It’s not Nphet but the pandemic itself that's really unfair

Blaming a virus does not fulfil psychological need to hold someone responsible

With the vaccination campaign, the HSE has undertaken the largest acute public health intervention in the history of this island.Photograph: Laura Hutton

With the vaccination campaign, the HSE has undertaken the largest acute public health intervention in the history of this island.Photograph: Laura Hutton

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Minister for Health Stephen Donnelly has said he is “disappointed and uncomfortable” at virulent criticism levelled against the National Public Health Emergency Team (Nphet) following their advice about the Delta variant of Covid-19.

Politicians can expect to feel uncomfortable from time to time, especially when the stakes are high. That is part of what democracy means. We should, however, expect civility in our public spaces.

The recent vitriol against Nphet is regrettable and, for the most part, wrong. Nphet offers independent, scientific advice to the Government. As Donnelly says, with masterful understatement: “They do not have an easy job.”

Brendan Kelly is professor of psychiatry at Trinity College Dublin

Time and again, Nphet has not hesitated to tell the Government bad news, even when it is politically inconvenient for the Government to hear. Telling truth to power is not easy. In a country of just five million people, such objectivity is rare. Nphet does not suffer from social desirability bias either: it does not shape its message to reflect public opinion.

Fourth wave

In the midst of a pandemic, it is impossible to overstate the value of Nphet’s independence of thought. Nphet’s dogged insistence on doing its job is one of our strongest tools against the virus.

Our other great strength is vaccination. The HSE has undertaken the largest acute public health intervention in the history of this island. There are bumps along the road, but these reflect evolving information about which vaccination schedules work best for whom. It is vital that these schedules are continually refined, in order to glean the very last drop of value from the precious vaccines. Lives and livelihoods depend on it.

Hospital Report

Confirmed cases in hospital Confirmed cases in ICU
448 88
Total doses distributed to Ireland Total doses administered in Ireland
8,557,330 7,293,281
Industry leaders ask for 'certainty' in a uniquely uncertain world. When they get neither, anger erupts. Nphet and the Government are blamed

We stand on the cusp of a fourth wave. Hopefully, the link between infection and illness will be considerably weakened through public health measures and an accelerated vaccination programme. Inevitably, Nphet will have more good and bad news over the coming months.

When Nphet delivers bad news, we tend to blame the communication process between Nphet and Government, or seek evidence that the Government is more responsible for the situation than it actually is. Commentators demand “clarity” when clarity is clearly impossible. Industry leaders ask for “certainty” in a uniquely uncertain world. When they get neither, anger erupts. Nphet and the Government are blamed.

While such criticism might be appropriate to a certain extent, there is a good deal of displacement going on. In other words, much of the frustration that is directed against Nphet and the Government should rightly be aimed at the virus itself.

Blaming a virus does not, however, fulfil our psychological need to hold a person responsible, so we shift our anger to politicians, the Government, Nphet or the media. Unsatisfying as it might be, it is the virus that we should blame. These other actors play far lesser roles.

Intrinsic unfairness

The same can be said about the social and economic impact of the pandemic. It is primarily the pandemic that is unfair, not Nphet or the Government. Like most infections, Covid-19 is most harmful among older adults and people with pre-existing illnesses. This intrinsic unfairness is echoed through all aspects of the pandemic, but is mostly attributable to the biology of the virus rather than actions taken or not taken by Nphet or our politicians.

Most of those who die (over four million to date) will die of a combination of infection, poverty and injustice

Sectors of the economy that do not rely on groups and gatherings are considerably less risky than those that do, such as hospitality, sports and live entertainment. This is desperately unfair on people who work in these sectors, but the unfairness is biological, not political.

As a medical doctor, I am privileged to have a job and to have been vaccinated earlier this year. Not everyone is so lucky. The virus, like most of nature, is grotesquely unfair. It is important that Government policy does not amplify this injustice, but the intrinsic, baseline unfairness lies with the pandemic itself, not the politicians or public health officials.

So, what next? What lies beyond a fourth wave?

Vaccination has changed everything. The virus might be a master replicator, but it meets its match when we combine vaccination with public health measures.

At global level, the outcome of this pandemic will be grimly similar to previous ones: most of those who die (over four million to date) will die of a combination of infection, poverty and injustice. Rich countries can ameliorate this by providing vaccines and economic support to countries in desperate need of both.

In Ireland, our strongest tools are vaccination, public health measures and consolidating our health system more broadly. Public policy should minimise the intrinsic unfairness of the pandemic and, where such unfairness inevitably persists, provide practical support and solidarity for those affected.

We need to return civility to our public spaces as we discuss these matters. We are stronger than we think, provided we respect each other. In the midst of a pandemic, the words of philosopher John Moriarty, in Dreamtime, are more relevant than ever: “We have a centre that will hold.”

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