No Government wants to preside over increased Covid deaths projected by modelling

Nphet’s figures are frightening – even if the worst-case scenario does not play out

A death toll of between 545 and 1,230 due to increased socialising and the impact of the highly transmissible Delta variant is considered more likely than the 2,170 fatalities projected by the National Public Health Emergency Team (Nphet) in a worst-case scenario.

Nphet on Monday night presented Government with four scenarios projecting the impact of the Covid-19 Delta variant if fuelled by increased social mixing, such as a return to indoor hospitality.

The stark figures put forward have been cited by Ministers as a reason why the resumption of services in pubs and restaurants must be delayed beyond July 5th.

Prof Philip Nolan, the chairman of Nphet's epidemiological modelling advisory group, last night posted a lengthy series of Twitter posts setting out the projections his team made and the reasons behind them. He offered some insight into what the most likely impact of Delta and increased socialising would be.

The “pessimistic” scenario includes as many as 2,170 deaths and estimates of around 682,000 cases and almost 13,000 hospitalisations over July, August and September.

“The full set of scenarios include a pessimistic scenario; while less likely than the central scenarios, the assumptions are a level of social mixing as occurred at the end of last summer, and transmission advantages for alpha and delta as reported from the UK.”

So what are those central scenarios?

Central 1 based on “higher social mixing from July 5th” projects 187,000 cases, 3,490 hospitalisations and 545 deaths.

Central 2, based on “moderate social mixing from July 5th” would see 408,000 cases 7,690 hospitalisations and 1,230 deaths.

Prof Nolan said that “even the most optimistic scenario with the Delta variant shows opening on 5 July risks a significant surge in cases”.

Taoiseach Micheál Martin and Tánaiste Leo Varadkar were asked on Tuesday if Nphet had told senior Ministers which of the scenarios they set out was most likely to happen.

Mr Martin suggested that how the spread of Covid-19 plays out could fall between the Central 1 and Central 2 scenarios but said "Nphet will be able to articulate where the risks are". Mr Varadkar said "logically" it could be between Central 1 and Central 2 - though he also pointed out the difference between the two scenarios was "quite big".

“The truth is it’s just not possible for us to know at the moment how long this Delta will last or how bad it will be,” the Tánaiste said.

"We will see that unfold in Scotland and England over the next couple of weeks. And we're erring on the side of caution here, and I think that's the right thing to do."

Prof Nolan said of Nphet’s modelling: “All this illustrates one thing: a variant with a transmission advantage can do very significant damage if we let it spread in a partially vaccinated population, the scale of the damage depends on the transmission advantage, and it starts slowly and escalates rapidly.”

Meanwhile, there has been much debate over how the expected acceleration of vaccinations among younger people was not factored into the modeling.

The National Immunisation Advisory Committee (Niac) has said Astra Zeneca and Jannsen – previously limited to the over-50s – can now be used for younger age groups.

Questions have been raised about which Ministers knew this change in the vaccination programme was not included in the Nphet projections when Cabinet made its decision on hospitality last Tuesday.

However, arguably it would have made little difference to the modeling and the decision on when to reopen indoor services in restaurants and pubs.

Even with the reduced four-week gap between AstraZeneca doses it would be six weeks before young people would be fully vaccinated, bringing us well into August, even if all of them could get the jab today, which of course is not going to happen.

The supplies aren’t here yet, and as Ministers have stressed in recent days, accelerating the rollout will be dependent on the deliveries arriving.

The argument over the expected changes in the vaccination rollout not being part of Nphet’s figures is something of a sideshow.

The bottom line is Nphet’s figures are frightening – even if the worst case scenario doesn’t play out.

No Government would want to preside over a situation that sees between 545 and 1,230 deaths over the next three months given how far the country has come in battling the pandemic since the dark days of January’s surge.

Ministers will be hoping that things don’t go as badly as feared in the UK, and that a system of vaccine passes for the hospitality sector, as sought by Nphet, can be developed so that the summer season can be saved for hospitality businesses and those keen to visit them.