The sight of tens of thousands of fans chanting and cheering their team on in Copenhagen contrasts sharply with the ‘pilot’ events Ireland has held, including 3,000 in the cavernous Croke Park, and fewer in League of Ireland grounds.
The Irish Government is following National Public Health Emergency Team (Nphet) advice, which is, as we’ve come to expect, cautious.
Many people like its caution. Caution has saved lives. But it has also cost people their lives and livelihoods.
It is not saving lives to prevent people from doing things we know are inherently safe, such as outdoor concerts and sports.
And it’s not saving lives to deny people access to vaccines that are pretty effective, and so have them sitting on shelves.
Nor is it saving lives to refuse to use rapid antigen tests that would help people engage in more activities, and could pick up outbreaks more quickly.
It surely can’t save lives to insist we treat all parts of Ireland equally, even when some places had virtually no disease this year, and others might have benefited from sharper, localised responses. Yet these are what the current Irish policy constitutes.
Whether Ireland has had a good or bad pandemic won’t be something we will be able to establish for years.
Some may point to the low number of excess deaths as evidence of an overreaction, but it can more plausibly be interpreted as evidence of an appropriate reaction.
Yet Ireland has also endured more restrictions, school closures, and business closures than any other European country.
The caution in not allowing us have crowds at matches cost us our hosting of Euro 2020 matches — not a big deal maybe, but it highlights the difference in the Irish approach to that in other places.
Bad policy often comes from bad policy-making structures. Formally there’s nothing new in the Irish decision-making structures for the Covid crisis. Cabinet is in charge.
But it’s clear that Nphet, the National Immunisation Advisory Committee (Niac), and the Health Service Executive (HSE) are more than just advisers to the Irish Government.
Nphet is supported by an Expert Advisory Group as well as 11 sub-groups, including an expert modelling group. The HSE relies on its National Crisis Management Team, which confers with Nphet on the response. Within Government the Department of Health advises Cabinet through the Covid Cabinet sub-committee.
The alphabet soup of agencies makes for slow decision-making. We have seen the farce of the chair of Nphet and Chief Medical Officer, Dr Tony Holohan, writing 30-page letters to the Health Minister, who is then expected to relay this to his Cabinet colleagues and senior officials in the Department of the Taoiseach.
This form of decision-making might make sense in normal times, when moving slowly on the basis of evidence is acceptable. But crisis decision-making entails making hard calls in real time, with limited information, involving moral trade-offs and political risk.
An effective response requires those different agencies and groups working together, feeding decision-makers with accurate up-to-date information and advice.
That should mean there would be relatively few people in the room making decisions, but that those people have access to all the right information. It should also mean those with expertise are willing to take risks with advice — offering opinions even before conclusive evidence is in.
Instead Ireland’s spiderweb of decision-making centres on Nphet, which though it has over 30 members, doesn’t appear to have much expertise in it.
Many are officials from the HSE or Department of Health, there are some public health specialists, but only this year were there experts in infectious diseases. Its unwieldy size makes it easy for Nphet to be dominated by the chair.
Dr Holohan has been described by some who deal with him as autocratic. This might be fine if he had expertise in the area of infectious diseases or epidemiology, and he was willing to give advice on the basis this is an emergency and so conclusive evidence rarely exists.
Instead he refuses to take reasonable risks. For instance, allowing rapid testing to enable an easing of restrictions on activities.
The Nphet position on this is irrational given the weight of evidence from other countries that it helps find potential outbreaks before they advance. Instead it is actively trying to discredit those tests with its remarkable performance of testing in front of an Oireachtas committee last week.
Nphet’s modelling has been consistently off. It was wildly wrong in underestimating the risks of opening indoor hospitality at Christmas. Its advice in March was that any increase in social mixing would see us in the middle of a fourth wave now. That hasn’t happened either.
Ireland has also adopted a very conservative vaccine regime that has led to the outrageous position that 40 to 49-year-olds are being fully vaccinated as quickly as the more vulnerable 60 to 69-year-old cohort.
We won’t use the better vaccines for the people who probably need them most, and are allowing the Janssen vaccines sit on shelves when they could be used to allow those in their 20s to travel and resume university.
Angela Merkel received her second vaccine last week. The second was different to the first.
Germany is one country that is trying out mix-and-match vaccines. It is an experimental approach that may give better protection, and also helps smooth out problems with the bumpy supply of vaccines. Again we refuse to try this.
The caution seems based on blame avoidance. Any decision made, even if it is the wrong one, can at least be defended on the basis that it was the advice. The advisers can in turn point to established clinical data, or say their modelling warned us.
The best time to have disbanded Nphet and reorganise the decision-making centred in the Department of the Taoiseach was last June when Micheál Martin became Taoiseach. The next best time is now.