Taoiseach Micheál Martin has said “nothing can be ruled out” in terms of Covid-19 restrictions and the Government is “extremely concerned” about the rising prevalence of the disease.

Speaking in Enniskillen, Co Fermanagh, Mr Martin said the Government can "never rule out" taking additional measures given the impact that reopening has had on the case numbers.

He said the Cabinet’s Covid-19 subcommittee will meet on Monday evening to discuss a potential pause on the full return to work and to discuss the National Public Health Emergency Team’s latest modelling on the disease. At this meeting, Ministers will do a “stock take” ahead of a full Cabinet meeting on Tuesday.

Hospital Report

Asked if he could rule out another lockdown, Mr Martin said: “We are in a different position to last year so the language of lockdowns has to be looked at differently.

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“We are very highly vaccinated as a country, over 90 odd per cent [of adults]. That is important. We are in a different space to what we were last year,” he said.

“That said we are extremely concerned, very concerned, about the high rise in numbers and indeed the impact that is having on hospitalisation, admissions to intensive care units and illness, but vaccination is protecting.”

Hospital

The Department of Health reported a further 3,805 Covid-19 cases on Sunday. As of 8am, there were 582 people in hospital with the virus (up 26 from Saturday), of which 106 were in intensive care units.

Mr Martin said the booster campaign was being rolled out and that was very important. “That will continue to expand and will give significant protection to key age groups and cohorts over the coming weeks.

“Secondly, we are looking to expand testing and tracing in particular antigen testing. The Minister for Health will be bringing forward proposals in respect of a wider deployment of antigen testing and also making it that bit more affordable for people if we want to introduce a culture of greater utilisation by people of antigen tests,” Mr Martin said.

"Thirdly in terms of the recommendations from Nphet in respect of working from home, we will make decisions on that advice early this week. We will have a Covid meeting tomorrow evening where we will give consideration to that advice and have a general stock-take with Nphet and other Cabinet Ministers in terms of the situation in relation to Covid right now and over the coming weeks."

Asked again about the possibility of further restrictions, he said: “Nothing can be ruled out in respect of Covid-19, we know that by now. That said, we are in a much different position to where we were last year because of vaccination and because we have the booster campaign.

“The evidence internationally is that the booster third dose is quite impactful, more impactful that the second dose, it is being said. Our data from the over-80s already is encouraging in that respect.

“We can having never rule out having to take measures.”

The Taoiseach said people needed to cut their levels of socialising.

In terms of antigen tests, he said the Government did not envisage making them available for free.

“We do want to encourage people to use antigen testing more frequently and we will look to make it more affordable,” he said.

On the recommendation from Nphet to return to a policy of working from home where possible, he said: “From September we advocated a phased return to the workplace. That is about 50 per cent now. That is one measure we have been asked to consider. It is important that we deliberate on that over a number of days.”

Mr Martin was also asked about further restrictions in the area of the night-time economy, as an example.

“Tomorrow evening the Covid Cabinet committee will be taking stock of that. We will be engaging with the chief medical officer and Nphet in terms of their modelling and how they see it. We haven’t set specific thresholds in respect of the amount of people in ICU.

“The earlier modelling suggested this could peak at the end of November, this wave. But there is a lot of uncertainty.”

The Taoiseach said that rather than getting into the specific issue of nightclubs the broader issue was the level of socialisation taking place.

Very grim

Meanwhile, HSE chief executive Paul Reid said hospitals were in a “very grim” situation and suffering “severe distress” as Covid-19 cases continue to soar.

He urged caution about seeing antigen testing as “the next silver bullet” and said we all need to get “back to the basics” of public health measures in relation to limiting our activities.

Speaking to RTÉ Radio’s This Week programme on Sunday, Mr Reid said 582 people were in hospital with Covid-19 of whom 106 were in ICU. Another 300 people were receiving enhanced supports.

“We have a high level of sickness and pressure on our emergency departments, we are seeing about 20 per cent up on our 2019 levels of many of our emergency departments.”

The health system is under heightened levels of strain due to Covid “but our hospitals in particular are now suffering severe distress.”

Consultants wanted him to relay that “we are really in a very grim situation with our ICUs and the levels of sickness we are treating” and that the picture in relation to the impact of Covid is “very distressing”.

Asked are hospitals returning to the situation they faced last January, he said it was necessary to be careful about that comparison. There were 2,000 Covid-19 positive patients in hospitals in January , the vaccination programme since has certainly helped and the picture “would be very different” were it not for that.

However, the stress levels in hospital now is as bad now as it was then, he said. In January, hospitals were only dealing with Covid, were not dealing with non-urgent care and the lockdown meant less traffic and less trauma coming into the hospitals, he said.

On the booster vaccination programme, he said 400,000 of two million booster shots under the programme have been completed and tens of thousands are scheduled over the coming weeks.

The programme has to operate on a schedule of six months between a person’s last vaccination and the booster jab and will primarily run up to and during December, with some run over into next year because of those who got their vaccinations later.

There has been very good progress across GPs and vaccination centres and the HSE will very shortly be bringing pharmacies into the mix, he said.

While vaccination is not compulsory for healthcare workers, their take-up is in the high ninety per cent and he expected that to continue, he said. Risk assessments are carried out where healthcare workers are not vaccinated and that can lead to those workers being allocated to other duties.

On antigen testing, he said the HSE, the Minister for Health and his department, and the chief medical officer are all working together in terms of the approach to antigen testing for schools overall. The HSE will be bringing recommendations this week to the Minister in that regard.

He urged caution about seeing antigen tests as “the next silver bullet”.

“We have been grasping over the last 20 months over what that next silver bullet is,” he said. “The reality of what we really need now is for everybody individually, all of us, to get back to the basics of public health measures. We need to retract from the level of activity that we are carrying out, it’s putting a level of strain on the healthcare system that we cannot cope with if it continues at the levels that it’s at.”

Asked about suggestions the government should offer free antigen tests, he said that was a policy decision for government and a cross-departmental working group will meet tomorrow to consider all aspects of that.

In response to calls by the Irish Nurses and Midwives Organisation for tougher measures to tackle assaults, threats and aggression by members of the public towards health workers, he agreed with the INMO such treatment is “completely unacceptable”.

“These are criminal acts and need to be treated as such,” he said.

There is no doubt healthcare settings can be extremely stressful situations for families, he said. The HSE takes seriously its duty of care to its staff but the public “also have a duty of care to respect our workforce”, who have made huge sacrifices over the past 20 months..

“We need to give them respect and whatever level of strengthening of security needs to be done, we will do that.”

Asked about calls by politicians and others for the HSE to be held accountable over failures in the treatment of Grace, an intellectually disabled woman, in a foster home in the south east, he said a commission has yet to complete its investigation of the matter and he did not wish to comment before that.

While HSE staff provide mostly extremely good care to people across the country on a daily basis, there were cases where harm has been caused, he said. The aim is to strengthen accountability in the HSE overall and he had advanced proposals to the HSE board in that regard, including having open disclosure, a culture of learning and holding people accountable.