Pandemic response – lessons learned?

Ireland’s Covid-19 strategy

Sir, – While Martin Feeley’s previous expression of doubt about Ireland’s Covid-19 strategy was poorly timed, there seems a lot of value in reviewing our approach to the outbreak now. In his recent presentation of the issues, I’d suggest he makes several arguments which are irrelevant or miss key points, however (“We destroyed young people’s lives for what?”, News, April 1st).

He suggests that as “we have the youngest population in Europe so we should have the lowest death rate”. This ignores the other obvious risk factor for very severe Covid, namely body weight. Most of our adult population is overweight, and a quarter are obese, ranking us ninth of 53 European countries for this problem.

Secondly, he suggests broadly that as the death rate of the disease is low, lockdowns were unnecessary and the risks to the hospital system negligible. It is not dead people who challenge the system though, but sick ones.

As a doctor working in an ICU at the time, I saw critically ill young people with Covid, including very fit individuals in their 20s and 30s, among them our own staff members. Dr Feeley seems to surmise that because, on average, severe cases were elderly, it posed no threat to the young.

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This is not so. Many got very sick with it, but survived with treatment.

It worth noting also, with hindsight of course, that Dr Feeley was expressing his misgivings in September 2020. The following month the New England Journal of Medicine reported the efficacy of two vaccines for the disease and they were available in Ireland before the year ended.

Looking at our actions overall, while Dr Feeley may wish to compare our outcomes with Sweden, surely it is the UK, with which we share a border, that offers the most meaningful assessment.

Slower to lock down, they have recorded 3,057 deaths per million population while we have seen 1,746, as per the Covid Worldometer website.

While we are still given to understand that the NHS provides a model of how our healthcare system should evolve, it is striking how much better our outcomes were in this natural experiment.

Despite that, I’m not certain that our strategy fairly prioritised the social wellbeing of young people, although I have no doubt about the motivations of those who made such difficult decisions at the time. A discussion about how to value quality versus quantity of life might be timely and informative before the next major infectious disease outbreak.

The National Institute for Health and Care Excellence in the UK values a year of perfect health at about £30,000. This at least makes meaningful and objective discussion possible. How to value the social life of young people, their sporting participation and interactions, is a difficult matter to grapple with. But reflecting on my own experience of life, I can think of few things I’d prize more. – Yours, etc,

BRIAN O’BRIEN,

Kinsale,

Co Cork.

Sir, – While, on one level, I could sympathise with some of the content of Dr Feeley’s gripes in Paul Cullen’s extensive article, he lost much of this reader’s attention by his gratuitously offensive jibe about “Tony Holohan or any of his henchmen”. During the height of the pandemic. 2020-2022, I would estimate that the vast bulk of Ireland’s population were very grateful to the chief medical officer and all levels of HSE workers and other service providers who worked expertly and tirelessly during the lockdown and beyond. It is easy at this remove to pick holes in a health policy that of necessity was evolving in the light of World Health Organisation and other international experience. Typically and conveniently it is the norm now to point to the light touch taken by Sweden during the pandemic, but that was atypical internationally. What about the strict controls imposed in Australia. New Zealand, US, China and by other nations? I am glad Dr Feeley recovered quickly from his Covid infection. Many patients, young and old, succumbed during the pandemic, with many of their families unable to attend loved one’s funerals due to absolutely essential Covid restrictions. We shall remember them. – Yours, etc,

PATRICK JUDGE,

Dún Laoghaire,

Co Dublin.