If people start socialising in the way they did prior to the pandemic, we risk having a fourth wave of Covid-19, an expert has warned in response to weekend scenes in Dublin city centre.
On Saturday, the chief medical officer, Dr Tony Holohan, said he was "absolutely shocked" by the scenes he'd witnessed in the south city centre when he'd gone into town to collect someone from work after 8pm.
“Like an open air party,” he said in a tweet. “This is what we do not need when we have made so much progress.”
Kingston Mills, a professor of immunology at Trinity College, Dublin, described video footage of scenes from Dublin city centre at the weekend as "pretty shocking" and "not something we want to see."
“It’s saddening to see what happened at the weekend, you can understand it, but the video [footage] is pretty shocking.”
Sam McConkey, a professor of infectious diseases at the Royal College of Surgeons in Ireland, said everyone knows because of what happened last Christmas, that “socialising December-style” leads to more transmission.
“It is definitely the case that we could blow this success that we have now with too much socialising, so we do have to take it cautiously.”
He said the cautious steps that had been taken since March, re-opening schools, and construction, and retail, had not led to increased transmission.
“But just because it was okay for those partial first steps, doesn’t mean we can go wild, and turn everything back to the summer of 2019.”
So far the steps taken had worked out okay, “but it is still possible to lose that by taking too big a step, too quickly, and unfortunately, going back to a 2019 type of summer could definitely put us back into a new and fourth wave.”
Indoors
Prof McConkey said that while socialising can lead to increased transmission, “indoor socialising is much worse than outdoors”, and spaced out groups of small groups of people is “probably safer” than having one big crowd.
He had taken a walk around St Stephen’s Green one weekend recently and saw a lot of people sitting on rugs, drinking “but it wasn’t one crowd, it was little groups of four and six, which isn’t so bad.”
“Going out in small groups outdoors to meet our neighbours is okay by the rules at this stage. But what we don’t want at this stage is a big crowd of one hundred or two hundred, and a lot of intimacy.”
He said when experts point out that vaccines such as Pfizer can provide ninety per cent protection against the disease, a lot of people think “that’s really good”. But the flipside is that there is a ten per cent failure rate.
“It doesn’t protect everybody, all the time . . . You are still taking a risk.”
Everyone is tired of the restraints imposed by the pandemic, he said.
“There is a sense that we all just want to say, it is fine now, we want to go back to how it was before. That is a really bad idea.”
It is now mostly unvaccinated young people who are getting the disease, the bulk of whom have not yet been infected and so have no immunity.
Prof Mills said he would be of the view that Ireland was on the “home run” in terms of beating Covid-19, if it wasn’t for the existence of new variants of the virus that vaccines give less protection against.
“The biggest issue in terms of us getting out of this without a fourth wave and another lockdown are the variants of concern,” he said.
Of particular concern was the so-called Indian variant, which is looking as if it will become the dominant variant in the UK.
“And without travel restrictions to Ireland, it is going to be very hard to keep it out of here.”
Concerns
Studies in the UK have raised concerns about the low level of protection the first dose of vaccines provides against this variant.
“We have 500,000 people fully vaccinated, and 1.8 million who have had one dose. But that 1.8 million are not protected if they are going to be exposed to the Indian variant. They have only a one in three chance that they will be protected, if the data from the UK is correct.”
Even when fully vaccinated, the AstraZeneca vaccine may only give 60 per cent protection against the Indian variant.
It is because of this that he believes people in their sixties and seventies who have only received the first dose of the AstraZeneca vaccine, should be given a second dose of the Pfizer or other mRNA vaccine.
The Indian, Brazilian and South African variants have all been shown to reduce the effectiveness of the vaccines that currently exist, but the pharmaceutical companies are already testing new variants of the vaccines in response.
“Once we have vaccinated the whole population,” Prof Mills said, “we are just going to have to start again, re-vaccinating with the variant-based vaccine.”
Once again, he said, “science is going to come to the rescue.”
He is not as pessimistic as he could be, because the vaccine-producing companies have done “a fantastic job in responding so quickly.”
The whole world is going to be trying to get the new vaccines once they are fully approved, and this will be a challenge, but the EU has already done a deal with Pfizer for two billion doses between this year and next year “on the basis that we will need them, which I think we will.”
Prof McConkey said that the public health system in Ireland had been improved in response to the pandemic, which will have widespread benefits in the years to come. He also said the people involved were now experienced in dealing with the virus, and know more about it.
