Coronavirus: People are scared but they want the truth

Facing into some of the hardest weeks this country will ever have experienced, it comes down to this: people in the first half of life have to act immediately to save the health and lives of people in the second half of life.

Older people too have to modify their activity but most of them already heed health messages and have reduced their social interactions as the years have passed.

The younger among us have to forswear their traditional pleasures – play, sport and gyms, socialising – for a period in order to cease being vectors for a disease that will likely spare them but may sicken and kill many of their parents and grandparents.

Most of them will live on to play and party again. But do they want it on their collective conscience that they spread the virus at a time when health services were overloaded and patients unable to access proper care?

How coronavirus became a corporate credit run

---

Italian FA to ask for Euro 2020 postponement

---

‘Herd immunity’ is not our policy, says UK’s health secretary

---

Coronavirus: EU ministers to discuss next steps as Donohoe promises support

---

There’s a story I read for my six-year-old that illustrates the challenge we’re facing – and the price we might pay for our foolishness.

In the legend the emperor of India wants to reward a wily sage who has designed a beautiful new chessboard. The sage says he doesn't want much; just a grain of rice on the first square of the board, double that on the second, and so on.

The emperor is delighted at the bargain he has struck – until his advisers tell him of the terrible mistake he has made. The sage’s reward is growing exponentially, and by the 64th square he has gained enough rice to cover all of India to the depth of one metre. The emperor is destitute, and the sage has taken all.

Substitute the virus for the sage with his grain of rice, and you can see where we are. With the number of cases doubling every few days, it isn’t so much about where we are right now, with our hundred-or-so cases; it’s where we’re headed that matters. We will be destitute, and the virus will have taken all we value, if we do not act.

And where we're headed, unfortunately, is towards an Italian-style meltdown; before the Government announced restrictive measures last Thursday, we were 14 days behind Italy in terms of a massive expansion in cases.

Just because social distancing and schools closures have been introduced does not mean that situation has improved, if the measures are not being followed or if they are not comprehensive enough. The pictures coming out of Temple Bar at the weekend would make you weep.

We won’t be able to say we weren’t warned. As one Italian doctor working though his country’s carnage said this week: “You will not recognise or prepare fast enough for the sudden influx of critically ill patients and they will keep coming.”

"It's coming at an exponential speed; gradually, and then suddenly," said British global health expert Prof Anthony Costello.

Ireland is in the gradual stage, and some are sleepwaking into the crisis. Official figures tell us we have 169 confirmed cases of the disease, but the real number is much higher. By how much we do not know, but it is clear the virus is circulating in the community in parts of the country; perhaps most of it.

By one US estimate, if you’re not diagnosing all cases, one death today means 800 true cases today. This points to the true number of cases here being a multiple of confirmed positive tests.

Yet as World Health Organisation (WHO) boss Dr Tedros Adhanom said on Friday: "You can't fight a virus if you don't know where it is."

We know the virus can spread before people show symptoms. Some people can act as “super-spreaders”; patient 31 in South Korea passed the disease on to thousands of people.

Remember, Italy is worse than Wuhan was at its worst. In Italy, one in eight infected patients have needed intensive care; in China, it was one in 20. The death rate is also much higher.

Remember, too, that Italy has a good healthcare system, better equipped and resourced in many ways than Ireland’s. Back in 2012, it had twice as many critical care beds as Ireland, and that still isn’t enough. We do have a lower proportion of over-65s than Italy, which should help.

We have a crisis but no plan for handling it. We won’t tell people how much of the population will be affected by the virus. We have implemented stringent measures but have only just started the computer modelling that will tell us what impact they will have. We don’t know how many cases are really out there in the population. We have a bottle-neck in testing, which hopefully will be only temporary.

The time for sugar-coating is past, for blandly saying most people will be okay

The WHO talks of stopping the virus, and countries like Taiwan and Singapore seems to have done just that, but our Government talks only of slowing the spread. Is that a failure of ambition, or a recognition that things have gone too far?

It may be the authorities have a national plan, and they know all the answers to the questions raised above. It may be they don’t want to scare people, to induce panic, to instigate more stockpiling.

These are all admirable motives but people are scared anyway. They are also ready for the truth. They know the threat they are facing and they want to know exactly how we are going to fight it.

The time for sugar-coating is past, for blandly saying most people will be okay. True, 80 per cent will suffer only mild or moderate illness, but this category includes patients who get pneumonia.

In Italy, one in 20 patients is their 30s, one in 10 in their 40s and one in seven in their 50s; this is by no means a disease confined to the very old.

Our new measures are a start but, as the WHO's Dr Mike Ryan said last week, the purpose of social distancing is only to "slightly slow down the virus so the your health system can cope".

Social distancing is not a panacea, he pointed out, and it’s not going to stop the pandemic on its own.

The way of achieving this is by rapidly finding possible cases, and by widespread testing, isolation and treatment. As much as possible, as quickly as possible.

There’s a lot to play for: countries that were well prepared and acted fast will have a fatality rate of less than 1 per cent; countries that are not, 3-5 per cent. Our actions over the coming days – whether we close bars and nightclubs, or lock down specific areas – will determine which outcome we get.