Covid-19: Getting to zero quicker, and staying there

Q&A: Why are some experts proposing tighter restrictions instead of easing lockdown?

Several prominent scientists and academics have called for a rethink on Ireland’s policy on tackling Covid-19, saying the aim should be to “crush” the virus rather than “live” with it.

Lead signatories in the "Crush The Curve Petition" are epidemiologist Prof Anthony Staines of DCU; infectious diseases ecologist Prof Gerard Killeen of UCC and immunologist Dr Tomás Ryan of TCD.

The petition has been signed by a number of experts who are not part of the Government’s Covid-19 advisory bodies.

The Government's current policy, signatories to the letter argue, will see Ireland "live with the virus under a long-term mitigation strategy, with the risk of future surges and lockdowns until when, or if, a vaccine becomes available".

Are they proposing that the country revert to lockdown?

No. They fully accept the case for easing lockdown. But they say they are proposing actions with a better chance of getting to zero quicker, and staying there.

Really fast testing, tracing and isolation is required, along with widespread wearing of face masks, and testing for people landing at Irish sea and air ports, says Prof Staines.

Every policy followed should be agreed between Dublin and Stormont. A "modest" push now could eliminate Covid-19 on the island, they contend, if tactics proven in New Zealand and South Korea are followed.

How long could it take?

The State’s actions up to now has brought the situation “very close to zero”. However, tough short-term restrictions now could limit the amount of pain to be endured.

Living with the virus will not be “normal”, they argue. Public transport will run with just a fifth of capacity; pubs and restaurants 30 per cent; schools, at best only 50 per cent.

The costs of childcare, already high, will be impossible for many. Offices will need to be expensively re-designed. Many people will lose their jobs. All of these are real costs, and will far exceed short-term costs of lockdown, they note.

Ultimately, Prof Staines suggests, “the biggest cost is long-term social distancing”. It will be required for much longer with containment/living with Covid-19, rather than crushing it.

Has Ireland’s approach not been to suppress and eliminate Covid-19 all along?

The State’s approach has been to minimise Covid-19 everywhere, while initially flattening the curve of rising cases to enable the healthcare system to cope. Now, the Government believes restrictions can be loosened.

That view would suggest that elimination is not possible at present, knowing the characteristics of Covid-19. Instead, carefully applied containment measures stay in place.

So what are the differences in approach?

Scientists and others in the “Crush The Curve” camp believe all the right decisions have been taken to bring numbers to zero, but only if they are enhanced and co-ordinated across the island.

If Ireland decides to live with the virus, the group believes, “extensive, and expensive, restrictions will continue for the foreseeable future. A vaccine will take at least two years, and there is no established treatment”.

On the other hand, countries that have suppressed the pandemic will enjoy greater freedoms than those where it persists. Travel, tourism and trade with other successful countries would be straightforward and beneficial.

Ultimately is this taking a narrow, over-cautious view when Covid-19 will be gone soon?

Arguably, no. The pandemic is far from over. Cases and deaths continue to rise and cause economic devastation and push healthcare systems to breaking point in many countries away from Europe and Asia.

In the Irish context, coronavirus has lost none of its ability to resurge quickly. We are not at zero in the way New Zealand is – it got to zero and has stayed there.

Perhaps the most concerning statistic is the one that shows that the vast majority of deaths involve people with underlying conditions – and estimated to be robbing 10 years of a person’s life on average.

Meanwhile, terrible uncertainty persists in the absence of a vaccine. Only 3-4 per cent of people have herd immunity, and no one is sure how much immunity Covid-19 antibodies offer in the first place.