The continuing rise in the number of people with Covid-19 in hospital is starting to cause some concern among experts but, so far, not so much as to force a rethink in policy.

Even if half the cases are incidental, the breaching on Monday of the 1,000 barrier for hospitalised patients with Covid-19 was an unwelcome reminder of the bad old days of the pandemic.

The figure is likely to continue rising because the number of infections has been growing for some weeks. As a result, hospitals are under enormous strain, and have themselves become centres of disease transmission.

Hospital Report

And while ICU numbers have remained stubbornly stable up to now, this figure may now start to creep upwards.

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Infectious diseases doctor Catherine Motherway summed up clinical sentiment on Monday when she admitted being “a little concerned” about the rise in cases, but noted that thanks to widespread immunity, the effect on people’s health “isn’t as dramatic as it was at the very beginning”.

The rise in hospitalisations is not unexpected, of course, given the extent to which society has opened up. The worry is that numbers might continue rising for some time, rather than plateauing and then falling again.

Vaccines and boosters continue to protect well against serious illness and death. Previous infection also confers immunity

Many thought the latter would have happened already, due to a combination of protection from boosters and prior infection. But it hasn’t quite worked out like that.

For a start, having had the Delta variant before doesn’t protect you from being infected with Omicron. Then, the protection afforded by vaccines and boosters is waning significantly over time. In addition, fewer people than hoped have bothered to get a booster – 70 per cent of adults compared with the 95 per cent who got a vaccine.

Many European countries are seeing cases increase, and some experts are already calling the start of a sixth wave. Again, mostly, it’s down to the lifting of restrictions, plus the rise of the BA.2 subvariant of Omicron.

Unlike earlier in the pandemic, most people can call on excellent tools to protect themselves against the virus. Vaccines and boosters continue to protect well against serious illness and death. Previous infection also confers immunity.

Vulnerable groups are at greater risk when disease is so prevalent in the community. Understandably, many feel their concerns have been forgotten since the restrictions were ended.

The National Public Health Emergency Team (Nphet), did warn, when recommending the lifting of restrictions last month, that the pandemic was not over and that the outlook was uncertain.

“We cannot fully rule out the reintroduction of measures in the future and we must continue to ensure our response is agile and flexible, with an ability to pivot rapidly and respond to any emerging threat,” chief medical officer Dr Tony Holohan told Government in January.

Communications deficit

The end of Nphet briefings has left a communications deficit, though, leaving some people feeling they are in the dark on the threat posed by the virus. The end of mass testing makes it harder to know how much infection is circulating; the daily number of antigen tests reported along with PCR tests is almost certainly an underestimate. Meanwhile, we seem to be genomically sequencing very few cases, so it is not certain we know enough about virus mutation.

There were mixed views at the time about the quick ending of the mask mandate, and some members have lingering regrets, but this is seen as water under the bridge now

BA.2 does not seem to be more harmful than Omicron but at some stage it is possible a more lethal variant will come along. We need to be able to spot this quickly when it happens.

When giving the green light to abolishing restrictions, Nphet did not foresee triggering their reintroduction when hospitalisations, ICU admissions or deaths reached a particular level, a former member says.

“The plan was to have surveillance, so we would have the information quickly on which decisions could be based.”

There were mixed views at the time about the quick ending of the mask mandate, and some members have lingering regrets, but this is seen as water under the bridge now.

With Nphet disbanded, the surveillance continues, largely under the radar, in the Department of Health and the Health Service Executive. No one is yet sounding an alarm bell and the hope remains that the current wave will “top out” within weeks. “Sometimes, you just have to hold steady,” the former Nphet member said on Monday.