Coronavirus is circulating among us more widely than data shows

Ireland’s first death from coronavirus makes this country the 29th to suffer a fatality from the disease.

It is clearly also a momentous turn of events in our battle against the disease, which began just 12 days ago with the announcement of the first confirmed case in our health system.

For one family it is also a personal tragedy; sadly it will not be the only one before things start to get better.

It is important to stress that the woman who has died was both elderly and had an underlying condition. All we know about this new disease tells us it hits people in these categories hardest. This is not to minimise what has happened, merely to place it in a context.

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Most people who are in good health – most of the population – have relatively little to fear from Covid-19, and will suffer only mild symptoms.

What is particularly worrying about this case is the fact that the woman acquired the disease in the community. She had no known history of travel, so the virus must have been transmitted locally.

We now have two such cases involving community transmission, in Cork and Naas. The first that was reported occurred almost a week ago, and yet remains a mystery.

The only logical conclusion to reach from this information, and the one favoured by a number of GPs I have talked to in recent days, is that Covid-19 is in circulation among us more widely than is indicated by just these cases.

Symptoms

As a result, and in common with other countries that have been slow to ramp up testing, we really don't know how many cases we have. By and large we only know of those cases we have "discovered" because they had symptoms, came home from Italy and tested positive.

As I’ve said previously, these travel criteria were too tightly circumscribed for too long; they still are, given the widespread community transmission apparent in many other European countries.

Those countries that have done best in limiting the spread of the virus have done so by testing large numbers of people, and then chasing up the leads provided by positive tests as vigorously as possible.

Some countries have offered free tests on demand for all who want them; others have drive-in centres for testing.

South Korea, for example, worked with local biotech companies to develop kits which were used to test more than 140,000 people in a short space of time.

Here the National Virus Reference Laboratory moved quickly to establish reliable Irish testing facilities in the earlier stages of the outbreak, but it remains the only location for processing tests nationally.

There are plans to widen the availability of testing to regional hospitals, but these need to be expedited so we have the capacity to test more broadly and to produce results more quickly if possible.

Concern

It also makes sense for GPs to be able to refer patients about whom they have concerns directly for testing, instead of having to consult with already overloaded public health officials.

Unfortunately, but inevitably, any increase in testing is likely to bring bad news in the form of more positive results. But it is only through having a more accurate picture of the spread of coronavirus in the country that we can make, and time, the restrictions necessary to prevent its spread.