Chief medical officer Tony Holohan has said Nphet may be forced to give "difficult advice" to the Government if Covid-19 cases continue to rise.

Dr Holohan warned that the Government cannot make people observe restrictions and it was up to the public to make changes which will bring about a reduction in transmission of Covid-19.

He told RTÉ Radio's Morning Ireland that Nphet will monitor the situation closely this week and that it is important to see signs of improvement.

Hospital Report

If that is not the case “if we think it is necessary to give difficult advice, then we will do so” though he stressed that it is too early to say if the present round of restrictions are working.

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If people have symptoms they should isolate and get a PCR test and close contacts should restrict activities for five days. It was important that the public trust the medical and expert advice, he said.

Dr Holohan said he agreed with the request that health care staff who were close contacts should continue to work. It was important to protect the healthcare system to ensure that services were available. Most of the staff within the health system had been vaccinated and were younger, he added.

Work from home

The recommendation for the public that if they could they should work from home was important, he stated, to cut down on activity.

It should not be acceptable that there were 125 people in ICU dependent on very intensive support because the health system was so severely impacted. But this was also the situation in other countries such as Austria where they had more intensive care beds but they were still dependent on restrictions.

Dr Holohan said Nphet had always acknowledged that antigen testing had a role to play, but the problem was that people were not using rapid testing correctly. A survey revealed that one in five people were using antigen tests each week and that only a third of those who tested positive had gone on to get a PCR test.

If people had symptoms they should get a PCR test, he urged. If there was a negative result in an antigen test, it did not mean that a person did not have the disease. The data showed that the public did not understand the advice on the correct use of antigen tests or how to use them properly.

Dr Holohan said he understood the concerns of the Irish National Teachers Organisation (INTO) and appealed to parents not to send their children to school if they had symptoms, the responsible thing to do was to keep them at home.

The booster campaign would be rolled out following Niac recommendations starting with older people, then those with underlying conditions and eventually on to those who were lower risk. Dr Holohan said he would not be surprised if Niac extended the range of groups to whom the booster should be given.

In a separate interview on Newstalk, Dr Holohan admitted that the midnight closing time in itself would not reduce numbers, but it “sends up a signal” that the situation is still serious. “This is a preventable respiratory infection,” he said.

He appeared to cast doubts on suggestions by the HSE that just 50 per cent of people were turning up for their booster shots stating that he was aware of one surgery in Tallaght with 400 patients where just 10 people did not turn up for their booster shot.

Minister for Higher Education Simon Harris said he was “encouraged today by the words of the CMO”, adding there is “nothing inevitable” about the spread of Covid-19.

Antigen tests

He said the Government needed to get on top of the question of antigen testing. “There’s two parts to that, there’s an issue around subsidy and cost, the Minister for Health will address that, and I’m sure will bring a proposal to Cabinet, I hope tomorrow,” said Mr Harris.

The second part was a plain language information campaign which would inform people about when and how to use an antigen test.

The general secretary of the INTO claimed that schools have been abandoned by the Department of Health.

There were more children at home now because of Covid-19, John Boyle said, 9,000 had tested positive which meant there were probably 13,000 to 14,000 more who were asymptomatic.

Mr Boyle told Newstalk Breakfast that 605 primary school teachers had tested positive for Covid-19 over the past two weeks which was leading to a shortage of teachers and meant that children were missing school.

“We are looking for solutions, but they have to come from the Department of Education and public health who have abandoned schools,” he said.

The fourth wave of the disease is leading to the cancellation of much elective surgery in hospitals.

Intensive care consultant Dr Andrew Westbrook has described the cancellation of a transplant operation at the Mater Hospital last week as "symptomatic" of the crisis caused by the lack of ICU beds.

“That’s a very unfortunate situation, for the patient involved, for the patient’s family and for the donor and for the donor’s family,” he told RTÉ Radio 1’s Morning Ireland programme.

The cancellation was symptomatic of the fact that the intensive care system in Ireland was under-resourced. There should be at least 550 ICU beds in the country, that was according to a report published 12 years ago, he said.

There had been a "slight increase" of 50 beds over the past year, there needed to be at least another 150 to 200 intensive care beds, that would just bring Ireland up to the "average" level in Europe.

“If we had that bed stock we could provide care for more acutely ill patients,” he stated.

Dr Westbrook pointed out that for every intensive care bed there had to be a fully trained team including at least six nurses.

Financial supports

Ministers are expected to consider retaining higher rates of financial supports for businesses at a special meeting today, in light of the deteriorating Covid-19 situation.

The Cabinet subcommittee on economics will receive an update on financial supports amid widespread infections across the State and new restrictions being imposed on businesses, particularly in the hospitality sector.

Industry sources said restaurants, hotels and pubs had been hit by a huge number of cancellations of Christmas parties.

While a proposal is anticipated in relation to the employment wage subsidy scheme (EWSS), a number of sources said they did not expect the Government to reverse reductions in pandemic unemployment payment (PUP) from €250 a week to €200, which kicked in last week. Opposition parties have been calling for the higher rates to be restored.

The EWSS gives businesses impacted by Covid-19 a subsidy per employee to help keep them in work. Payments for each employee are due to fall to €203 per week on December 1st, from the existing rates of €250 and €350. For those receiving €203 at present, this is due to fall to €151.

The subcommittee – which includes the five most senior ministers in Government – will discuss putting a stay on those reductions until after the Christmas period.