The State’s public health team has not recommended a move to higher levels of restrictions, it has emerged.

Two senior sources confirmed that the National Public Health Emergency Team (Nphet) remains seriously concerned about Covid-19 figures and have told Government that the situation must continue to be monitored.

But a move to a higher level of restrictions has not been recommended.

Hospital Report

One source said there was “nothing too dramatic” at the meeting held on Thursday and that another ten days at least will be needed to see if the current restrictions are dampening the figures.

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A letter has been sent to Government from the team. This will be considered at a Cabinet sub committee on Friday alongside plans for enhanced enforcement of Level 3 measures.

New cases

The Department of Health has reported one additional death related to Covid-19 and 506 further cases of the disease, including 91 in Dublin.

This brings the number of deaths from the disease in the State to 1,817 since the first death was recorded in March at the start of the pandemic.

Of the new cases, some 64 per cent are under the age of 45, while 39 per cent are associated with outbreaks or are close contacts of a confirmed case.

Fifty-nine cases, or 12 per cent, identified as community transmission.

There were 76 positive cases in Cork, 53 in Donegal, 42 in Meath and the remaining 244 were spread across 21 counties.

The latest figures shows that there were 159 patients with confirmed Covid-19 in hospital and 25 in intensive care units.

On Wednesday, there were 155 patients with Covid-19 in hospital and 27 in intensive care units, including 15 on ventilators.

This compares with 121 in hospital and 22 in ICU a week earlier, and 48 in hospital and six in ICU a month earlier.

Four cases have been denotified, bringing the total number of confirmed cases to 40,086 in Ireland.

Earlier on Thursday, health experts and practitioners called for an escalation of national controls and restrictions to combat the increasing spread of coronavirus.

“My view is we do need to take increased restrictions, what we’ve been doing in Dublin for the last three weeks and for the rest of the country for the last few days has not been adequate to keep the increase in coronavirus in Ireland under control,” said infectious diseases consultant Prof Sam McConkey on Thursday morning. “So we need increased measures of some sort.”

The call comes after Chief Medical Officer Dr Tony Holohan on Wednesday said he is more concerned about how Covid-19 is spreading in the State now than he was when Nphet recommended to Government that the country be moved to Level 5 restrictions. The country was, instead, moved to Level 3.

Speaking at his first media appearance since returning from an extended period of leave, and since the recommendation, he said: “If anything . . . the level of concern that I had [on Sunday] is less than the level of concern I have now.”

He said: “All of the major indicators of this disease have gotten worse – our concern is getting greater and faster.”

Speaking on Newstalk Breakfast on Thursday, Prof McConkey said the fact that case numbers in Dublin were levelling off was not necessarily “a good thing”.

“Things like admissions and the number of outbreaks are going up. I think we’re seeing some impact, a definite sort of inflection point compared to a few weeks ago,” he said. “Dublin figures have stabilised, but to be stabilised, where we’re at, at Level 3 for a long time like 6 months or a year or more is not a solution to this.”

Prof McConkey said he favoured a tougher approach for a shorter amount of time. “My view is we’d all be better off to have two months of tighter restrictions, getting better control of it, and getting it down,” he said.

Asked about the R number - the number of people each person infected with the virus transmits it to - Prof McConkey said: “The issue is if Dublin R rate stays at 1 we could be in this for months or years, none of us want to be where we’re at now for months, years, that’s very unsatisfactory.”

R number

Prof Philip Nolan, chair of the Irish epidemiological modelling group, on Wednesday said the R number, which needs to be below 1 to suppress the disease, is likely at about 1.2.

However, he said this is flattered by Dublin’s performance. Prof Nolan said the number in the capital is likely around one, and in the rest of the country is about 1.5.

If the R number remains at a level of 1.2 to 1.4, Nphet expects to see 1,100-1,500 cases per day by the end of the first week in November, and 350-450 people in hospital by that date.

Prof McConkey said he largely agreed with those projections. He also said there is a need for a joint policy on Covid-19 for Ireland and the UK.

Speaking about rising hospital admissions, he said the idea that “we can protect the elderly and the vulnerable from coronavirus, unfortunately [is] not true.”

Border

Meanwhile, Donegal GP Martin Coyne has said that Level 3 restrictions would work if people did what they’re supposed to do. However, the open Border with Northern Ireland was also a problem, he told RTÉ radio’s Today with Claire Byrne show.

On the same show, Tomás Ryan, associate professor of biochemistry at Trinity College Dublin said that the Government should have had contingency plans in place for each Level when they announced the Plan for Living with Covid-19.

It would be appropriate now to move to Level 5 countrywide and then restrictions could be reduced at local level in counties where levels of transmission were lower, he said.

There is a need for a change in strategy, he said. The current Government policy of “negotiating with public health officials” is not working. “The virus doesn’t care about the five levels.”

Infectious diseases consultant Paddy Mallon said that, as a society, behaviour had changed since the first wave and “we have learned how to protect the old and vulnerable”.

But, he said, the health system was still seeing increased hospitalisations and ICU utilisation. The situation was not overwhelming yet, but at the current trajectory the situation would soon be unsustainable, he warned.

Too many people were doing things that they didn’t need to be doing, he said. Having coffee in each other’s houses, hosting books clubs, “small little actions that are all contributing to transmission between households.”

“I don’t envy anyone on Nphet or the Government having to make decisions,” he added.

“Every action requires community actions, if you don’t have buy in, we will have a sub optimal response.”

Difficult decisions will have to be made and they will have to be made quickly, he said. “We all just need to work harder.”

Tánaiste Leo Varadkar has warned that a short lockdown may still happen despite the Government rejecting this week the advice of Nphet to move to Level 5.

Sources present a meeting of the Fine Gael parliamentary party on Tuesday night said that Mr Varadkar warned that a circuit-breaker lockdown may be on the horizon.

“He basically said that a circuit-breaker lockdown might, or might not work, but left us under no illusions that it is on the horizon,” said one source.