No new Covid-19 deaths reported for second day in a row and 242 fresh cases

Nphet warns Government ‘major increase’ in socialising could see 450 cases a day before end of year

Chief medical officer Dr Tony Holohan  said in a letter on December 3rd that there was ‘significant concern’ over the level of new infections. Photograph: Collins
Chief medical officer Dr Tony Holohan said in a letter on December 3rd that there was ‘significant concern’ over the level of new infections. Photograph: Collins

No new deaths of Covid-19 patients have been reported by the National Public Health Emergency Team (Nphet) for the second day in a row. This leaves at 2,099 the total number of deaths in the pandemic.

Nphet also reported 242 confirmed cases of the virus, bringing to 74,468 the total number of cases in the Republic.

Of the cases notified on Monday, 113 are men and 129 are women while 63 per cent are under 45 years of age. The median age is 37 years old.

There were 76 cases in Dublin; 27 in Donegal; 22 in Kilkenny; 16 in Galway; 14 in Louth and the remaining 87 cases are spread across 18 other counties.

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As of 2pm, 223 Covid-19 patients are hospitalised, of which 28 are in ICU. There have been nine additional hospitalisations in the past 24 hours.

It is "more likely than not" that Ireland will be experiencing "challenging" levels of Covid-19 transmission in January due to increased socialising over Christmas, chief medical officer Dr Tony Holohan has forecast.

It was less likely that the country will be able to avert significant levels of infections, he told the Nphet briefing on Monday.

Asked what Nphet’s alternative was to the imposition of recurrent lockdowns, Dr Holohan said officials did not want to be in a position where the only recommendation they made to Government was for tight and challenging restrictions “but if we have to do it we will”.

He said a combination of the measures applied, a high level of compliance among the public and the strengthening of public health capacity so that outbreaks can be quickly picked up and controlled had the greatest potential for avoiding harder measures targeted at the entire population.

However, high case numbers along with increased socialising made it more likely than not that challenging levels of disease transmission will occur in January.

Dr Holohan said he was “surprised” by the European Centre for Disease Control (ECDC) guidance last week that stated that air travel was not a high-risk activity.

Nphet does not agreed with this advice and has made its views known within the ECDC, he said. Its advice remained that people avoid non-essential travel this Christmas.

He said plans for the rollout of Covid-19 vaccines in Ireland are “well advanced” and the taskforce overseeing it was on schedule to publish its detailed proposals on Friday.

Dr Holohan said that since restrictions were eased, people have a lot more opportunities to do things such as shopping or travelling.

He urged the public to “select from that menu” by doing one or two things rather than the entire list. If people do “everything”, he warned this will result in increased socialisation and crowding, thereby increasing the risk of virus transmission.

He said case numbers have “bottomed out” above 250 a day. “We’ve passed the low point at a much higher level than we would have liked.”

Evidence of the disimproving figures can be seen in the divergence between Ireland’s 14-day incidence, which is down 25 per cent, and our seven-day incidence, which is up 11 per cent.

However, there was good reason to be hopeful about the situation and if things were kept under control, a surge in infections could be avoided, Dr Holohan said.

The national incidence of the disease has increased slightly to 80 cases per 100,000 people over the past 14 days. The five-day moving average of cases now stands at 288 cases per day.

Donegal and Kilkenny, where there are major hospital outbreaks, continue to have the highest county incidences, at 232.4 and 172.3 respectively. Leitrim has the lowest incidence, at 15.6.

So far this month, there have been 16 deaths, compared to 147 in November and 120 in October.

Nphet officials reported 49 ongoing virus outbreaks in hospitals, in 18 different institutions, involving 921 cases. Some 443 of these cases are healthcare workers.

Since October, 73 deaths have been linked to hospital outbreaks and 32 in nursing homes. Some 99 nursing homes deaths have occurred since October.

The number of people who think the worst of the pandemic is over now surpasses those who say the worst is still to come, according to the latest polling figures carried out for Nphet.

Meanwhile, public health officials have clarified advice issued last week in relation to religious services, particularly over the Christmas period. The Health Protection Surveillance Centre says musical instruments that are physically blown by mouth, such as brass and wind instruments should be avoided at such services. However, pipe organs can be played “as long as all the appropriate public health measures are in place”.

Earlier, it emerged that Nphet had warned the Government a “major increase” in socialisation could see 450 cases of Covid-19 infection per day being diagnosed before the end of the year.

Such a level would be above the point at which Nphet has estimated a three-week intervention would be required to bring cases back under control.

In a letter sent last week, Nphet warned Minister for Health Stephen Donnelly that significant growth in socialisation and the diversity of contacts over the festive period could "lead to much higher levels of viral transmission than have been seen to date".

The public health team’s modelling shows that if the R number, which estimates how quickly the disease is spreading through the population, grows to 2.0 from December 22nd to January 6th, between 300 and 450 cases per day could be seen by New Year’s Day, and 800 to 1n 200 per day by the second week of January.

The five-day currently stands at 295.

The letter also flags concerns about the impact of an increased caseload on curtailing the spread of the virus, arguing that due to “resource constraints”, “any significant increase in incidence over the coming weeks has the potential to once again challenge the timely investigation and management of cases, clusters, and outbreaks by the Departments of Public Health.”

The letter outlines more conservative projections, which are based on keeping the R number at 1.4 of below.

In these scenarios cases could still be as high as 300 to 600 per day by the second week in January.

Nphet has previously told the Government that a three-week intervention would have to take place when cases are around 400 per day in order to be effective.

The letter, sent on December 3rd, and after the Government decided to unwind the Level 5 restrictions, also flags concerns around international travel which “has the potential to rapidly undermine the progress achieved by the country in recent weeks”.

In the letter, chief medical officer Dr Tony Holohan told Mr Donnelly that Ireland made “great progress” during the recent lockdown period, with “significant suppression of viral transmission”.

However, he says there is “significant concern” over the level of infection, which has stalled.

“The number of confirmed cases in intensive care and deaths associated with Covid-19 are not reducing. We continue to observe persistently high incidence in older persons, a population group most vulnerable to morbidity and mortality associated with the disease.”

Dr Holohan also said there had been increases movement in society and more contact between people “in anticipation of the recent relaxation of Level 5 measures and we now approach the Christmas period with a significantly high force of infection and healthcare burden.”

Nphet last week endorsed a joint paper on prioritisation - the order in which different groups will be selected for vaccination - from the Department of Health and the National Immunisation Advisory Committee.

Dr Holohan told Mr Donnelly that the prioritisation list is “based on ethical principles” and takes into account a range of factors, including the characteristics of Covid-19 and how it spreads, the individuals most susceptible to infection and the characteristics of different candidate vaccines.

The list of provisional priority groups, which is contained in the paper approved by Nphet, will remain under review. “Vaccine allocation strategies depend upon a number of factors, including vaccine efficacy in different age/risk groups, the availability of effective therapeutics, and the epidemiological situation at the time the vaccine becomes available,” Dr Holohan wrote.

The letter also confirms that there will be a serial testing programme for healthcare workers in acute settings put in place in early January, along the lines of those in place for nursing homes and meat factories.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.

Jack Horgan-Jones

Jack Horgan-Jones

Jack Horgan-Jones is a Political Correspondent with The Irish Times