Derry,” he added.

“The figures last night show that they are the most pronounced area in Northern Ireland. So we’ll always have a blow-back to that but there are some exceptional issues, which is the hospital and wake.”

‘Better understanding’

Donegal TD Joe McHugh said there needs to be a “better understanding of where the issues are” within the county and that the Border is presenting “a massive problem”.

“Altnagelvin Hospital [in Co Derry] is at capacity and it’s not a question of equipment. A doctor who spoke this morning was saying it was a question of actually having enough staff to deal with their level of demand.

“Altnagelvin is not just a hospital for Derry, it acts as a hospital for Inishowen as well,” said Mr McHugh, who feared for the consequences of any near-term easing of Northern Ireland’s measures to tackle the virus.

"The region is so intrinsically linked in terms of work, commuting. Buncrana is effectively a satellite town of Derry city and that's going to be a major problem if the North relax their rules even further."

Cross-border commuting in both directions is driving the numbers, said Jimmy Stafford, president of the Letterkenny Chamber of Commerce, pointing to the Letterkenny-based multinationals Pramerica, Zeus and Optum.

“Between them they employ over 4,500 people,” he said, though he accepted that many of them are working from home. “That’s happening both ways. We’ve people in Donegal who work over the border.”