A further 5,419 new cases of Covid-19 have been reported in the State.

As of 8am on Friday, 528 people were in hospital with the virus with 110 of those in ICU.

The latest figures comes at the Taoiseach is about to update the nation on new restrictions on hospitality and household visits ahead of the festive period.

Hospital Report

Earlier it was reported that the Omicron variant could drive cases to between 6,000-15,000 per day after Christmas, depending on how serious it is, and the degree of socialisation that happens during the festive period.

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The scenarios are outlined in the latest letter to Government from the National Public Health Emergency Team (Nphet), sent on Thursday night.

It outlines that around seven people per day are dying currently associated with Covid, or 200 per month, which could rise further given high case counts – although booster shots may control this.

It warns that even moderate reductions in vaccine effectiveness or increases in transmissability associated with the Omicron variant would result in a “high to very high” surge in disease.

In a pessimistic scenario, where the variant is 40 per cent more transmissable than the currently-dominant Delta variant, cases could peak at between 8,000 and 15,000 per day. This scenario also assumes a much higher degree of social mixing over Christmas – some 20 per cent more than last year.

It also assumes that there’s a lesser degree of acquired immunity – ie, that people who have previously had the disease are immune to it.

These scenarios project between 750 and 1,300 people needing general hospital care and 200-400 people needing critical care in January.

The optimistic scenario is modelled on the basis, again, that vaccines are 30 per cent less effective at preventing symptomatic disease, but that the new variant is only five per cent more transmissable. Assuming higher latent levels of immunity among people - ie, that a lot more people have been infected and are immune, and that the variant doesn’t negate this, cases grow to between 6,000 and 8,000 per day.

This would come against the backdrop of a “challenging” position in the health service, notwithstanding early signs that a plateau has happened, albeit at a high level. With much still unknown about the impact of Omicron, the potential impact on disease trajectory and on the HSE is “highly uncertain,” the letter states.

‘Serious challenges’

The modelling undertaken on Omicron assumes it becomes dominant – accounting for more than half of transmissions – by January 6th and then accounts for 90 per cent of transmission within 28 days, which is similar to what happened with Alpha, then called the UK variant, last year and early in 2021.

The variant has been detected at a time when socialisation is expected to increase over the Christmas period, while increased compliance seen among the public may not persist over the festive season, Chief Medical Officer Dr Tony Holohan warned Mr Donnelly.

Much of this socialisation will take place indoors, between generations and involving people with a recent travel history. Furthermore, there is an expectation of increased influenza following last years low levels of disease.

When these factors are combined, the letter warns that they have the capacity to present “serious challenges” in the weeks ahead and while it is “impossible to quantify the level of risk”, this may only become clear “when it may be too late to take mitigating measures,” the letter warns.

As previously reported this morning, it recommends that nightclubs should close, that indoor hospitality should return to pre-October 22nd measures. This means maximum groups of six per table, no multiple table bookings, no intermingling between tables and that 50 per cent capacity limits be imposed on indoor gatherings.

The letter says that it is “strongly advised” that visits to private homes should be kept to a maximum of three other households “recognising the need for some flexibility depending on individual circumstances”.

People are advised to limit their contacts, especially with those aged 50 and older and with underlying conditions who might not have yet received a booster.

Compliance concern

The letter outlines Nphet’s concern that “compliance by many sectors with the public health measures already in place is not optimal”, citing social distancing in retail, masks on public transport, the checking of the Covid pass and the facilitation of employees working from home. It calls for more acceleration of the booster programme.

According to the letter, the pandemic is currently “precarious” but the R number is estimated to be about 1 – meaning the pandemic “stable at the moment”. Demand for testing is higher than at any other point during the pandemic. It outlines how 276 patients were receiving “advanced respiratory support” outside critical care – a measure of the demand placed on the hospital system due to Covid. “The potential for the numbers of Covid patients requiring this level of care in a ward setting to increase and for the number of non-Covid patients to remain at a similar level for the foreseeable future is of deep concern.”

With high levels of patients coming into hospitals, even with the private healthcare system deputised through the SafetyNet arrangement Dr Holohan warned that “the ongoing detrimental impact of the pandemic on the delivery of non-Covid care cannot be overstated”.

Pointing to the need to drive down Covid in the community, he wrote: “This level of ongoing demand is extremely difficult for the health system, and critical care units in particular, to sustain.

“While there has been intensive work over the course of the pandemic to increase capacity, even the most well-resourced health system would find it difficult to cope with levels of demand above what is currently being seen”