62,000:‘REAL VIRUS LEVEL’
Expert says ‘we’re blind’ to true numbers 14 more deaths but isolation plan starting to pay off Schools won’t be back before September, sources conf irm
THERE could be as many as 62,000 people in Ireland capable of spreading the killer coronavirus, an expert revealed last night.
Although physical distancing has had some effect, Health Minister Simon Harris was at pains yesterday to insist that everyone must adhere to the new lockdown rules.
The stark warning comes amid fears that in the coming weeks, Ireland will exceed the level of infection reached in China’s Hubei Province, where the virus emerged. The imminent prospect of a ‘Hubei scenario’, if we don’t drastically cut infection levels by strictly following the lockdown rules, is predicted by the European Centre for Disease Control.
It comes after a steep rise in cases in intensive care, a soaring community infection rate of 51% and emerging cluster outbreaks in vulnerable locations such as nursing homes and hospitals. This was the catalyst that sparked the lockdown order on Friday.
The new reality means schools will not now open before the summer holidays.
The number of deaths from the virus rose
by 14 to 36 yesterday, and confirmed cases rose by 294 to 2,415, as Minister Harris and others warned that the country could very shortly run out of intensive care unit beds to treat the critically ill.
Based on that number of deaths and confirmed cases, Queen’s University Professor Ultan Power predicted that more than 62,000 could be capable of spreading the disease. (See panel.)
‘These are estimates but the ballpark figures will be reasonably accurate. Recent evidence suggests there may be upwards of 60% who have mild symptoms or are asymptomatic,’ he said. And he warned: ‘We’re blind about how many people are walking around with the virus unless they present with symptoms.’
Minister Harris said yesterday that the only way Ireland can limit the damage is for the public to comply with lockdown restrictions that ban groups of people; individuals from travelling more than 2km from home; and to shut all non-essential businesses for at least two weeks. He reiterated the advice that over-70s and other vulnerable groups should ‘cocoon’ themselves away from the virus.
However, he said that physical distancing was working. ‘We have already seen, as a result of the measures people are taking, keeping their distance, the number of contacts people make when they are
‘We’re blind about how many have the virus’
diagnosed with Covid-19 has significantly fallen. The average person diagnosed with Covid-19 had an average of 20 contacts two weeks ago, the average person diagthat nosed with Covid-19 now has an average of five contacts, so you are helping already and reducing the number of cases in our country.
‘The projections were 10,000 confirmed cases by tomorrow and 15,000 by the end of the week that doesn’t now appear to be case and that’s thanks to the people.’
But he issued a warning about ‘a very concerning situation’ in relation to ICU capacity, and that there were currently more than 70 people with coronavirus in ICU beds – of which there were initially only 250 in the country. After talks with private hospitals the HSE now has access to around 500 such beds.
‘The objective here, with the measures we are taking, is to try, in the second week of these measures, to see a reduction in the reliance of ICU,’ Mr Harris said. ‘The first point we need to remember is that we need to stop people needing ICU beds… by keeping them well.’
And Dr Catherine Motherway, president of the Intensive Care Society of Ireland, said there was a limit to how much ICU capacity could be increased, adding: ‘We need people to stay at home, do what they are asked to do and slow the surge.’
She told RTÉ radio: ‘We can double our bed numbers, I would imagine with reasonable confidence, and I would imagine with a reasonable standard of care. Beyond that it will get very difficult.’
As UK deaths passed 1,000 a senior Irish Government source explained that an increase in ICU admissions, coupled with advice from the European Central Disease Control body, caused them to move quickly. ‘I’m not sure we’re going to be through this by July, we could be in a better place by July in terms of the virus, but I’m just not sure,’ said the source.
‘One of the strategies here is to flatten the curve, but a product of is it stays with us longer. Who knows…’ A source also confirmed this means that the schools will not reopen before the summer.
For his part, Mr Harris said the restrictions would be reviewed at the end of the two-week period, but added: ‘I have to be very clear, we’re not going to be saying at the end of the two weeks that everything is going to be fine, far from it. This is something that is going to be with us for quite a period of time potentially many months. You would hope for some progress in two weeks.’
The prospect of Ireland reaching levels of infections similar to Hubei in China at the height of its peak came as the Government’s last tranche of emergency legislation, signed into law on Friday night by President Michael D Higgins, has already seen thousands of gardaí deployed throughout the country to police the lockdown.
Last night, food retailers asked people to ‘shop responsibly’ and warned, for the first time that, although general supplies are adequate, some products will become harder to source.
One senior minister warned last night: ‘The strictest of restrictions will, we hope, be lifted in two weeks but, and we don’t want to alarm people, we don’t believe the country will be near back to normal even by late summer. I can’t tell you what that means yet, but we believe it is highly unlikely that the schoolchildren will be back in school before September.’
The true scale of the challenge
Ireland faces in the coming weeks has been defined by the ECDC predictions – from which Ireland takes its guidance. It says there is no longer any doubt that a Hubei scenario is likely throughout all of Europe in the next two weeks.
The Hubei scenario is defined as 100 actively infectious cases per 100,000 – the rate at which the virus peaked in China. ‘Unless modified by effective intervention… half of all EU/EEA countries will reach a rate of 100 cases per 100 000 of the population by the end of March,’ the ECDC predicted late this week.
The prediction model expects the
‘Some products will be harder to source’
remaining EU nations to hit that level by mid-April. At this rate every health system in Europe will be overwhelmed. In line with this expectation the HSE – which has commissioned €200million in emergency equipment from China – is at present expecting the virus to peak in Ireland in the middle of April.
‘We don’t believe that we have peaked,’ HSE Chief Operations Officer Anne O’Connor said late this week. ‘We are certainly working towards a peak in possibly mid-April, the second week in April,’ she said.
To prepare for that, all non-essential health services – including surgery – have been halted, private hospitals have been emptied to boost the national bed capacity and temporary morgues, to include refrigerated trucks, are being prepared. A peak by mid-April would imply a slower rate of increase than the 30% daily increase Taoiseach Leo Varadkar warned of on March 14, when the Government first moved to intervene with school closures. At that point Mr Varadkar warned of 15,000 confirmed cases by the end of this month – a figure now expected to be about 4,000.
This suggests physical distancing and lockdown measures already in place may be succeeding in slowing down the speed of the pandemic here, or else that Ireland’s testing is lagging behind the real curve.
But the 4,000 figure is also an indication that Ireland is now approaching the ‘Hubei scenario’ at speed and is likely to exceed it, unless a further limitation effort succeeds. Based on the population of 4.8m, Ireland will reach this point when 4,800 people are diagnosed as being still actively infected in the previous 14 days. In the week after the Taoiseach’s St Patrick’s Day address Ireland had average daily increases of 22.5%. But as of last night the daily increase had reduced and stands at 14%. That would mean 3,100 infected by March 31, rising to 22,000 in mid-April and 160,000 by the end of April.
Predicting future infection rates from daily percentage increases – as the Taoiseach did at the beginning to the crisis – is a crude measure. But it does illustrate what could happen if nothing is done to slow down the virus.
‘Yes you can do those projections and yes that’s what they project,’ said Trinity College Professor of Healthcare Modelling and Statistics, Catherine Comiskey. ‘The maths is correct. But it does not necessarily model what’s going to happen in real life because people are changing their behaviour and if they continue to do that, the percentage growth will not stay constant. It will reduce.’
‘It’s unlikely schools will open before September’