Government advised to bring in full six-week Level 5 lockdown with closure of non-essential retail

New UK coronavirus variant confirmed in the State as 938 cases reported

Chief medical officer Dr Tony Holohan, siad every form of discretionary socialisation really has to stop if we’re to have a chance of suppressing this kind of level of transmission. Photograph: Colin Keegan, Collins Dublin

Chief medical officer Dr Tony Holohan, siad every form of discretionary socialisation really has to stop if we’re to have a chance of suppressing this kind of level of transmission. Photograph: Colin Keegan, Collins Dublin

 

Public health officials have advised the Government to institute a full Level 5 lockdown for six weeks from St Stephen’s Day, which would entail a closure of non-essential retail.

Government sources confirmed that the recommendation had been made in a letter sent by the National Public Health Emergency Team (Nphet) following its meeting on Wednesday, but indicated that a decision would not be taken immediately.

Under published Level 5 plans from the Government, such a move would rule out visits to private homes or gardens from Saturday, however this was due to be the case a week later on January 1st.

The Government made the decision on Tuesday morning to keep non-essential retail open after Christmas, although the hospitality sector will close at 3pm on Thursday.

It comes as preliminary data showed the presence of the new UK variant of coronavirus in the State, Dr Cillian de Gascun of the National Virus Reference Laboratory has said.

News about the strain of the virus, which is thought to be far more infectious, being present in the State came as 938 further cases and 13 more deaths were reported by Nphet.

Prof de Gascun told a Nphet briefing that monitoring of samples taken last weekend suggested the variant may be present in around 10 per cent of the swabs analysed, but that this needed further validation through whole genome sequencing.

“It’s probable that those results will reflect the presence of the UK variant,” he said.

However, senior members of Nphet said on Wednesday night that they did not believe the UK variant is currently substantially driving infection here.

Chief Medical Officer Dr Tony Holohan said that since restrictions were changed at the beginning of December, “the level of social contact that has happened, in particular around hospitality, has led to a very significant increase in the transmission of this infection.”

Despite the presence of the UK variant, he said: “We don’t think that’s been an important part of transmission in this country, we’ve seen a significant amount of social engagement that can explain this extent of really worrying numbers.”

“We don’t believe at this point that we have evidence that there’s widespread transmission occurring with this new variant at this point in time,” he said.

Dr de Gascun said the results suggested that the variant is likely concentrated in the east of the country, and agreed that it was unlikely to be the main factor in the increase in cases.

“Given the timing, it probably wouldn’t in and of itself account for the significant increase in case numbers that we found,” he said. He estimated that the UK variant had been in the country since the second week of December, at least, and may have been introduced in late November. He said he would be surprised if it were the main driver of infection in the State. Based on the UK experience, the prevalence of the variant in Ireland “may be on the way up”.

“Every indicator of the disease is rising and rising rapidly. Our level of concern continues to escalate. We must do all we can individually and collectively to change the course of this disease,” the chief medical officer said.

Socialisation

Dr Holohan said “every form of discretionary socialisation really has to stop if we’re to have a chance of suppressing this kind of level of transmission”. He said there was a “clear temporal association” between the opening of hospitality and a very significant increase in the spread of the disease.

Prof Nolan said the relaxation of December 1st caused an increase in cases, but the relaxation of restrictions on hospitality “coincides with a very rapid acceleration in the level of disease”.

Asked why data does not reflect outbreaks in hospitality settings, Dr Ronan Glynn, the deputy chief medical officer said that of 7,000 cases in the last fortnight, the source of infection was unknown in 3,000 cases. The briefing heard that instances of transmission that occurred in hospitality settings are likely to be recorded sometimes as being managed in family homes, due to how contact tracing takes place.

There were 938 new cases and 13 further deaths reported. Of these 300 are in Dublin, 110 in Cork, 72 in Limerick, 68 in Donegal, 41 in Kildare and the remaining 347 cases are spread across 21 other counties.

School reopening

Asked about the reopening of schools in January, Dr Holohan said “we are not raising any issue about that at this point in time”. However, citing previous closure of healthcare and the impact on nursing homes he warned that high levels of community transmission “represent a risk to all the things that happen in society”.

“It’s very difficult to assure and protect and prevent infection getting into every part of society and the economy,” he said.

“We now have a level of disease in the population that’s simply not in control, we have to re-establish control of this infection, drive down the levels if we’re going to continue to assure ourselves that we cam maintain these essential public services.”

Modelling presented at the briefing showed a rapidly deteriorating situation as the country prepares for Christmas, with the average cases having more doubled in a week to 713 per day. The third wave, chair pf Nphet’s epidemiological advisory group Prof Philip Nolan said, is rising as rapidly as the first in March, and is present in all age cohorts. “Very worryingly, we have seen an increase in the number of people in hospital,” he said.

Meanwhile, the level of positive tests being returned continues to rise with 20,000 tests done on Tuesday with a positivity of 5.2 per cent. He pointed out that during the second wave, it took 17 days to grow from 300 cases per day to 800 on average, which had taken place in just eight days from December 15. However, this is higher among samples taken from the community, with around six per cent of tests positive. He said that in some GP practices that are part of the State’s sentinel network, set up to monitor the spread of disease, the positivity rate was up to 10 per cent.

“This very significant increase in cases, exponential increase in cases that we’ve been seeing over this very short period of time is accelerating very rapidly indeed.” He said the growth rate in Dublin may be higher than in the rest of the country, and that the incidence of the disease has doubled, or more, in age groups of 65 or more, he said.

Hospital cases

There is an increase in the numbers of people in hospital “very early”, Prof Nolan said, compared to the most recent wave. “The disease is spread evenly across the population this time around, and that means hospitalisations are occurring earlier,” he said.

“The disease has risen rapidly and across all parts of the population,” he said. “It’s looking more like the pattern of the first wave back in March.” The current estimate of the R number, which measures how rapidly the disease is spreading, is between 1.5 and 1.8.

While this is likely to reduce, Prof Nolan said that even if it is brought down to close to 1.0, “we will unfortunately be looking at around 1,000 cases constantly well into the New Year.” If it at 1.2, it will likely be around 2,000 cases during February. The virus is growing at a rate of seven to nine per cent per day. Aside from spikes which led to localised lockdowns in Kildare, Laois and Offaly during the summer, he said this was the highest growth rate that has been reported since March.

Similarly, the R number has not been this high since April, he said, while the number of close contacts per confirmed case is also growing across all age groups.

At an R of 1.4, he said there would be an average of 1,100 cases per day by January 4, and 1,600 cases by January 18 th. If it can be forced down to 1.1, the daily case numbers on those dates will be 1,000 and 1,200 respectively, he said.

However, he said that he does not anticipate that the current measures will be successful at bringing the R number down below 1, suggesting that more stringent measures will be needed to suppress growth. “I’m not confident that they will,” he said. “Given the nature of the measures and our experience to date, I’m not confident that they alone are sufficient, particularly given where we’re starting from.”

“We have a collective problem here, we’re being hit very hard by a rapidly escalating and rapidly transmitting virus,” he said.

“We expect to see a very significant number of cases, and unfortunately, hospitalisations in the coming weeks and there is predicted a very significant strain on our health services as a consequence.”

“We need to stay at home if possible, we need to revise our Christmas plans,” he said.

HSE warning

Earlier the head of Health Service Executive (HSE) warned the country is facing “very serious and dangerous” levels of Covid-19 spread, which threatens to have a “major impact” on the hospital system.

Paul Reid, HSE chief executive, said health officials were now as concerned as they had been at the start of the pandemic in March.

Dr Colm Henry, HSE chief clinical officer, said recent days had seen “extraordinary growth in infection beyond what our extreme versions of modelling would have predicted.”

“We are deteriorating at a more rapid pace, in seven days, than any other country in Europe, ” he said. The rate at which the virus was spreading had reached a “frightening level,” he said.

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