Better coronavirus testing key to society returning to some kind of normality

Ireland’s fate remains finely balanced as we enter possibly our strangest Easter since 1916

Officials have been unforthcoming about the   figures, but it is clear that there are serious delays in getting a test, and in the results of these tests being processed. Photograph: Alan Betson

Officials have been unforthcoming about the figures, but it is clear that there are serious delays in getting a test, and in the results of these tests being processed. Photograph: Alan Betson

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So, as we enter possibly our strangest Easter since 1916, how are we doing?

In summary: well enough to feel proud of our achievements in stemming the spread of coronavirus but, unfortunately, not well enough to justify lifting restrictive measures yet.

To recapitulate what I’ve written in previous columns, the good things we’ve done include: reacting early; following an evidence-led strategy; allowing the experts to lead our response; introducing step-wise measures and adhering to them; invoking radical changes when these were needed; ramping up capacity to deal with a surge in cases; and pulling together as a nation.

Against this, we have not excelled in some areas: by failing to limit foreign travel early; in relation to protecting staff, through widespread provision of protective equipment and other measures; protecting nursing homes and other vulnerable environments; providing widespread, fast testing; and providing widespread, speedy contact tracing.

Worldwide PPE shortage

Some of these problems involved circumstances beyond our control, to some extent, such as the worldwide shortage of personal protective equipment, and reagent for testing, or internal EU politics that allowed free movement of people to continue for too long.

As a result, our performance is more mid-table in terms of international comparison, rather than the “top tier” asserted by officials in relation to our testing capability.

Currently, we rank 21st in Europe for the number of tests carried out relative to population, just behind Denmark and Italy, and ahead of the likes of Spain, the Netherlands, France and the United Kingdom.

As for deaths per 1 million of population, we rank in a respectable 12th position in Europe.

There are all sort of caveats to be applied to these kinds of international league tables; for example, some countries are counting Covid-19 deaths only if they occur in hospital.

However, they give some indication of the progress we have made – and the road still to be travelled.

It is hard not to be envious of the countries that are winning plaudits for their responses. Iceland, for example, is testing over nine times as many people as we are at present; New Zealand, an island nation with a similar population to that of Ireland, has recorded two deaths against our 263.

Some countries have managed to keep more sectors of society open – such as schools – thus lessening the economic and social disruption involved, although their results have varied.

But even countries that have been lauded for their speedy response to coronavirus, also known as Covid-19, when it first emerged have hit a few speed bumps. Singapore, which used tough travel restrictions and efficient contact tracing to put a stop to the spread of the virus, has seen cases jump in recent days, mostly linked to migrant workers living in cramped accommodation.

Here in Ireland, we have managed thanks to the Government-imposed restrictions to reduce the reproduction number, the “R naught”, to about 1, from 4.5 several weeks ago. This means that whereas 4.5 people used to contract the disease from each sick person, now just one other person does.

Better position

This is the best measure we have for estimating how far and how fast a virus is likely to spread through a population. If the R0 drop below 1, the virus peters out; if it rises above this number, it takes off again.

We can see from this figure that our fate remains finely balanced; Norway, to take one example, is in a better position with an R0 of 0.7.

The other obstacle to lifting restrictions is the continuing failings in testing. Officials have been unforthcoming about the figures, but it is clear that there are serious delays in getting a test, and in the results of these tests being processed.

The wider significance is that we are not in a position to lift restrictions because that might risk a rise in cases, and we have to be able to detect these cases quickly. That can only happen when we have a comprehensive and responsive testing process in place.

The better we can do testing – including of people without symptoms – and selective quarantines, the more we can forego social distancing and get society back to some kind of normality.

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