Terse exchange with Donnelly over timing of response
Just before 10am on Saturday, October 10 last - five days after the Government rejected public health advice to lockdown for six weeks - Dr Tony Holohan, the chief medical officer, texted Stephen Donnelly with worrying news.
"Minister," he wrote. "Case numbers well up today."
He included figures from the Health Protection Surveillance Centre reporting 1,011 new cases - the first time in around six months that Ireland was reporting over 1,000 new cases in a single day and well above the 617 cases reported the previous day.
Holohan told the Health Minister that those figures would be made public that evening, that his team would be looking at the numbers in more detail over the day and that he was available to discuss should he wish.
Donnelly did not text back. Seven hours later Holohan texted again: "Minister, grateful if we could have a word. Finalising statement re cases. Thanks Tony."
It is unclear if Donnelly spoke to his chief adviser on the pandemic at all that day. His spokesman said it was "not possible to source at this point the telephone records" for October 10.
Donnelly did, however, speak to the Sunday Independent that afternoon for an article that was to be published the following day in which growing concerns about his performance were highlighted.
That article, based on interviews with more than a dozen ministers, TDs and officials, painted a picture of a minister overly sensitive to criticism, lacking in empathy, and whose condescending approach had alienated and annoyed party and Coalition colleagues, officials and opposition TDs.
The Sunday Independent can this weekend reveal how the relationship between Donnelly and Holohan appeared to become strained and somewhat tense over October and November last year as the nation grappled with a second wave of the virus that would eventually result in a second lockdown. Emails and text messages released under Freedom of Information detail a number of terse and somewhat testy exchanges. Most notable is the CMO's stark warning in early November about the "weakness" of the State's border controls that left him unable to assure the minister that Ireland was protected from new strains of the virus. This was just weeks before the first cases of the so-called UK variant - now the dominant one in the country - was confirmed in Ireland.
The text messages released to this newspaper also reveal Holohan's concern about some of the minister's public health messaging.
On October 12 he texted Donnelly to say that case numbers in Dublin were "up again as it has been over the weekend" and said he would "urge caution on your public messaging re rates in Dublin". The previous day, Donnelly had told RTÉ of "positive news" in the capital where the R number - the reproductive rate of the virus - stood at 1. On Twitter, he said the latest figures "suggest that transmission is slowing in Dublin".
Donnelly did not respond to Holohan's text on that issue. Eleven days later, on Thursday, October 22, Holohan texted Donnelly to inform him the R number for Dublin had gone up to between 1.2 and 1.3. Donnelly responded with a thumbs-up emoji.
By that stage the Government had decided to lockdown for six weeks. As the measures came into effect in the early hours of Thursday, October 22, the CMO sent a lengthy message to Donnelly at 5.32am ahead of an appearance on Morning Ireland.
The minister was due to address controversy over the HSE's contact tracing system effectively collapsing the previous weekend as more than 2,000 people who tested positive were told to alert their own close contacts.
Holohan's message contained six bullet points conveying his concern that the question of being able to "contact trace this number of cases or not completely misses the point". The message of the Level 5 restrictions for six weeks was, he wrote in all caps, that "WE ARE ALL CLOSE CONTACTS". He concluded that "this is a crucial point which is being totally missed" and said he was available to talk in advance of the interview. Donnelly sent a brief response: "Thanks for that Tony."
As the nation settled into its latest lockdown, written correspondence between the minister and his chief medical officer, which had been almost daily between the CMO sending the latest case numbers or the minister asking for information on an issue, became less frequent.
The CMO informed Donnelly of a positive case in Portlaoise prison on October 29. The following day they discussed the need to share more data about the virus between EU countries ahead of Donnelly's participation in an EU health ministers meeting.
Just after lunchtime on Sunday, November 1, Donnelly sent a lengthy email to Holohan with a list of 10 issues he wanted the CMO's office and Nphet to "investigate further as a matter of urgency". The email stretches to three pages when printed out and covers issues from the impact of poor ventilation on the spread of the virus to better contact tracing and use of rapid testing to examining occupancy rates on school transport.
Holohan responded the next day, saying he "completely" shared the minister's view on these issues, but noted the issues were "to some extent" already under consideration either by Nphet or the Department/HSE. He said he hoped to be able to be in a position to give him an initial response across all areas by the following evening.
Holohan did not respond in writing to a separate email Donnelly sent the previous day asking for his position on coursing clubs. Donnelly had included correspondence which stated that coursing clubs were "furious" that they had to suspend their season. The correspondent, whose identity was not disclosed, wrote: "Again the regulations make no sense and are not consistent. I can walk through the countryside with my dog but I cannot bring a gun?"
Donnelly sent another email on November 4 asking Holohan to provide a view on the matter. There is no record of Holohan responding to the minister's query about hare coursing. "This was a matter that was being raised in the Dáil and Minister Donnelly was seeking an expert view on it," the minister's spokesperson said yesterday.
The following day, November 5, Donnelly asked Holohan via text if Nphet could discuss ideas for areas where case numbers were not falling, in particular local electoral areas in Dublin. The minister said he planned to convene a meeting involving the two of them, the HSE and local TDs to "see what can be done to engage the groups who appear to have had enough of the Covid measures. Would be great to have Nphet's advice going into that".
But the CMO texted back to say he had "reservations" about such an approach.
"We have no response capacity at that level. We are focusing on building public health capacity at a geographic level of public health departments which will be out (sic) best means of having a genuine localised response capacity for when we re-establish control of this disease," he said, adding he was happy to discuss it after the Nphet meeting.
Minutes of the Nphet meeting that day do not record any discussion of Donnelly's idea.
The following day, November 6, focus had shifted to an emerging issue in Denmark where a new strain of coronavirus was found to have transmitted from mink to humans, resulting in the Danish government announcing a cull of more than 17 million mink.
It was the exchanges between Donnelly and his CMO over this issue that would open up the ground for Holohan to restate his and Nphet's long-held concerns about overseas travel in a manner notably more strident than he has stated publicly before.
It began at 8.14am when Donnelly texted Holohan to ask if there were "any considerations re the three mink farms in Ireland?".
Holohan responded that he didn't know, before adding: "But my primary concern first is implications for human health."
He said that a risk assessment was being carried out and that he would have a position later in the day, noting that the UK's decision to enforce a 14-day quarantine on arrivals "doesn't appear to make sense".
The UK government had at that time announced a ban on all non-UK citizens coming from Denmark, imposing a strict 14-day isolation requirement on its citizens returning from Denmark, and anyone in their household, with fines of up to £1,000 for non-compliance.
Email records show that Northern Ireland Health Minister Robin Swann wrote to Donnelly on Saturday, November 7, requesting that the same measures be introduced in Ireland to "ensure this strain does not reach our shores".
Swann had previously complained to Donnelly that 'Dublin dodge' was being used by Northern Ireland residents travelling through the Republic to avoid quarantine requirements.
But Donnelly, citing legal advice, had argued that passenger locator form information obtained from passengers in Dublin could not be shared with authorities in Belfast.
Noting this position in his November 7 letter, Swann urgently asked him to contact all Northern Ireland-bound travellers to ensure they were aware of their need to self- isolate.
That same evening, at 8.13pm, Donnelly emailed the CMO and officials asking that the public health team engage directly with their counterparts in the North and the UK "as a matter or urgency" to understand the UK position, which he described as "decidedly more robust" and the rationale for it. He attached a scientific paper on the mink issue that Transport Minister Eamon Ryan had been given by his UK counterpart.
Dr Holohan sent a response just after 9pm that evening noting that "as discussed yesterday", he and public health officials had been engaging with their Northern and UK counterparts. "We have a good understanding of UK decision to apply a full travel ban in respect of Denmark," he wrote. He added that the HSE, the Departments of Agriculture, Transport, and Foreign Affairs and the port authorities "have the measures in place which you have been briefed on".
In concluding his email, Holohan gave a stark warning: "In respect of our ability to respond more effectively at this stage, I must point to the relative weakness of measures we can apply at points of entry to Ireland in respect of travellers. These are advisory only and do not allow the kind of action undertaken by the UK.
"Our Covid border control measures do not give assurance to me as Chief Medical Office (sic) and as a result provide me no basis for assuring you as Minister for Health that we have appropriate public health controls in place to protect Ireland from importation of this disease. This is particularly concerning now that such a potentially serious development as mutation may be has arisen."
The following day, Sunday, November 8, Donnelly sent the CMO a terse response, saying "it would have been useful if you had aired your concerns, or indeed any concerns whatsoever in regard to border controls, when asked for your view at the Cabinet sub-committee some weeks ago where the border control protocols were being discussed and agreed".
Holohan wrote back to Donnelly at 4.33pm that afternoon to say that, as he recalled, the Cabinet sub-committee meeting was about implementing the EU framework for travel and what measures would apply for testing.
He said his "overriding concern" at that time was the "rapidly rising scale of the disease domestically". He pointed out that international travel had been a "major concern in early summer when disease levels were very low here" and that Nphet had made recommendations to Government. He said that public health officials "still have concerns about one-off tests and how we can be satisfied as to their validity as a basis for setting aside the advisory on restrictions of movement for travellers" who are coming from countries designated by the EU as orange and red under the bloc's traffic light system.
He pointed out that these concerns were articulated by him at the Cabinet committee meeting and had been raised subsequently. "We'll maintain our focus on travel as an issue which will increase in importance as the disease status may improve domestically," he wrote. He concluded by suggesting a meeting the following day to go through these issues.
There is no record of Donnelly responding to this email.
Indeed, Holohan's concerns about the State's border controls had been well ventilated publicly and privately to the Government last summer.
In a letter to Donnelly's predecessor Simon Harris on May 8 last, Nphet advised that work be undertaken to introduce "a range of more stringent requirements related to travel from overseas", including: mandatory completion of passenger locator forms; restrictions on non-essential travel from all non-EEA and UK countries with exemptions for Irish citizens; a "mandatory regime of self-isolation for 14 days at a designated facility" for all overseas arrivals with exceptions for supply-chain workers and those travelling to other jurisdictions such as the North; and a public information campaign to deter all non-essential travel.
These recommendations formed the basis of a memo that Harris brought to Cabinet the following week. But there was strong resistance to the idea of mandatory quarantine in hotels. "Who will guard that centre? It will make Direct Provision look like a tea party," then justice minister Charlie Flanagan is quoted as telling the meeting in Shane Ross's book In Bed With The Blueshirts. Flanagan will not comment on that account - but does not deny it. "Would armed gardaí or the army enforce the mandatory hotel stay?" he told the Sunday Independent this weekend. "Comparisons with New Zealand and Australia are wide of the mark. We are an island with strong business and people-to-people links with Europe and the world."
Ultimately the Cabinet agreed at that point in mid-May to task officials in the Departments of Health, Justice, Transport, Foreign Affairs and the Attorney General's office to examine the practicalities of the mandatory quarantine regime.
Two senior figures with knowledge of the internal government debate at the time said that resistance from some ministers and senior officials, and concerns over its workability given the open Border with the North meant, as one put it, "it didn't go anywhere".
This weekend Donnelly's spokesperson did not respond to specific questions about whether he raised the CMO's November 7 warning about border control measures with Government colleagues and pushed for swifter introduction of quarantine measures.
Donnelly's spokesperson referred to Ireland having agreed to the EU 'traffic light system' in September and applying 14-day restriction measures on arrivals from orange and red countries on October 20. They added that on November 9, "the Government decided to impose a two-week self-isolation period for people arriving from Denmark and to continue to proceed with the EU-wide approach for other countries."
The spokesperson noted that Nphet's position on travel and border measures "has been clear for some time".
"It has advocated for this at press briefings, in published letters and directly to senior government figures. This includes calling for hotel quarantining as far back as last May 2020 in a letter to Mr Harris. The EU-wide approach was designed to combat the spread of a virus which had already mutated several times, including Italian and Spanish mutations of the Wuhan strain. The flu virus mutates from year to year. There are numerous different strains of the common cold," they said.
They also cited recommendations and advice in Nphet letters on travel over the past year, including "renewed consideration of the area of international travel" and the "importance of protecting the progress the country has achieved through application of Level 5 restrictions and of avoiding a reseeding of cases through international travel".
The Government moved last week to introduce a limited set of mandatory quarantine requirements that are still weeks away from being introduced. The Department of Health has been put in charge of the new regime with Donnelly described by the Taoiseach at the Cabinet meeting last week as "the lead minister for quarantine".
Asked to characterise the minister's relationship with his chief medical officer yesterday, Donnelly's spokesperson said: "The minister has an excellent working relationship with the CMO. Emails and text messages from any period are just a small part of their communications - they speak regularly by phone and in person and have numerous interactions in the department together, including significant briefings as required."