Struggling to combat Covid-19

Sir, – Your front page article “BCG study ‘a potential game-changer” (Kevin O’Sullivan, April 4th) raised the possibility that BCG vaccination might alter the course of Covid-19 disease.

According to the figures given in The Irish Times (April 6th), the death rate per 100,000 population is more than twice as high in Northern Ireland as it is in the Republic. In the Republic, BCG was introduced in 1937 (in Dublin at least) and given to children at birth, and the programme continued until 2015. In the UK – and it is believed Northern Ireland, BCG was not introduced until 1953 and the programme stopped (except for children of immigrants) in 2005. Only children over the age of 10 years were immunised. Could this difference in BCG programmes partly account for the difference in death rates currently seen in the two parts of the island? – Yours, etc,

DAVID ALNWICK,

(Former Public Health

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Adviser with UNICEF and

WHO),

Co Cavan.

Sir, – As former chairperson of St Joseph’s Association for the Intellectually Disabled Portrane I wish to echo concerns set out on April 4th by Seamus Cowman, Royal College of Surgeons.

With this terrible pandemic there has been a concentration on nursing homes recently and rightfully so, with the news on clusters there, but no mention of facilities all over the country for people with an intellectual disability/mental health issues, where there may not be clusters but there are huge concerns with Covid-19.

These most vulnerable residents with the huge extra strain on staff in congregated settings must also be protected with resources. A thought also for families and a feeling of helplessness at not been able to visit their loved ones at this terrible time. – Yours, etc,

EAMONN TIERNEY,

Dublin 13.

A chara, – Up to 50 per cent of joggers I am seeing are not adhering to the two-metre guideline from the HSE when overtaking pedestrians.

It is disturbing watching some of them puffing and panting as they approach a pedestrian from behind and then brush shoulders as they overtake.

May I suggest to the HSE, that it tells all joggers they must wear high-vis clothing and must get on to to the road and provide the two-metre space when overtaking.

If a car is coming and it is too dangerous to get on the road, they should either stop or jog on the spot. – Is mise,

ALEX STAVELEY,

Donabate,

Co Dublin.

Sir, – Ian McShane (“2020 Behaviour & Attitudes Sign of the Times survey, Weekend Review, April 4th), concludes that the radical behavioural changes made by the public to defeat Covid-19 provides many with the confidence required to do the same to help save the planet.

The high level of compliance to the Covid-19 measures is motivated by self-interest which is an immediate threat to our lives and the lives of the ones we love. The motivation for an individual to take climate change mitigation action is much weaker based on self-interest.

For example, it is socially acceptable to take a flight anywhere in the planet to get rest and relaxation in the full knowledge that this pumps a large amount of CO2 into the atmosphere, contributing to climate change. There is a widespread lack of empathy and understanding that this non-essential flight negatively impacts the lives and livelihoods of vulnerable communities, many of whom live in developing countries and generate minimal levels of CO2 themselves. To save our planet, we need to develop an enlightened self-interest that includes the interests and welfare of everyone that shares our planet and not just those in our community. – Yours, etc,

MARK FOX,

Shankill, Dublin 18.

Sir, – Amid all the gloom of the Covid-19 pandemic it was heartening to read the article by Jack Power (Home News, April 4th) about Elizabeth McCullough and her dedicated team in the consular section of our Department of Foreign Affairs, and their great efforts to bring Irish citizens and other EU citizens home.

Our department is quite small in comparison to other EU countries such as the UK, Germany or France, so it is really amazing how they have managed to bring 400 people back to Ireland. In this time of crisis it is important to salute our public servants in all the work they do for us behind the scenes. – Yours, etc,

TERRY BARRY,

Dublin 13.

Sir, – Recent events in Ireland have involved a lot of publicity about intensive care units and how they are managed. Stories from other countries suggesting that admission to ICU is based on age grounds alone are unsettling and seem to be thoroughly ageist. It raises questions about the rules pertaining to the admission of patients to intensive care units in Ireland, not just during the current crisis, but also previously and into the future.

Which patients are admitted to ICU and which patients are not accepted for ventilator and other high-tech treatment? Which specialty of doctors makes this decision, how is the decision made, is the decision-making consistent throughout the country and does it vary from hospital to hospital or even from doctor to doctor? Does the patient or his family always have the same input into the decision-making? And is there a open arbitration system in place when the patient and his family disagree with the doctors’ decision?

Hopefully a benefit of the current pandemic will be that we as a nation will focus more closely on these issues and that more clarity will be introduced not only into decisions around ICU admission, but also other related issues such as advance directives, “do not resuscitate” orders, and the overall ethics of end-of-life care. – Yours, etc,

Dr MIKE FORDE,

Glenageary,

Co. Dublin.