Coronavirus is subdued but not gone. This is a strange juncture

The risk is low for now but uncertainty abounds and consensus is wearing thin

Dr Tony Holohan, Chief Medical Officer with the Department of Health has said that compliance by the public in relation to use of face coverings is not where the HSE would like it to be. Video: RTE News Now

 

In pandemic terms, although it may not feel like it, these are the best of times.

Gone are the horrors of the past few months: the gruesome death toll; the sense that danger was lurking around every corner; the unprecedented lockdown and other privations.

Activities we previously took for granted – a visit to a clothes shop, a drive to the hills, the ping of a tennis ball – have about them the freshness of any new experience, after months of isolation and restrictions.

We have been warned of possible dark days ahead, but for now, the threat posed by coronavirus is as low as it has been since early March.

All of which places us in a strange position. We have been given new freedoms but are told to use them sparingly. More and more we are being told to wear masks, when at this point in time the threat from the virus is very low.

We do appear to be tantalisingly close to wiping out the virus for the moment, but then we are also close to wiping out our economy

Many are exhausted, yet there seems to be no end in sight. The consensus on the way forward that existed in March and April has broken down, inside and beyond the scientific community. Many experts promote mask-wearing; others continue to doubt. Some scientists want to crush the curve, rather than simply flatten it. Ireland’s figures for coronavirus cases and deaths can look good or bad, depending on the prism through which they are viewed.

The noise can be deafening, but some things are clear. We are doing pretty well just now, with new numbers of confirmed cases in low double figures each day since the start of the month. The rate at which the virus is being transmitted has stayed stable despite the lifting of restrictions.

We do appear to be tantalisingly close to wiping out the virus for the moment, but then we are also close to wiping out our economy.

We now have the capacity to test on a substantial scale, though we still do not have the necessary speed. To achieve that, we need to complete the process of automation and reduce the number of individual steps involved.

Contacts rising

The rise in the average number of contacts per case, from two to 3.5 since restrictions were lifted, is not unexpected as people start to move around more. It is also, given the low numbers at present, manageable.

Contact tracing, too, needs to be speeded up. Many cases are closed out within a day but the handling of more complex health worker cases can take long periods. Contact tracing speeds may drop dramatically as international travel resumes and contacts need to be tracked down across international boundaries.

Most of all, we need contingency planning for a rise in cases as society loosens up. How will we stop the virus getting back into nursing homes? How will we staff our hospitals and nursing homes next autumn and winter? How can we react quickly to specific outbreaks?

The biggest challenge will be to open up international travel without setting off another wave of infection

The issue of masks has become divisive and confusing, with the arguments for and against being expressed in ever more strident terms. Compared with handwashing and keeping your distance, mask-wearing seems to make a relatively minor contribution to limiting the spread of the virus; however, it may prove sufficient to tip the balance in terms of controlling the spread of the outbreak.

The reproduction number, the measure of how many people a confirmed case goes on to infect, will probably edge upwards as society opens up. The marginal value of masks may lie in helping to keep this value below one – meaning the outbreak declines – as opposed to rising above one, which would cause the outbreak to take off again.

The biggest challenge will be to open up international travel without setting off another wave of infection. This is likely to take place gradually through “air bridges” joining countries with low case figures. Ireland is well placed now to be able to sign up to reciprocal deals with other parts of Europe where the virus has been largely suppressed, leading to a resumption of flights. Get this wrong, and we risk a fresh surge of cases later in the summer.

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