With decisions imminent on the final community reopening planned for next week, trends around Covid-19 are certainly mixed.
Not surprisingly, there has been widespread strain from the pandemic, accompanied by some disappointment with the mass ‘knockout’ vaccination that was introduced in Ireland.
Despite having one of the highest vaccination rates in the world, we currently have one of the highest rates of the disease in Europe.
While many of our neighbors talk about the pandemic in the past tense, the talk here is about a possible fifth wave.
As usual there is no certainty about what will happen, nor consensus among experts, but we are starting from a high base in terms of the number of cases.
We find ourselves in a worse position than countries that have closed down less – or hardly at all – and which have fewer people vaccinated.
Currently, the infection rate of Covid-19 in Ireland is about three times that of France, Germany and Denmark. We are four times the level in Sweden, five times the level in Italy and about six times the level in Spain.
The gap has been around for months, but it hasn’t been sufficiently explained. Ireland has clearly suffered from its proximity to the United Kingdom, where case numbers have been higher than in most cases of the pandemic.
|Confirmed cases in hospital||Confirmed cases in the intensive care unit|
Officials point out that Ireland has larger and more multigenerational families where transmission can occur. Critics of official policy maintain that we are not doing enough to enhance the effect of vaccination, for example, by demanding higher ventilation standards or masks on young children.
Intensive care beds
So Ireland is entering winter in the face of Covid-19 a floor higher than almost anywhere in Europe except the UK. Meanwhile, our ceiling is lower because we have fewer hospitals and critical care beds even after the improvements made during the pandemic.
This limited room for maneuver informs the caution behind much of our pandemic policy. There is a real fear that the health system will be overwhelmed if things change quickly, which is often the case with Covid-19.
The percentage of positive tests has gone up since last September, and now stands at 8 percent. Counties like Kerry Waterford, which were less affected earlier, are now at the top of the list. The rise in cases appears to be due less to specific outbreaks and more to broader trends related to the reopening of society, and it is happening across the state.
Many other countries are experiencing sudden spikes in cases, most of which are mild and short-lived. This is also true here now that so many are vaccinated, but even that small minority of cases that lead to serious illness are adding to the pressure on health services.
The number of Covid-19 patients in hospital has been rising steadily for several months, and is currently about 10 times higher than it was at the beginning of July. ICU numbers are five times higher.
Most of these people are not immune, but thanks to a breakthrough infection, there are almost as many vaccinated Covid-19 patients in the ICU as there were Covid-19 patients in the ICU a year ago. Several people also died from the virus in the past month, as they did in the run-up to Christmas last year.
Outbreaks and localized outbreaks can be expected at this stage of the pandemic. We have been warned not to expect it as society opens up. The main questions are: Are they predictable? What drives them? Can it be contained?
Uncertainty about these answers is driving the recent bout of tension among officials. Daily case numbers topped 2,000 three times in the past week, but we don’t know why yet.
So far, modeling has done a reasonable job of predicting trends, albeit on the optimistic end of the scenarios developed.
Officials expected a rise in the number of cases among young people and a subsequent stabilization, and this happened. Now cases are increasing among the elderly, of which a greater proportion will become ill.
Logic would suggest that we look at the performance of vaccines, which experts say are still 80 percent effective after six months. In June, Chief Medical Officer Dr. Tony Holohan praised the « total eradication » of Covid among vaccinators, but for all the heavy lifting that vaccines are doing, cracks in the defenses they provide are now visible.
The clamor for reinforcements, starting with over-60s and health care workers, will rise in the coming weeks.
At this point, it appears that plans may have to be adjusted for further reopening, rather than dismantling them or imposing new restrictions, so that this wave can be kept within the confines of a bad winter.
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