Covid-19: Containing BA.2 variant would need ‘extreme measures’, Donnelly says

Emergency department taskforce asks Minister for urgent fresh public health advice

The Minister for Health has said the extra transmissibility of the BA.2 variant means “quite extreme measures” would be needed to contain it.

Stephen Donnelly is understood to have told an online meeting of Fianna Fáil members on Monday night that there are likely several hundred thousand cases of Covid every week, with daily numbers several times higher than those being tracked by PCR and antigen tests.

Sources indicated that Mr Donnelly told the meeting said that the current transmissibility of the variant meant that extremely restrictive measures would be needed, and said that he is told by the Chief Medical Officer (CMO) that extra restrictions of this level are not currently advised.

Hospital Report

This is due to the fact that despite the massive pressure coming onto the hospital system arising from the enormous levels of infection, associated staff absenteeism, and infection prevention and control measures.

He told the meeting that around half the 53 people in critical care units who have Covid are there because of it, and that around the same number are not fully vaccinated. Saying the number of people in critical care who are fully vaccinated is probably in the high teens, he said this was a relatively low figure at a national level, and will hopefully remain low.

On masks, he told the meeting that while the legal requirement to wear masks had been disposed of, the public health advice to do so had been retained, and that he would do so going into anywhere that distancing was not possible or on public transport, he would wear one.

He told the members of his party that there was an ongoing scaling back of testing and tracing underway, and the same was true for mass vaccination centres, which are becoming less central to the vaccination effort. However, he said his Department and the HSE are working on a medium term plan - and an emergency plan to scale up testing, tracing and vaccination if a serious variant of concern arrives.

Emergency departments

Separately an emergency department taskforce is to write to Mr Donnelly seeking fresh public advice amid concern about rising Covid-19 cases.

The taskforce, which is co-chaired by the HSE’s chief operating officer Anne O’Connor and the general secretary of the INMO Phil Ni Sheaghdha, met on Monday.

A source on the taskforce said the meeting heard concerns about the impact of the current wave on hospitals as well as concerns about high levels of sickness amongst staff.

It was agreed that a letter would be sent on Monday evening calling on the Minister to re-assess the current public health advice around restrictions and seek expert advice, potentially from the chief medical officer Tony Holohan.

“The message here was, Heuston, we have a problem. We want the Minister to make reasonable recommendations around how can practically deal with this situation. This is a matter of urgency as patient’s lives are at stake,” a source said.

In the letter, seen by the Irish Times, the group calls on the Minister to urgently convene “the necessary public health resources and advisors to consider any and all measures that may now be appropriate in order to provide an increased level of protection to health and social care service provision.”

“Thankfully in both January and now, the level of acuity is such that the demand for ICU is not proportionately impacted by the case levels of Covid-19. However a key difference is that there are now little if any public health restrictions in place and there is a consequent higher demand for unscheduled care in our hospitals. This is combined with an increase in the level of Covid-19 related absence amongst staff across all services, acute and community with over 5,200 absent in the most recent figures collated.

“The overcrowding in our emergency departments as a result of the combination of all of the above is considered by the ED Taskforce members to be presenting a level of risk to patients and staff that is unsustainable.”

It is understood there were misgivings expressed during the meeting from officials that the taskforce did not have the authority to issue such a letter to the Minister but it was agreed that it would be sent.

The taskforce will reconvene next week to consider the responses from Government. Also on the taskforce are unions, officials from the Department of Health and patient advocate groups.

Earlier on Monday HSE chief executive Paul Reid said the number of patients with Covid-19 in hospital is causing "huge stress" on the system, at more than 1,600 .

Masks

Mr Reid has renewed calls for the public to wear masks “appropriately”, as he said there are no indications of a downward trend in prevalence.

As of 8am on Monday, there were 1,624 people with Covid-19 in hospitals, up from 1,569 on Saturday.

There were 157 new admissions over the past 24 hours, with 59 discharges, according to data from the Government’s Covid hub.

However, the number of patients in ICU has remained relatively stable, at 54.

The Department of Health has released the weekend’s Covid-19 case numbers. On Saturday 7,754 PCR-confirmed cases were recorded, with 5,432 people registering a positive antigen test through the HSE’s online portal.

On Sunday, 6,940 PCR-confirmed cases were recorded, with 6,466 people registering a positive antigen test.

On Monday, the Health Protection Surveillance Centre has been notified of 5,263 PCR-confirmed cases.

The number of hospitalised Covid patients has been increasing steadily in recent weeks, as the highly transmissible BA.2 variant of the virus became dominant, now accounting for almost 95 per cent of cases.

Mr Reid said the number of Covid-positive patients in hospital “is causing huge stress on the healthcare system”.

“We need to turn this tide again asap [as soon as possible] and repeat doing the basics. Please wear your mask appropriately, come forward for your booster or primary vaccine and isolate if [you have] symptoms,” he said on Twitter.

Mr Reid said the high level of cases make it “feel like we’re entering rather than leaving something”.

The experience of other countries in Europe was that the current variant waned after a while, meaning Ireland was likely to be dealing with the current wave of the virus "well into April", he told RTÉ Radio One.

Residential care systems were also affected by the latest surge, with 67 per cent experiencing outbreaks, making it difficult to discharge patients from acute hospitals.

There were also “very significant impacts for the well over 6,000 staff and clinical teams out [of work] through the impact of Covid”, he said.

Pressure

Dr Fergal Hickey, spokesman for the Irish Association of Emergency Medicine, said the elastic band has snapped with regard to the pressure on emergency departments.

The situation is the “probably the worst I’ve ever seen in my career”, he said, adding that hospitals are “teeming” with Covid.

In Sligo General Hospital, where Dr Hickey works, there are currently six wards with Covid patients.

Virologist Gerald Barry expressed support to reintroduce protective measures, such as mask-wearing, ventilation and good air quality.

“These new waves are reality,” he told RTÉ’s Radio One, saying it was not a situation where society could “just sit back” and allow repeated waves of the virus to “wash over us”.

Dr Barry said the BA.2 variant was the most infectious virus he had ever seen and the easing of restrictions had created an environment that allowed it to spread.

Speaking on RTÉ Radio's Today with Claire Byrne on Monday, Minister for Justice Helen McEntee said any move to return to mandatory mask wearing would require engagement between the Government and public health officials.

The vast majority of people were wearing masks even though they were not mandatory, she said, adding that she has noticed more people wearing face coverings while out shopping.

While mask wearing was not mandatory at present “that’s not to say that the situation won’t change”, she said.

Members of Government and chief medical officer Dr Tony Holohan have previously indicated there is no need to reintroduce public health restrictions.