Explainer: Lockdown measures still carry the heaviest load, but soon vaccines will take over

The population's adherence to public health guidelines is the primary reason for the steady fall in Covid-19 case numbers

A jogger passes a mural by Brazilian artist Gabriel Marques in Dublin’s Grand Canal area. Photo: Niall Carson/PA Wire

Eilish O'Regan Twitter Email

April 20 2021 02:30 AM

It might sound like we are slowly jabbing our way out of lockdown.

But the truth is it’s our own ongoing sacrifices that are still accounting for most of the boost which has led us to this current improved and optimistic point in the pandemic.

Vaccination is helping to speed up the fall in incidence in some high-risk groups, as well as sickness, hospitalisations and deaths.

But we have to thank ourselves for still doing most of the heavy lifting by loyally sticking to restrictions and foregoing so much.

Vaccination versus staying power

The declining incidence of Covid-19 in all age groups in recent weeks is not due to vaccination but the enormous efforts of people to follow lockdown measures, according to deputy chief medical officer Dr Ronan Glynn. He has pointed to the “fantastic impact” of vaccines on health care workers and residents of nursing homes. But vaccination is not wide enough yet to take the entire credit, although it will take over more of the burden in the coming weeks.

Vaccine effect

By last Saturday, 1.2 million doses had been administered. Of these, 851,828 people have got one dose and 351,802 are fully vaccinated. The positive impact of this is already clear.

Over-65s in long-term care

Older residents in long-term care saw an increase in infection once there was a surge in cases in the wider community during all three waves so far. It was near to impossible for nursing homes and other long-term care facilities to keep the virus at the door. In January long-term care residents made up around 7pc of all cases of the virus. But they have been given the vaccine since late December. They now make up only a fraction of cases – just under 0.5pc. There is a direct link between a fall in cases and a drop in infection, hospitalisation and death.

Healthcare workers

The other high-risk group to benefit from vaccination are frontline healthcare workers, 347,313 of whom have got at least one dose with nearly 100,000 fully protected. They made up around 15pc of cases of the virus in January but this dropped to 2.5pc recently. The pattern used to be that as more Covid-19 patients were admitted to hospital, health staff got more infections. From February, as vaccination of staff took more effect, that same trend was not seen although there continued to be a high level of patients with the virus admitted.

Over-65s

The incidence of infection in over-65s has fallen and the roll-out to the over-70s has had a significant positive effect. The improvement has been particularly prominent in the over-75s. While the fall in incidence in the wider population up to last week was around 2-4pc a day, it was 7-9pc in the over-70s so it is falling twice as quickly in this age group. However, according to Prof Philip Nolan, in data available up to last week, much of this breakthrough in the over-65s in the wider community is due to people continuing to be very careful about meeting others. All over-70s should have received a second vaccine by the middle of next month.

Close contacts test

The barometer which is most likely to cause a frown or smile on public health officials is the number of close contacts people have. It has remained at around 2.6 for several weeks, which has been described as heroic. What is also clear is that if people are meeting up – and two households can do so outdoors – they are doing so in the open-air where the chances of the virus being passed on are much lower.

Serious illness

The number of people seriously ill with the virus in intensive care is down to 50, the lowest since the end of December. Overall, 183 Covid-19 patients were in hospital yesterday morning. Vaccination of older groups and increasingly people with underlying illness is protecting more of those who are most prone to illness from Covid-19. Around 70pc of cases now notified daily are in people under 45 years of age. The median age is 31.

Old reliables

There may be other factors helping to curb the spread, such as walk-in testing clinics in local hotspots. But it comes back to the ongoing need to lean heavily on the “old reliables” – basic public health measures – for several weeks to come until a high proportion of the population get a vaccine dose. This means keeping a distance, wearing a mask and avoiding indoor meetings with other households. Public health doctors are again reporting outbreaks from people meeting up.

Crunch decisions must be taken next week about opening up from May onwards and how fast we shake off the shelter of lockdown. We will increasingly look to vaccination as an alternative safeguard to keep us from harm.