Pandemonium: leaks and learnings behind scenes of Covid response

Pandemonium: Power, Politics and Ireland’s Pandemic was published on May 5th, just a few weeks after most Covid restrictions in the State had been lifted, and days after the Department of Health stopped announcing daily Covid statistics. As such, the book is timely and comprehensive in its coverage of the pandemic.

It also delivers what it promises; that is, “the inside story of Ireland’s pandemic: every decision, every player, every text, every leak”. The book covers the two-year period from January 2020 (starting with a prophetic email from Kevin Cunningham to then taoiseach Leo Varadkar about the novel coronavirus, stating “It is important to understand that the future is not like the past”) to the relaxing of restrictions with the Omicron variant in February 2022.

If reading about a pandemic can be a strangely enjoyable experience, this is the book that makes it just that.

One of the reasons is that it is written with the right mix of narrative and dialogue. Another is that for much of the action we are flies on the wall, watching a cast of characters interact and at times spark off each other, as they try to get to grips with Covid. This is a war story, set in the command centre, with no shortage of generals pitting their wits against an invisible enemy. It’s also about how people put their shoulders to the wheel and go the extra distance – repeatedly.

The degree of access that the two authors, journalists Hugh O’Connell and Jack Horgan-Jones (who in on The Irish Times political team) had to the key decision-makers may surprise readers (as it did me) as well as the candour of on and off the record briefings. This seems to indicate a well-earned level of trust between the authors and members of the National Public Health Emergency Team (Nphet), Department of Health officials, politicians, as well as political and Health Service Executive staff. All seemed to want to tell their story or get things off their chest – maybe to set the record straight for now, or perhaps for posterity.

Much has been written about the relationships between Nphet and politicians through the pandemic. Key players in this relationship were the State’s chief medical officer Dr Tony Holohan and Minister for Health Stephen Donnelly, and Tánaiste Leo Varadkar and Taoiseach Micheál Martin – and the authors clearly show the tensions, the cracks and some of the dysfunctionality in these relationships. Meetings over leaks are described as “carnage”. The Danish mink coronavirus issue “caused a snippy exchange between Donnelly and Holohan”.

The differing opinions between Nphet and Donnelly about antigen tests (“snake oil”) over a lengthy period, until antigen tests became the go-to product in 2022, are highlighted. Senior civil servant Robert Watt is said to have publicly “love-bombed HSE chief Paul Reid, while behind the scenes frustrations continued, especially with Reid’s media strategy”.

Two pivotal and dramatic events receive justifiable special coverage. The first is the return of Holohan to work in October 2020 after a period of leave, and the subsequent rapid change of Nphet advice to move to a Level-5 response instead of the Level 3 as proposed by Nphet , and the subsequent souring of relationships (this chapter is titled “The Ugliest Meeting”). The second is the surge of Covid-19 after the Taoiseach’s “meaningful Christmas”, when our healthcare system came closest to being overrun.

Being seasoned political analysts, the authors do not hide their views on politicians: Tánaiste Leo Varadkar (“It was a remark typical of Varadkar when he was angry; cutting, brief and primed for leaking, which it duly was.”) and Donnelly (“Relationships between Stephen Donnelly and certain journalists and outlets could be frosty, and sometimes rocky.”).

Although many of the events in this book have been previously well covered in the media, there are a few heretofore unknown events detailed. The report commissioned by Nphet and the HSE into infection in healthcare workers, which found infections skewed disproportionately to those in long-term residential facilities, such as nursing homes; this report was never approved by the HSE and never sent to Nphet, and was effectively buried, “which meant views from 400 healthcare workers never saw the light of day”.

There was also an EY consultancy team brought in by politicians to work on data-capture in relation to public compliance which fell foul of Holohan and Philip Nolan, chair of the Irish Epidemiological Modelling Advisory Group. And then there was the Nphet meeting that went on “so long (eight hours) that one member went to the dentist, while continuing to listen to proceedings on their earphones”.

Pandemonium is an enjoyable read – both for the general public and for those professionally involved in the pandemic. It will complement more academic tomes and official reports, as well as the memoirs of some of the subjects of this book that will no doubt follow in due course.

As a history of the past two years, one hopes the authors put a link to the digital version of Pandemonium in the time capsule of their census forms.

Patricia Fitzpatrick is professor of epidemiology & biomedical statistics at UCD