Ireland recently made the headlines all over the world – for the wrong reason. We had the highest daily number of new confirmed cases of Covid-19 anywhere. The seven-day rolling average hit 1,394 cases per million – ahead of the UK on 810, and the US on 653.
We had been doing so well. On 13 December the chief medical officer, Dr Tony Holohan, announced that Ireland had the lowest number of cases per capita in Europe. We felt pretty good about ourselves. So how did it all go so wrong, and in such a short time? You don’t need to be an epidemiologist to figure it out.
The Irish love Christmas, and a major cause of this surge was socialising. The government knew that we would want to be with family and friends at Christmas. Like Santa telling us we had to be nice, they told us when imposing the second lockdown in October that if we all behaved ourselves and got the viral count right down, we could have some kind of a Christmas. We did so well that Santa Claus told us we could go to restaurants and that three households could meet up on Christmas Day. But no more than that, and only in a safe environment with good ventilation, and for a limited amount of time. The hope was that we would get away it because the level of virus in the community was so low.
A stark warning came from Irishman Dr Gabriel Scally, of the Royal Society of Medicine in the UK, who said: “If we have a very merry Christmas, and meet lots of friends and relations, then I fear that in January and February we may well be burying some relations.” Experts warned of a spike in cases in January but the hope was that it would somehow be manageable. What happened instead was a disaster. Instead of flattening the curve on the horizontal axis, we flattened it on the vertical as case numbers skyrocketed.
Numbers began to creep up just before Christmas. In November a plea had gone from the government for people abroad not to come home for Christmas. The vast majority acquiesced. Around 54,000 came home as opposed to the usual 600,000. This was upsetting for many families who reunite at Christmas – the issue of emigration still being a very real one in Ireland, especially for those coming back from the UK.
But cases continued to climb exponentially. The plan was to reintroduce restrictions on 6 January but by 22 December the situation was looking dire. After an emergency meeting, the taoiseach, Micheál Martin, announced that the country would return to stringent level 5 restrictions from 24 December to 12 January at the earliest. On 30 December, as the situation worsened even more, the restrictions were extended until 31 January. And on 6 January all schools were closed, until 1 February.
Ireland is now in as strict a lockdown as it was back in April. There is a dull sense that what the government has done is the right thing. People are exhausted and fed up but many want even harsher restrictions to truly suppress the virus. The blame game continues. Some criticise the government, saying that we shouldn’t have opened up when we did. That it should have somehow tried harder to stop people socialising at Christmas.
A good comparison can be drawn with Finland which back in December had a similar number of cases to Ireland. It opened up restaurants and yet there has been no spike. Why is that? Some put it down to Irish families being slightly larger on average, which increased the numbers gathering at Christmas. Another big factor could be Irish conviviality – something we are proud of, but which has done for us when it comes to Covid-19. The new variant is unlikely to have played a big part in the surge, although it may be contributing to the current numbers.
What now? The situation seems to be stabilising somewhat, with evidence of less contact between people, and the testing positivity rate progressively falling. But hospitals are filling up with people who became infected over the Christmas period. There is a real fear that they will be overwhelmed within the next two weeks or so. Seventy per cent of cases are now in people under 45, which gives some hope, as that age group has a much lower mortality than older people. The death rate is somewhat stable, among the lowest in Europe currently, but the fear of escalation remains. There were 15 deaths in a single nursing home in one week.
Many businesses are unlikely to recover, especially in the devastated hospitality sector, and there is still no sign of when the pubs might reopen. Dublin with no pubs open since March is but one example of how outrageous it all is.
Meanwhile, people are questioning why it is that a few kilometres up the road from Dublin, in Northern Ireland, the Oxford/AstraZeneca vaccine is being widely used. Why not here? It’s also still possible to fly into Belfast from England and then cross the border into Ireland with limited checks. Flying into Dublin requires evidence of a negative test. Covid-19 loves these kinds of absurdities.
We are, therefore, at the lowest point in this pandemic. It’s like we’re in a deep pit – but there is a ladder out of it, towards the light of the vaccines. The first shipment of the Moderna vaccine arrived this week. Ireland wants to be like Israel when it comes to vaccination, with 2 million people there vaccinated already. Our minister for health has said that 4 million of us will be inoculated by September. We’re hoping that the widespread rollout of the vaccines and the warmer weather when we all move outdoors again will give us what we all crave. An end to the blame game. And a return to some kind of life when Covid-19 is no longer to be feared but managed.
Luke O’Neill is an immunologist in the School of Biochemistry and Immunology, Trinity College Dublin