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The Government’s revised reopening plan comprises two elements: minimalist changes to the timetable for the easing of restrictions and the approval of tools that should have been sanctioned some time ago.
Chief among the latter are antigen testing, which will take on a larger role in the State's armoury, and the extension of the vaccine booster scheme to all those aged 60 and over. The Government's hands were tied on the booster shots because the National Immunisation Advisory Committee (Niac) was engaged in lengthy deliberations on the issue and formally recommended an extension only on Monday. Emerging evidence from the UK and Israel shows that effectiveness wanes after five months. That, combined with rising incidence levels, made it difficult for the Government to choose any other course, although real ethical questions arise given the dire shortage of vaccines in the developing world.
The case for antigen testing has been clear for much longer, yet the Government's public health advisers maintained a sceptical view of its value even as most European states adopted it as a key tool in the fight against Covid-19. The National Public Health Emergency Team (Nphet) is clearly correct that PCR tests are more reliable, but the relevant comparison is not between antigen and PCR; it is between antigen and no test at all. That is particularly true given that fully vaccinated close contacts are no longer being sent for PCR tests by the Health Service Executive. If antigen tests capture even a small proportion of cases that would otherwise have gone undetected, they will have served a useful purpose.
Various theories have been offered for the recent spike in cases, none of them persuasive on their own but together amounting to a potent combination. If waning vaccine effectiveness is one factor – it is difficult to tell given that the Government does not give a regular breakdown of case numbers or hospital admissions by vaccination status – then gathering in crowds must be another. That is why the biggest risk taken by Government is to create more opportunities for people to mix in big numbers, which it did by sanctioning the reopening of nightclubs, longer pub hours, and the lifting of attendance limits at weddings, religious ceremonies and sports events.
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It is not a wholesale lifting of restrictions – rules around mask-wearing and the use of the Covid cert are to continue for longer than previously flagged, and the return to workplaces will slow down – but it is nonetheless a significant shift at a time when several of the country’s ICU units are almost full. Those hospital admission numbers are now by far the most important to watch. Should they continue to rise at current rates, and with the benefits of a wider booster scheme weeks if not months away, the reimposition of restrictions remains a real possibility.