Case numbers here are among Europe’s highest, so why aren’t we deploying proper antigen testing as a weapon?
Why is Ireland doing so badly when it comes to the case rate for Covid-19?
As of last Friday, Ireland lay seventh in Europe in one league table you don’t want to be at the top of — the league table of how the number of weekly cases of Covid-19 is increasing. The preceding week saw a 50pc increase in cases.
The preceding week saw a 43pc increase in cases. Not as bad as the Netherlands, which had a 62pc increase, but not as good as many of the countries we see being in our group — countries with similar levels of vaccine uptake to us. Denmark, Germany, Belgium, Finland, Greece, France, Austria, Norway, Switzerland, Italy, Spain, and Sweden are all doing much better than us, and some of them, such as Italy, are seeing a significant decrease in weekly cases.
In another league table — cases per one million of population in the past two weeks — we are also doing badly, being in the same group as the UK and countries in Eastern Europe.
It is important to point out, however, that in yet another league table (yes, there are lots of them and that’s why we need experts to help us interpret all this) we’re performing well — the number of people in hospital and the ICU. Some consider this the most important league table of all because it’s a measure of people being really sick and dying.
Countries like France, and especially Eastern European countries, are doing much worse than us. The reason for this is the level of vaccination.
Across the world the story is reassuringly consistent — vaccines are holding up against the nasty Delta variant, which is now known to be at least twice as dangerous as the previous variants in terms of putting people in hospital and really harming them. If we didn’t have the level of vaccination that we do, our hospital system would most likely be overwhelmed by Delta. The vaccines are breaking that chain from case numbers to severe illness. They have turned Covid-19 into what is effectively an endemic disease — still out there, but manageable.
That doesn’t mean that we should give up the fight, however. People are still ending up in hospital and becoming very ill. Those who survive are at risk of Long Covid, and in another important finding last week, in a study of over 250,000 people, more than half still had symptoms six months after recovery, which included breathlessness on exertion, lung abnormalities and mental health disorders like chronic anxiety. Covid-19 remains a disease you don’t want to get.
So even though the rise in case numbers is a cause for concern, it’s not as big a concern because of the level of vaccination we’ve achieved.
If you’re vaccinated and you become infected, there is also less of a chance of Long Covid, because your immune system will hopefully protect you from the disease progressing, although that is still an unknown. Case numbers, however, will still lead to some people getting severe disease, so we need to do what we can to get the numbers down, and surely aim to be more like our European neighbours.
The big questions are: Why is this happening? What can we do to put things right? And how will all of this affect the decision that is coming this week on the final reopening of our country on October 22?
Some say case numbers are increasing because Delta hit us earlier than other countries and so it’s taking longer to get it under control. Another possible reason is our proximity to the UK and Northern Ireland, where cases are also very high, given the level of travel between our countries.
We know what to do to try and get the situation under control. First and foremost, if you are unvaccinated, go for the vaccine, and if you’ve had only one shot of the two-shot vaccines then get the second one.
Even though vaccinated people might become infected, there will be fewer of them than in an unvaccinated population, because the vaccines are still protecting against infection. Vaccination decreases transmission overall in a population. This is what happens with other infections and is the case with Covid-19.
In Ireland, 300,000 adults are unvaccinated and another 70,000 people have had only one dose of a two-dose vaccine. The deputy chief medical officer Ronan Glynn said last week that the spread of the disease in these 370,000 people is having a disproportionate impact on the profile of Covid-19 in our hospitals and ICUs, with two out of every three people in the ICU being unvaccinated.
It was also stated that the 10pc of our adult population who are unvaccinated are responsible for 50pc of hospital admissions. He therefore reminded everyone: “The single most important thing you can do to protect yourself from Covid-19 is to get vaccinated.”
The next most important piece of advice is, if you have symptoms, stay home and get a test. The symptoms might resemble a cold, so people might not take them so seriously.
A sure-fire way to keep this virus circulating is for infected people, whether vaccinated or not, to meet up with other people. It looks like we’ll have to keep wearing masks in crowded places. We also need to keep up with good ventilation as that is a major way to stop the virus spreading.
There is, however, one more thing that we have not done well on. Antigen testing. In most of the countries that are beating us in the league tables of case numbers, antigen testing is being widely deployed. And yet it remains a rarity in Ireland, in spite of much advice to say it should be deployed more widely and effectively. It’s not foolproof, and if the virus is running rampant in a country, it can still break through. But it’s another weapon to use, and we don’t seem to be using it as effectively as other countries.
As we head towards October 22 and the full easing of restrictions, the numbers are being examined very closely.
Philip Nolan says we are on a ‘knife edge’. He said we will know a lot more tomorrow from the data being gathered. The Government has a tough decision to make. They were hoping that the various numbers would have gone in a better direction.
One scenario is that we proceed with the plan on October 22 but maintain the need for vaccine certs or evidence for prior infection for indoor activities, and keep up the mask wearing. It will mainly be younger people who will be socialising in night clubs and bars, and they are at a much lower risk of severe disease anyway.
The booster campaign will, however, be very important as that will protect older and vulnerable people from infection leading to severe disease. The Government will need to be confident that it will be rolled out as quickly as possible.
If we keep night clubs closed and restrict bars, we’re mainly doing that for the unvaccinated people, who are prepared to take risks anyway, as is their right. The issue then becomes number of ICU beds being occupied by people with Covid-19.
Yet again, the next few days are critical (how often have we heard that?) but we can be optimistic because the vaccines are still protecting us. After October 22, it remains unlikely that our hospitals will be under pressure like they were before the vaccines were deployed. Let’s hope so.
Luke O’Neill is professor of biochemistry in the school of biochemistry and immunology at Trinity College Dublin