Nphet minutes show ‘differing views’ among members on removal of Covid pass

Some members of the National Public Health Emergency Team (Nphet) argued for the retention of the Covid-19 pass system during a meeting last month which ended with the team approving the easing of most pandemic curbs.

Minutes from the group’s January 20th meeting, which paved the way for the removal of almost all restrictions, including the need for the digital pass to access indoor hospitality, note there were “differing views” on whether the certification system should be retained.

Some members in favour of retaining the pass said it provided reassurance for vulnerable populations and provided a reminder – especially to unvaccinated people – that they need to “remain cautious about exposing themselves to higher risk environments”.

It was also argued the pass could assist in increasing booster vaccine uptake, but the minutes acknowledged this was “not the intended purpose” of the pass.

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The meeting agreed, however, that the pass had “diminishing utility” due to the fact that vaccine effectiveness against symptomatic infection wanes over time. While vaccine passes were updated to show booster doses, people did not need a third dose in order to access indoor hospitality.

Not proportionate

The team considered whether to add a requirement for a third booster dose to the pass but “this wasn’t deemed a proportionate measure given the current epidemiological profile of the disease”. There would also be practical difficulties with continuing with the pass as it would have to “continuously recognise evolving vaccine policy”.

Chief medical officer Dr Tony Holohan told the meeting that Nphet would need to provide a "firm public health rationale" for keeping any of the measures.

The minutes show some discussion took place in relation to easing measures gradually, but a more accelerated approach was favoured, with all measures apart from masks and some other interventions being advised for immediate removal.

The meeting heard that despite the less severe impact of the Omicron strain on those infected, it was “unlikely to be the last variant of concern” and the need for new measures could not be ruled out in the future. The minutes note cases were likely to “increase again next winter and that it is important to prepare for this”.

Key measures

It was “noted with concern” that a unified outbreak management IT system was not yet in place, and the team heard suggestions that rather than focusing on case numbers, emphasis should shift to the numbers of deaths, people in hospital and intensive care units as the key measures of the severity of the disease.

The discussions also focused on the long-term impact of Covid-19 on healthcare, and how legacy impacts risked combining with long-standing deficits in care. The minutes show the team discussed how “the pandemic has shone a light on how inequalities in our society make us vulnerable as a whole”.

“Increasing our resilience to future health threats will require that these inequalities be addressed,” the minutes state.

However, with case numbers not converting into hospitalisations, the meeting agreed “the focus must now turn to non-Covid care and to those patients who have time critical needs”.

“There is an urgent need to address waiting lists and to mitigate the harm caused by the delay in patients presenting for treatments as a result of the Covid-19 restrictions,” Nphet members said.

Backlogs worsened

There was an acknowledgement that existing backlogs in the health service had been “worsened by the cessation of certain services and procedures over the course of the pandemic and the potential for long Covid to increase the burden on health services in the future.

“This further underlined the need for an ongoing strengthening of health service capacity,” the minutes say.

“Due to the impact of Covid-19, the health service is under significant strain and will continue to be for some time after the pandemic has subsided,” the meeting heard, while also acknowledging that as focus moved from Covid, “attention must be retained on the long-standing deficits that were exposed during the pandemic”.