‘Cases could have hit 120,000 a day without measures’
Ireland is likely to remain in virtual lockdown for much of 2020 to fight the coronavirus, it has been starkly warned.
Hopes have been dashed that some of the toughest restrictions on social and sporting life will be lifted by summer, and there should be a return to relative normality soon.
Chief medical officer Dr Tony Holohan said people will be dealing with restrictions of one kind or another until a coronavirus vaccine is available.
But scientists have said a vaccine is 12 to 18 months away.
Dr Holohan’s expert group will spend the next few weeks before the May 5 extension exit date looking at what restrictive measures – which could have some social or economic benefit – may be eased.
But he said “anything that happens after May 5 will be conditional on what we see in the behaviour of the virus” and any resurgence will lead to a renewed clampdown.
Health Minister Simon Harris also said physical distancing will remain “a big part of life”, even after restrictions are eased, in the absence of a vaccine or effective treatment for coronavirus.
He said commentary about life getting back to normal as Ireland is doing well in the battle is “dangerous talk”.
Dr Colm Henry of the HSE said: “It does not seem in Ireland or abroad that we are looking at a peak, a fall and a back-to-normal. That does not seem to be plausible.”
Another 31 people have died from the virus, bringing the death toll to 365. The oldest person to die since the start of the outbreak here was 105 and the youngest 30.
They include 167 residents of nursing homes and 32 others in residential settings caring for people who are physically vulnerable.
The number of confirmed cases of the virus rose to 10,467, of which 527 are recent with 465 relating to a backlog of older tests sent for reading to a German laboratory.
Dr Holohan again warned there can be no lifting of any restrictions without a proper coronavirus testing system in place - otherwise the country would be trying to suppress the virus "blindfolded".
Health officials insisted the greatest concern is now around the outbreaks of infection in nursing homes and other residential centres.
Asked why so many nursing homes are still not seeing promised supports, officials said that the facilities which are in greatest difficulty containing the virus are being tackled first.
There are now more safeguards around the discharge of patients from hospitals to nursing homes, after some owners feared it was bringing infection into these facilities.
Any patient who is transferred from hospital to a nursing home must have two negative swab tests.
A backlog of around 11,000 tests will also be cleared at the end of this week and the testing process here will be speeded up - although it remains in a state of uncertainty because of the risk that laboratory reagents may be in short supply.
To date there have been 269 patients admitted to intensive care and 167 patients are still receiving the high level of treatment. While 37 people have died there, 65 have been discharged.
So far hospitals have not had to call on surge critical care capacity, and there are more than 130 critical care beds free.
Mr Harris said there is good progress but it's fragile and at a "really critical stage" and it could still "go either way" in terms of ending up like badly hit countries elsewhere.
He said modelling shows that the number of new cases could have been as high as 120,000-a-day if no restrictions on the public had been put in place.
One of the key factors in determining when to ease restrictions will be the "R-number" or reproductive number of how many people are being infected by individuals who have Covid-19.
This number needs to be below one. While it is hovering around one at present, health authorities are not yet prepared to say that it is below that figure.
The minister said the R-number could be below one within weeks. "We could be suppressing the virus.
"In three weeks' time I could be sitting here with you, telling the Irish people we're suppressing the virus," he said.
But he said no one should assume it was inevitable - and these things "don't happen by accident" and require "massive sacrifices".
"I think if we stick with it, stick the course, we can get that figure below one," Mr Harris said.
Meanwhile, a stand-off continues between some hospital consultants and the HSE.
Consultants who are treating private patients only are continuing to resist signing a HSE contract, which would see them employed in the public system for a number of months.
This follows the takeover of private hospitals by the HSE during the coronavirus emergency.
The Irish Hospital Consultants Association (IHCA) said an understanding had been reached on April 8 between the doctors' representatives and the HSE.
It provided for both existing patients of full-time private practice consultants and new referrals necessitated by the Covid-19 emergency to be cared for on an agreed basis.
This would have allowed the consultants to use their own private consulting rooms.
"However, this did not materialise in the written updated draft contract circulated by the HSE on April 10," the IHCA said.
"If this proposed version was to apply, consultants would be liable for costs which would likely exceed their income thereby forcing the closure of consulting rooms needed to provide timely outpatient care."
The doctors will "voluntarily deliver urgent inpatient care and continue to provide time critical essential care from consulting rooms to permit an opportunity for agreement on the proposed contract without further delay. But patients and consultants need certainty as the current impasse is untenable."
Visit our Covid-19 vaccine dashboard for updates on the roll out of the vaccination program and the rate of Coronavirus cases Ireland
The economic tragedy now playing out in Ireland is unprecedented - the speed of the shutdown, the emptiness of our shuttered streets and other realities that we must now learn to live with.