Almost halfway through six weeks of Level 5 restrictions, there is at least plenty of good news to balance the lockdown-induced gloom and hardship.
The prospect of a vaccine solution to this crisis continues to move closer with Pfizer’s announcement on Monday of encouraging early results from phase-three trials of its vaccine.
The bad news is that a vaccine appears to be the Government’s only strategy for avoiding further lockdown. If Ministers have already formulated a detailed plan for opening up the country, they have – unusually – managed to keep it very close to their chests.
Hospital Report
But with three weeks to go before restrictions are due to be lifted on December 1st, it still isn’t clear how – or even if – this is going to happen. Of course, much depends on trends over the rest of this month, but if the country is to be ready for “living with Covid-19” in a way that doesn’t see the virus return, elaborate preparations will have to be made in terms of the rules we operate, the staff we hire and the tests we use.
No country has controlled this virus without stopping, or heavily minimising, new cases entering its territory
We will also finally have to stop merely talking about an all-Ireland approach and actually take steps to ensure the Republic and the North are in synch on Covid-19. In reality, the opposite seems to be happening – witness the yawning gap in incidence rates on either side of the Border and the divergence in approach to travel with Denmark in the light of that country’s problem with mink farms.
Eight months after the pandemic started, we have no effective quarantine arrangements in place for travellers, virtually no testing regime at airports and no real idea where anyone coming into the country goes.
No country has controlled this virus without stopping, or heavily minimising, new cases entering its territory. Research has shown most of our cases originated in Spain. But at least our disarray is egalitarian in that the same lack of purview applies to visitors from areas with low transmission as much as those coming from “red” zones.
These shortcomings explain why we have had to rely so heavily on lockdowns to achieve suppression of the virus. But as US president-elect Joe Biden said on Monday: “Social distancing is not a light switch. It is a dial.” And that dial needs to be fine-tuned so evidence-based decisions can be made about opening or closing specific businesses, bars, restaurants and so on.
The pity is that the learning about how to suppress the virus is out there. We can pick up ideas from the countries that have implemented effective strategies without taking on board elements that might not sit well with our culture.
If there was proven herd immunity, this approach might not be necessary. If we knew for certain a vaccine was coming and it would work widely, we could probably live with the remnants of this surge and even the beginnings of another in the New Year.
However, we don’t have these certainties, and therefore we have to work with what we have to achieve a result. Many analysts advocate a Swiss cheese approach, where actions are the layers of the cheese and the flaws that arise are the holes in any approach. Every slice has holes but when stacked together their impact is minimal and protection is maximised.
Defence layers
Thomas Pueyo, one of the clearest analysts of the challenges we face, talks of four layers of defence: stopping many infections from coming in (with what he calls “fences”); for those infected that make it, minimising the people they meet (“bubbles”); minimising the likelihood they will infect someone else (“contra-infection”); and when they do infect someone, identifying the infection quickly (“test, trace, isolate”).
“None of them is perfect. All have holes that let infections pass. But together they form an impenetrable defence,” he reasons.
Pueyo argues that western countries (Ireland included) have majored on social distancing, which “stops the economy”, rather than beefing up other measures. “And [so] they keep destroying their economies instead of learning how to dance with the other layers.”
For Ireland, this strategy would mean a greater emphasis on effective quarantine and much greater alignment with Northern Ireland (assuming cross-Border travel restrictions are politically unacceptable).
The EU-inspired move to a traffic-light system for international travel is a step in the right direction but the lack of testing options is worrying. There appears to be no prospect of any rapid testing being approved here this year, even though it is hard to see how travel with low-Covid regions could restart without it.