Covid-19: India may be added to hotel quarantine list as concern grows over new variant

Medical experts urge caution on extending gap between doses of vaccines

Senior public health officials will meet on Wednesday to discuss potentially adding India to the mandatory hotel quarantine list of high-risk countries.

Two Government sources said the expert advisory group on travel will likely make a recommendation on the status of India following the meeting.

The department of health in Northern Ireland announced on Tuesday morning that India has been added to its "red list" of countries in line with a UK-wide decision.

Hospital Report

Three cases of the B1617 variant, first identified in India, have been confirmed in the Republic, it was disclosed on Monday. At least two of the cases are travel-related and the other one is being investigated.

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The expert advisory group on travel was established in early March and examines the risks associated with various countries before making recommendations to the chief medical officer, who in turn makes recommendations to the Minister for Health.

This team will consider factors including the risk of sustained human transmission of Covid-19, as measured by the 14-day incidence in that country relative to that in Ireland, in addition to the risk of importation of a variant of concern.

Eleven deaths and 390 further Covid-19 cases were reported by health authorities in the Republic on Tuesday.

Of the fatalities notified to the Health Protection Surveillance Centre, four occurred this month, two in March, four in February and one in January.

There have now been 4,847 deaths in the Republic since the pandemic began.

As of 8am on Tuesday, 179 patients were being treated in hospital of which 48 have been admitted to intensive care units. There were 18 additional hospitalisations in the past 24 hours.

As of April 18th, 1,208,459 doses of Covid-19 vaccine had been administered in the Republic: 855,512 people have received their first dose and 352,947 people had received their second dose.

One further death

In Northern Ireland, there was one further death of a patient who had previously tested positive for Covid-19, while another 124 people tested positive for the virus in the previous 24-hour reporting period.

Professor of immunovirology at UCC Liam Fanning has said India should be added to the list of countries for which mandatory hotel quarantine was necessary. However, Prof Fanning was optimistic that the vaccine programme would offer protection from the new Indian variant of the virus, which had been deemed "of interest".

Speaking on Newstalk Breakfast on Tuesday, Prof Fanning said that being vaccinated meant a person was “not starting from zero” in terms of immunity and that vaccines offer a level of protection. The mandatory hotel quarantine system was proving effective in picking up cases and would help to keep variants out of the country, he said.

Gerald Barry, an assistant professor of virology at UCD, told RTÉ Radio’s Morning Ireland that the Indian variant, while being “of interest” at present, was likely to become “of concern” as more data emerged.

However, he said it was important that members of the public do not panic each time a variant emerges, as “they are going to hear of lots [of variants]”.

While there is concern that new variants could be more easily transmitted and could be vaccine-resistant, the best way to stop transmission is to keep case numbers as low as possible, he said.

The virus changed itself every time it replicated, so the more people that are vaccinated the less likely the variant is to change and get stronger. That meant it was important to roll out the vaccine programme as quickly as possible, he said.

“We need to keep using the same tactics to keep case numbers down, not just in Ireland, but across the world,” he said.

Extending the gap

Meanwhile, senior doctors and medical experts have urged caution on extending the gap between doses of Covid-19 vaccines, saying a significant benefit to the vaccination programme would be needed to justify it.

Minister for Health Stephen Donnelly has sought the advice of deputy chief medical officer Dr Ronan Glynn and the National Immunisation Advisory Committee (Niac) on the possibility. Research has shown good levels of immunity from a single dose.

Dr Denis McCauley, GP chairman of the Irish Medical Organisation (IMO), said he believed it would not greatly accelerate the vaccination programme. Modelling showing an “enormous, obvious difference” would have to be published to justify such a move.

He argued it could not be done until the very vulnerable were fully covered with a four-week gap between doses. “To delay their 90 per cent coverage [the efficacy reached from two shots] would be unjustifiable medically and morally”.

Dr Glynn said there were pros and cons, but “it would mean that the programme overall will finish later, and for a large number of people they’ll be waiting longer to be fully vaccinated”.

A decision will not be taken until later in the week.