It is relatively straightforward to make a statutory instrument under the Health Act 1947 imposing, in varying degrees, local, regional or national lockdowns. By the stroke of a ministerial pen, an economic sector can be closed down, severely restricted, or permitted to trade as normal.
The acronym Nphet stands for National Public Health Emergency Team. It is there to deal with public health emergencies. We are in an emergency, have been since March 2020. The State's reaction to the Covid-19 emergency has gone through a number of phases and a succession of planned levels of response. Looking at how Israel is coping with its emergency (which became much more seriously out of hand than the pandemic in Ireland), we can see that 150,000 Israelis are now being vaccinated daily and that they have already passed the one-million vaccination milepost. Several features deserve mention.
Whatever the rights and wrongs of what Israel is doing, one thing is clear: they are treating this emergency as an emergency
Hospital Report
First, the prime minister took personal charge of the vaccination programme once vaccines became available. Second, Israel has an integrated national health service which has advanced files for its citizens. Third, and disgracefully, Israel is making little or no provision for Palestinians in the occupied territories or Gaza.
Whatever the rights and wrongs of what Israel is doing, one thing is clear: they are treating this emergency as an emergency. But the actual rate of vaccination in Ireland seems to be at a tiny, if well publicised, trickle, compared to what is happening in Israel.
It is strange that our public health emergency team, while being in a position to advise on lockdown and other reactive steps, does not appear to take such a strong public role in advising the Government on the vaccination drive. That appears left to the Health Service Executive and Department of Health. I have emphasised previously here that hindsight is 20:20 vision and that it is easy to pass judgment in retrospect on the State's performance in combatting Covid.
But in truth, our experts have been confronted with several possible scenarios for many months now. One was that development of a vaccine could take between three and five years, if it happened at all. That scenario was trumpeted loudly by some who wanted to follow the zero-Covid strategy. Some of those people predicted a huge death toll in Ireland running to many tens of thousands. Happily, they have been proved wrong.
Another scenario for which any expert advisory group would be expected to prepare was that a vaccine or several vaccines would become available by late 2020 or early 2021 (as has happened). That scenario logically required detailed planning for the implementation of a mass vaccination programme. Such planning would have to make contingency arrangements for the sequence of vaccination of different groups within society, the legal issues including indemnity, privacy, proof of immunisation, consent and data protection issues. Some of that is entailed in flu vaccination programmes.
It does not seem that this second scenario has been the subject of serious detailed and advanced planning. There appears to be a last-minute approach to the reality of mass immunisation in Ireland.
Infection rate declining
It is not unduly cynical to note that it is far easier to plan for lockdowns, partial or total, than it is to do the slog work involved in preparing information technology, distribution arrangements, personnel training and the various legal and administrative steps required to achieve what is happening in Israel.
There are some tentative signs the infection rate is already declining from that which existed up to December 29th
Of course, operating within a European Union context in relation to approval and acquisition of vaccines may complicate the process. It seems that EU approval is taking a rather leisurely stroll compared to the frantic speed adopted in countries most gravely affected, on a per capita basis (including the United Kingdom).
Most people now want those who claim to be expert advisers on a public health emergency to be as publicly involved in firing up the vaccination programme as they appear to have been in closing down the economy. Tánaiste Leo Varadkar is right to ask that the present measures be given a chance to work before further clampdowns are proposed.
There are some tentative signs that the infection rate is already declining from that which existed up to December 29th. There is no use challenging the department, HSE and, in so far as they are different, personnel of the public health emergency team on why we find ourselves facing an intensive care crisis. It’s been staring us collectively in the face since it being reported in 2009.
An emergency must be treated as an emergency. GK Chesterton famously said: “If a job’s worth doing, it’s worth doing badly.” This is not an acceptance of incompetence; it is a retort to the hesitant and to perfectionists and procrastinators. It needs to be heeded now.
