Nphet says normal life ‘some way off’ and vaccination unlikely to fully halt Covid-19

Country’s health infrastructure is ‘not fit for purpose’, public health experts say

People enter a vaccination centre at St Mary’s Hospital in the Phoenix Park, in Dublin. In a new letter to Government Nphet has called for a new ‘widely distributed but co-ordinated testing regime’ to be rolled out across the country. Photograph: Dara Mac Dónaill

People enter a vaccination centre at St Mary’s Hospital in the Phoenix Park, in Dublin. In a new letter to Government Nphet has called for a new ‘widely distributed but co-ordinated testing regime’ to be rolled out across the country. Photograph: Dara Mac Dónaill

 

Normal life in Ireland is still “some way off” and Covid-19 will remain in circulation for years to come, the State’s public health team has warned the Government.

The National Public Health Emergency Team has sent detailed advice to the Government on how to handle the next stage of the pandemic and have warned there is now a need to address “long standing deficiencies” as vaccination or herd immunity is unlikely to fully halt the virus.

The team has warned that health infrastructure is not fit for purpose and that reforms are needed in public health capacity included accelerated recruitment.

They have also called for a new “widely distributed but co-ordinated testing regime” to be rolled out across the country which could include a rapid testing system.

In terms of the new variants, Nphet has also called for increased “whole-genome sequencing capacity to enable the comprehensive monitoring of variants of concern and to support outbreak management” as well as the development of a national wastewater surveillance programme.

Addressing the coming months and years, the public health experts said that “normal” life was likely “still someway off” and it would be “critical” that adequate mental health supports are in place.

“The long-term future epidemiology of this virus is unknown. Eliminating the virus or reaching herd immunity from vaccination alone is unlikely to be possible, it would require very high coverage in all adult age groups, not alone in Ireland but globally, and for the vaccine to be highly effective against transmission. The impact of variants is also unknown. This means that the virus is likely to continue to be in circulation in future years,” the document states.

“The severity of disease that it will cause and the requirements for ongoing vaccination will become known in time. As a country, and especially as a health service, there will need to be robust long-term planning for the ongoing management of this virus.

“More generally, there is a very real threat of future pandemics and it will be essential that lessons are learned from this pandemic and a process is put in place in the near term to ensure future preparedness.”

The team warned that “infrastructure, and in many cases the way we deliver care, including staffing frameworks and skill mix, are not fit for purpose as we continue to live with Covid-19 and as we prepare for the possibility of future pandemics”.

In terms of public health capacity, the Government has also been warned that public health professionals “have been to the forefront of managing the response to the pandemic” and “will be critical in the rollout of the vaccination programme”.

“The pandemic has highlighted deficits in workforce capacity, IT infrastructure and overall service delivery, and it is clear that public health must be reformed and strengthened.”

To this end they say recruitment must now be accelerated for public health teams.

Overall, Nphet warned that the pandemic “has been characterised as a marathon and not a sprint. This requires sustainable responses that are capable of being maintained in the medium to long term while remaining flexible to adapt to the evolving status of the disease.”

The team also warned again of the higher risk associated with certain activities including “dining, drinking, exercising, singing or shouting”.

“While outdoor activities are safer, the risks are higher when there are large gatherings, limited social distancing, dense congregation, mixing among groups, and communal travelling to activities.”

Nphet also addressed the issue of communications over the coming weeks in their advice to Government. Under the heading of “tone of voice”, the team said “we will adopt and maintain a specific tone in our vocabulary eg Virus: chase, aggressive, contain, control, responsibility, consequences” and for “vaccines: evidence led, expert, clinical, which establishes a new chapter beginning on March 5 which builds on what we have learnt through 2020.”