Between May and September 2020 we had an opportunity to prepare for the next wave of Covid-19. We have not done so. During this time, Ireland changed governments, changed ministers for health, the politicians took a six-week break, and community medical services have remained in a deep freeze, waiting for the next wave.

We had an opportunity to safely open the country and to secure our borders, and develop workable “red” and “green” lists, similar to our EU neighbours and indeed those around the world. We were listening to the “experts of the day” and our politicians saying we should adopt a New Zealand model, knowing that would never work, as New Zealand does not have a border with Northern Ireland. We wasted time and our economy has suffered.

Every day of indecision has resulted in more businesses going under. While many “third world” countries in the Caribbean and Central America had robust polymerase chain reaction (PCR) screening set up by mid-August to prepare their economies to open up, we didn’t. If the Caribbean and Central American countries can do it right, what does this say about Ireland?

Hospital Report

Who is in charge of our plan to deal with Covid-19? It appears everyone and no one

I met a biotech company recently which has the same PCR technology being used in the Caribbean, and which approached the Health Service Executive in April about getting its test validated in Ireland so it could be utilised at the airports. It is still waiting for assistance. I was interviewed about the sniffer dogs that are being used in Finland to detect Covid-19 – a great idea! It appears that when Irish sniffer dog experts approached our Government they were rejected. I met a Temple Bar association which has a robust plan to safely open up our city centre. They had gone to Hong Kong back in April and have a blueprint to safely open the area. They have approached our Government and, no joy. Who is in charge of our plan to deal with Covid-19? It appears everyone and no one. Who is accountable? Always the other guy.

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Scientific understandings

European groups have been set up to share best practice to deal with Covid moving forward. Who is the Irish representative on these groups? I have reviewed the proceedings of a World Health Organisation-supported initiative chaired by Dr Y Yazdanpanah, the Global Research Collaboration for Infectious Diseases Preparedness, which outlines necessary steps to deal with the Covid pandemic. Who was the Irish representative from this group, if any? Ireland has failed to implement most of the recommendations outlined by this group and other EU forums tackling Covid-19.

And the Irish official response to a Covid vaccine? We were told by a Department of Health official in April “we will stay in lockdown for 18 months until they mass produce the Covid vaccine”. And recently one of our Ministers stating the Covid vaccine would be here in February 2021 and will be given to our most at risk. However, there is no approved Covid vaccine and even if there is, such predictions are without scientific understandings of the vaccine development process. What expert opinion did our Irish officials receive to come up with such statements? It appears to me like no expert input was obtained.

Other countries have used face masks/coverings as a critical part of their plan; we have been late to require such Covid prevention

So who are our “experts” that we have engaged to develop a robust plan for Ireland? When you hire an “expert” you should interview them, look at their CV, and look at their experience and expertise; and then utilise their expertise based on their skill set. There seems to be no such process in place in Ireland regarding our Covid experts. Opinion and decisions regarding Covid-19 seem to be largely influenced by the media view on what is most newsworthy, and often the most “extreme” experts of the day are getting their time on the airwaves or on Twitter.

Inclusive representation

We need an expert group consisting of true experts based on a skill set, and we need representatives with a diverse variety of “skill” sets at the table, not just HSE/Department of Health managers and public health officials. We are dealing with more than just the medical consequences of Covid-19 in Ireland. Decisions are affecting the future of us all, and there needs to be inclusive representation.

I am not downplaying how difficult living with Covid-19 will be. Covid can be lethal. But we performed quite well in the first wave and managed to control it. Our hospitals managed to cope with the first wave. There is no indication that the second wave will be more severe than the first. We are in a better place than February. While we need “contingency” plans for “worse-case scenarios”, we must also continue all of our other services in parallel.

So, who is in charge of making these decisions? What is our masterplan to win the war on Covid-19? We have to fight many battles on many fronts, all in parallel. At present we have not optimally utilised all of the expertise we have in Ireland. Other countries have used face masks/coverings as a critical part of their plan; we have been late to require such Covid prevention, and still do not emphasise or enforce use of face masks.

Our citizens, and indeed many of our politicians, have lost faith in the current leadership and the dependence on lockdown as a plan. What is the rationale for a countrywide lockdown being considered where just a few weeks before we published the long-awaited Living with Covid-19 manifesto, which focused on regional and local measures, if measures needed to be taken.

Going forward, we need a united Ireland with strong leadership; a Covid-19 “czar” who can unify all of the disparate groups that appear to be operating at odds with each other or at the very least appear not to be talking to each other.

Reacting only to the Covid-19 numbers with lockdown results in more damage to Ireland and its population; and damage to their medical, psychological and economic health. We need fine-tuned local and regional decisions to deal with Covid-19, not the blunt instrument of a countrywide lockdown.

Dr Jack Lambert is professor of medicine and infectious diseases at the Mater and UCD school of medicine