Covid-19: Outlook for coming four weeks ‘uncertain and dangerous’, says Nolan

Nine in 10 need to be vaccinated to reach herd immunity due to mutant strains, HSE suggests

The Chief Clinical Officer of the HSE, Colm Henry, has said that the vaccine rollout will have to include children if Ireland is to reach herd immunity due to the more transmissible delta variant. Video: RTÉ

 

Professor Philip Nolan, chair of Nphet’s data modelling team, has said the Covid related outlook for the coming four weeks remains “uncertain and dangerous”.

In a thread posted on Twitter on Thursday evening, Prof Nolan said case numbers were continuing to rise, which would lead to an “as-yet-unknown level of severe disease and mortality” over the next two to four weeks.

The number of hospitalisations and deaths from the virus would be “much less” than in previous waves, due to the vaccine rollout, he said.

However, the rate of growth of the virus, currently increasing at about six per cent a day, was “very concerning,” he said. “If this continues case numbers will double every 12 days, building up a very large force of infection,” he said.

Prof Nolan said the incidence of Covid-19 was continuing to “rise rapidly” among 16 to 35-year-olds but it is also rising significantly within other age cohorts. “We are starting to see cases in those aged 65 and older, a group where a few weeks back the infection was almost eliminated,” he said.

His comments came after a further 1,189 new cases of Covid-19 have been reported in the State on Thursday afternoon. There are 95 patients in hospital with the virus as of 8am on Thursday, with 23 of those in ICU.

“The Delta variant is now dominant across the EU and, in recent weeks, we have noticed a sharp increase in the level of travel-related cases of Covid-19,” deputy chief medical officer Dr Ronan Glynn said.

“As disease incidence increases both here in Ireland, and across Europe, it is important that, if you intend on travelling, you are aware of the disease profile in the area you are visiting, as well as the public health measures in place locally.”

“Only those who are fully vaccinated or who have recovered from Covid-19 in the last 180 days should be considering international travel at this time.

“If you have recently returned to Ireland and have any symptoms of Covid-19 including fever, cough, headache, sore throat or a blocked or runny nose then please self-isolate and get tested without delay.”

Mutant strains

Earlier the Health Service Executive suggested that nine in 10 people in Ireland would have to be vaccinated to reach herd immunity against Covid-19 because of mutant strains, meaning children would have to get the jab.

As things stand, it was confirmed on Thursday, some 99 per cent of those aged 80 and over have been vaccinated. the corresponding figure for those in their 70s is 98 per cent and 95 per cent of those in their 60s.

Up until now, 93 per cent of those in their 50s have received their jabs with the figure standing at 87 per cent for those in their 40s.

Vaccination of people aged in their 30s is ongoing, but figures show a 73 per cent uptake to date.

Last year’s prediction that inoculating just six in ten of the population against coronavirus could provide wider protection for society was based on the less transmissible “wild type” original strain, said Colm Henry, HSE chief clinical officer.

The National Immunisation Advisory Committee (Niac) will have to weigh up the benefits of mass administering children in Ireland with jabs against any potential threat to them from the vaccine itself, he said.

“This is a challenge being faced across the world,” he said at the HSE weekly Covid 19 briefing.

“What we thought initially, based on much cruder estimates a year ago, based on the wild type Covid we were dealing with last year, it was 60 to 70 per cent of the population [that would reach herd immunity].

“But because we are dealing with a much more transmissible variant, to reach that concept of herd immunity , which every country is far away from yet, the estimate has gone up to 85 to 90 per cent.”

The concept of herd immunity suggests when enough people in a population are either vaccinated against a disease or have developed natural resistance through infection then it stems its spread.

If Ireland were to reach herd immunity through vaccination alone, Mr Henry said “by extension it would include the population (to be vaccinated) extending to children.”

“In advising vaccination for children, Niac like other agencies across Europe and the world have to consider the relative risks and benefits for children, for whom Covid 19 presents a very low risk in terms of serious illness, hospitalisation, ICU and death,” he added.

Mr Henry said a balance would need to be considered between “what is a very low risk” to children from being infected by the virus “against any risks the vaccine may have in younger age groups”.

Different approaches

The US and the UK have differed in their approaches.

Authorities in the US recommend children over the age of 12 be vaccinated, and steps are already being taken to give children under 12 jabs by mid-winter.

In the UK this week, it was decided to only offer children over 12 a vaccine if they are at higher risk through underlying conditions or if they are living with someone who is at higher risk of serious illness through infection.

Mr Henry said he doesn’t expect Niac to immediately “come out with emphatic recommendations” for younger children in Ireland as it was currently assessing whether to recommend jabs for 12- to 15-year-olds.

Advice for children younger than 12 is “going to be much more complicated”, he said.

On whether Ireland can reach herd immunity without vaccinating children, he said “to to reach that critical proportion, it would infer we would need to include age groups going right down to children, but that’s based on the current estimate of herd immunity that might be required to deal with the increased transmissibility of Delta [variant].”

Niac would have to review the “real world evidence” before making any recommendations to the HSE and the Department of Health, he said.

Hospitalisations

According to figures published by the HSE on Thursday morning, there are 18 people in hospital with Covid-19 who are fully vaccinated against the virus.

A total of 86 people are in hospital with the virus, as of 8pm on Wednesday with 22 patients in intensive care (ICU).

Letterkenny Hospital has the highest number of Covid-19 patients (12), followed by Mayo University Hospital (9) and St James’s Hospital in Dublin (8).

The HSE data shows there are 18 patients with Covid-19 who are fully vaccinated as of 8am on Wednesday. Galway University has the highest number of fully vaccinated patients (4), followed by Letterkenny Hospital (3).

It did not provide details on which vaccines these patients had received.

More than 5.3 million Covid-19 vaccines have been administered to date, with 66 per cent of adults now fully vaccinated against Covid-19 and 80 per cent partially, HSE chief executive Paul Reid said on Thursday.

“Delta poses a huge risk to this progress but one that we can meet head on. Let’s aim to support our healthcare workers having a manageable August. One that they all deserve,” Mr Reid said on Twitter.

‘Significant increases’

A further 1,378 cases of Covid-19 were confirmed in the State on Wednesday. Tánaiste Leo Varadkar said the Delta wave of coronavirus could peak at 4,000 cases a day.

Deputy chief medical officer Dr Ronan Glynn has warned of a “significant increase” in hospitalisations and intensive care admissions if incidence of Covid-19 continues to rise.

Dr Glynn said the 14-day incidence rate has increased from 93 per 100,000 in the week of June 24th to 246 per 100,000 on Wednesday.

He said the five-day moving average of cases has increased from 300 to 1,182 cases per day over the same period.

The latest estimate of the growth rate of new cases is approximately 6 per cent to 7 per cent per day.

According to Dr Glynn, incidence is highest and increasing rapidly in those aged 19-24 and 16-18, though it is also rising in other age groups.