Covid-19: How did Ireland fall from grace to its current 'worst-in-world' statistics?

We had more stringent restrictions, for longer, than most other places in Europe, so what’s going wrong?

A record surge in Covid-19 cases in Ireland was due to increased social mixing over Christmas and was not caused by a new variant from Britain, Dr Mike Ryan of the World Health Organisation has said.

 

The speed of Ireland’s fall from grace in terms of Covid-19 statistics is astonishing and perplexing. From having the lowest incidence in Europe at the end of November, we now appear to rank worst in the world by international measures of the disease.

Even by the more formal official figures produced by chief medical officer Dr Tony Holohan at the National Public Health Emergency Team briefing this week, it is clear the change in Ireland’s fortunes has been massive and unparalleled among our neighbours.

By last Sunday, the 14-day incidence had reached 1,245 cases per 100,000 people, with only the Czech Republic recording a higher figure. Within the space of a fortnight, the incidence here grew more than six-fold.

No other country came near; Portugal saw its 14-day incidence increase by 94 per cent, and the UK recorded a 78 per cent rise, compared to our’s rising by 518 per cent. While cases in Ireland hit record levels, the numbers declined in about half of all European countries.

The figures are all the more alarming for having come on the back of lengthy restrictions stretching back to September. Restrictions were eased during December following a six-week lockdown, but they were not completely lifted.

Though much of the rest of Europe has had to be reacquainted with lockdown in recent weeks, Ireland has had more stringent restrictions, for longer, than most other places in Europe. The policing of public health measures here, though, has been lighter touch than elsewhere.

So what happened in December to set us up for our current fate?

By the time restrictions had eased at the start of the month, daily cases had fallen to about 400, far higher than had been hoped for. That meant there was still plenty of disease in the community, too much for the contact tracing system to keep up with.

Problem areas

People were still picking up the disease in problem areas such as hospitals. The Border continued to act as a sieve, channelling new infections from the high-incidence North to the (then) low-incidence Republic.

Dr Holohan’s data, culled from opinion polls and mobility data, paint a picture of a people who, at that point, started worrying less and moving about more. As Christmas approached, retail, recreational activity and traffic rose to levels not seen since before the pandemic. Some people acted “as if nothing had happened,” he observed.

This pattern of activity served to seed more and more cases, and events over Christmas then “sealed the deal”. Those who had socialised before the holiday season got together with their families for Christmas Day, ensuring the virus was spread across generations. Some of these new infections then transmitted further among those who partied around the start of the new year.

This activity, occurring often in ill-ventilated, dry, indoor locations because it was winter, explains why we now have a third wave, but it does not fully account for the magnitude of that wave.

Other countries had Christmas, winter weather, and restrictions going up and down, but they’re not in the same pickle.

New variant

This is why the new variant, first identified in Kent in England, is coming under more scrutiny. It now accounts for almost half of all samples genetically sequenced in Irish labs, and is on the way to becoming the dominant strain here.

It is surely no coincidence that, apart from Czech Republic, the other European country battling a steep rise in cases over the past six weeks is the UK.

Some 50,000 people flew into Dublin Airport over the Christmas and new year period, including 1,500 from the UK after the Government banned flights from Britain on December 21st to prevent the spread of the variant.

This traffic can only have accelerated the rise of the variant and the general spread of the disease.

“It’s a perfect storm – all these humans coming close together in heated indoor spaces, and then the new variant thrown into the mix,” says Prof Karina Butler, chair of the National Immunisation Advisory Committee.

In the run-up to Christmas, Butler booked a meal out with her husband. On arrival in the pub, she found the dining area crowded and ill-ventilated.

“It wasn’t a good environment, so we left.” How many others stayed?

ICU numbers

The number of patients hospitalised is now twice as high as in the spring, while ICU numbers have just surpassed the peak of the first surge.

Deaths lag even further behind cases, but there is as yet no sign of excess deaths this winter, according to European figures. Ireland’s 14-day mortality rate remains the second lowest in Europe, after Finland.

This will change too, especially if hospitals are overwhelmed, but we may well escape the worst that some other countries experienced.

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