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Jennifer O'Connell: We've had enough of being micro-managed by Nphet

Public would respond better to clear rules than to clamour of discordant messaging

One of the striking features of this crisis is how the public has tended to move more quickly and with more alacrity than the authorities. Whenever case numbers started to rise and restrictions were looming, people tended to pre-emptively change their behaviour.

While chief medical officer (CMO) Dr Tony Holohan publicly worried back in the spring of 2020 that people might see wearing a mask as "a little bit like a hurling helmet" and put themselves "in danger", many just got on with it and started wearing the mask. The National Public Health Emergency Team (Nphet) spent many months dithering about antigen tests, but again swathes of the public appear to have decided that an antigen test might not be more effective than a PCR test, but it's definitely more effective than no test.

Now we’ve entered a new phase and the guidance coming from the public-health authorities, the Health Service Executive and the Government is that... well, that’s the thing. Nobody is entirely sure. There’s no shortage of messaging, but not much clarity. Often, it feels as though Holohan is laying down the gauntlet to Government through the medium of his weekly press briefings.

Nightclubs are fine, but not more than three times a week. Joining the full capacity crowd at a football match is okay too, but don't hug your granny for a week afterwards

So we’re told in one breath by Nphet to work from home; in the next by the Government that it has no plans to tell us to return to working from home; in the next by Nphet that we should work from home wherever possible. Before the Government even has a chance to discuss the advice, unions and employers groups are out giving their reaction to it, as though it’s already policy.

The confusion and contradictions don’t end there. Everywhere is open, but we’re being asked to cut our social contacts by half. Nightclubs are fine, but not more than three times a week. Joining the full capacity crowd at a football match is okay too, but don’t hug your granny for a week afterwards. The caseload among the five- to 12-year-old age group rose 43 per cent in a week, but only two school outbreaks were officially notified, and Nphet insists “child-to-child transmission is uncommon in school settings”. Presumably they’re surrounded by a magic shield once they walk through the school gate.

If we were still in the grip of a rapidly unfolding crisis, some of this ambiguity would be understandable. And yet, despite the high numbers of people testing positive, the fourth wave of the virus is of a different character. By the middle of this week, 57 per cent of people admitted to hospital and 43 per cent in ICU were fully vaccinated. At first glance, that’s worrying, but it means that the unvaccinated or partially vaccinated 11 per cent of the population account for more than one in three of those in hospital (some are unknown) and more than half of those in ICU. The vaccine isn’t stopping everyone getting sick, but it’s stopping many getting very sick.

A tension seems to be emerging between the Government's desire to take back control of the messaging and continue to allow the public to enjoy some semblance of freedom, and Nphet's reluctance to give up its pulpit, undoubtedly because it believes the situation remains precarious. To be fair, trying to forecast the course of this virulent, mutating virus is like trying to juggle with jelly. Just two months ago, Holohan was so confident about its trajectory, he wrote to the Minister for Health Stephen Donnelly to recommend that automatic contact tracing of all close contacts be discontinued. Six weeks ago, Nphet's chief epidemiological adviser Philip Nolan announced that we were close to suppressing the virus.

And now, here we are again. Last week, Holohan wrote to the Government to ask for public-health messaging to be "strengthened in the lead-up to Christmas". It's hard to imagine what more public-health messaging he could possibly imagine we need, beyond the weekly press conferences, the radio ads, interviews and the dire daily toll of case numbers. A better call might be for fewer voices and more clarity and impact. Because with Covid communications everyone's job and no one's, it isn't clear who's actually in charge. On any given day, we might hear from the Minister for Health, the Taoiseach, the CMO, the head of the HSE, the chair of the epidemiological advisory group, and they're not always saying the same things. Our public-health figures have become simply public figures. The contrast with the UK is telling – their CMO Dr Chris Whitty hasn't featured in media headlines at all over the past month.

I suspect the public might respond better to a few clear, fair rules to the current clamour of discordant messaging and the looming threat of more lockdowns

Unsurprisingly, the public has tuned out. The Economic and Social Research Institute pointed out this week that in every wave of the virus so far, as case numbers rose, people got worried and moderated their behaviour. That hasn't happened this time. As the head of its behavioural research unit, Pete Lunn, said, we're vaccinated. We know the probability of serious disease is low.

Still, the threat hasn't gone away. Every country in Europe is grappling with a virus that is more evasive and more resilient than anyone anticipated. Austria is days away from introducing a lockdown for the unvaccinated. The Dutch government is to close bars, restaurants and non-essential shops at 7pm for three weeks, reopening only to the vaccinated. Germany is looking at introducing "2G" – a regime where only the two-thirds of the population who are vaccinated or recovered have access to most places.

Ireland is in a comparatively fortunate position, yet it's not clear what the policy approach in this new phase should be. Much of the talk is of emphasising individual action and personal responsibility over more rules and regulations. I suspect the public might respond better to a few clear, fair rules than to the current clamour of discordant messaging and the looming threat of more lockdowns. Once again, many people seem to have made up their own minds regardless. What they have decided is that they've had enough of feeling micromanaged by Nphet.