Failure to test and trace is a strange omission from the new exit roadmap
Over reliance on lockdown strategy leaves us prone to deadly virus – and its dire ramif ications
ORIGINALLY the Government might have intended this bank holiday weekend as something of a watershed in coronavirus’s trajectory. An end to lockdown would create a feelgood atmosphere in the country after weeks of stress and anguish, and a wave of appreciation for the powers-that-be. But instead of the prospect of some semblance of normal life, the public, as expected, has to settle for two extra weeks of restrictions with only minor relaxations and a timetable for opening up the country that continues to lean heavily on lockdown rather than testing and contact tracing as a means of helping us to co-exist with Covid-19.
For while there is a chink of hope in the very existence of a 21-page timetable towards our ‘new normal’ the almost complete absence of any concrete plans for the two most important elements in allowing our economy to take faltering steps to recovery is disheartening and worrying for the future.
The Government managed its expectations expertly but as it contemplates the next few weeks, it could do well to consider how much more the public will sacrifice in a strategy dominated by lockdown and indeed devoid of a stable new administration to give it democratic credibility.
For make no mistake the public’s acceptance of lockdown as a strategic tool has reached a tipping point and its patience may be no more elastic than the public’s finances, especially if people feel their jobs and livelihoods are being lost because a targeted testing programme has not been put in place.
This week, the news from the frontline has been relatively positive. In the Dáil on Thursday, Minister Simon Harris paid tribute to the good work in getting the R0 (the reproduction number or number of other people a person with the disease goes on to infect) down to between 0.5 and 0.8 which means the epidemic is burning itself out.
When lockdown began, the R0 rate was 2.4 and 100 people were being hospitalised every day. Now the number of new cases, death rates and admissions to ICU are, although high, steadily moving in the right direction.
Hospital admissions for Covid-19 have been flat since the start of April, while the number of confirmed cases in critical care beds has fallen from a high of 160 on April 9 to 99 yesterday. There’s a further reason to be cheerful in that the fear of the HSE being overwhelmed has never been realised and that at least half of its intensive care beds are free. So far so good.
The stumbling block however is that all this unravels once the fiasco of testing and tracing – the blame for which can be laid squarely at the Government’s door – becomes part of the equation.
From the outset, the goalposts have continually changed about the testing targets for the disease and while the finger of blame has been pointed to the shortage of swabs and chemical reagents as well as the high-handed failure of the National Public Health Emergency Team (NPHET) to consult with the HSE about its test capacity, the actual cause of the delay is shrouded in mystery.
Yet the ramifications are enormous. Test and trace along with lockdown were the three tactics by which the Government was to wage its fight against Covid-19.
The fact that two of them are compromised means that lockdown has become the main strategy for containing spread of the virus; when the health of the nation wholly depends on it, its wind-down becomes infinitely riskier and the Government, consequently, more cautious.
In a letter to the Irish Times yesterday, one of the country’s foremost scientists, Professor David McConnell, fellow emeritus in Trinity College, pleaded for the Government to introduce more testing and tracing. His letter is worth quoting from at length: ‘The discussion of Covid-19 is going round and round, dominated by lockdown and the end of lockdown, as if lockdown were the only show in town. There is some discussion of testing but little reference to what should be the main long-term reason for testing – driving the virus into extinction,’ Professor McConnell wrote.
‘In the absence of vaccines and anti-virals, which are many months away, there is only one strategic way of ending this pandemic: trace, test, isolate, find contacts and test and isolate them, find the next ring of contacts and test and isolate them, and so on, until no new positives are identified…’
South Korea had used this tactic and now has no new cases of community-transmitted
‘Causes of the delay shrouded in mystery’
‘Have we considered using Korean labs?’
infections, he wrote.
‘Have plans been drawn up for a nationwide testing scheme of this kind on this scale, which is at least 10 times what has been mentioned? If not, have we considered involving Korean labs, which must now have spare capacity, in carrying out tests for us?
‘I do plead that the heroic public, our students, and our deeply wounded businesses and their employees, and so many other specific groups in the firing line, deserve some straight answers to these and related questions.’
Putting an economy on ice does not, as it suggests, preserve it intact, it can cause it to crash over a cliff, along with the hopes of a generation of workers who will be saddled with the enormous repair bill for years to come.
Already there are serious concerns about the cost of the sticking plasters; the welfare payment for those who lost their job due to the pandemic and the wage subsidy to employers to retain their workforce. The Dáil’s Budget Office says there are conflicting costings for the emergency measures with the total expected to add up to €6.5bn, far exceeding the original estimate of €3.7bn.
That’s why it’s so important we use every weapon in our armoury against this pandemic, making the lacklustre attitude to testing and tracing inexplicable.
The workings and make up of the
NPHET is another problematic area. Fears expressed by Sage, NPHET’s equivalent in the UK, that politicians might use it as a shield to cover their mistakes seemed to materialise here when, under pressure from Labour leader Alan Kelly in the Dáil, the Taoiseach seemed to pass the buck to the experts. He told the Dáil that he was not on the NPHET or any expert advisory group; he didn’t have access to HSE documents and that the questions should ideally be directed at the HSE or Dr Tony Holohan.
The politicisation of an impartial expert advisory service to help steer the Government through the pandemic was understandable in the early days.
But at this stage, seven weeks into the crisis, fresh thinking could be sought from another set of experts and to prevent the groupthink which the Taoiseach has repeatedly said he despises.
Recruiting new blood onto the NPHET would also help address the controversy about its membership and the transparency of its decision making. Both Micheál Martin and Mr Kelly have raised concerns about the lack of clarity about the basis upon which key decisions are taken, with the latter demanding that the NPHET appear in front of the Health Committee.
‘It should answer questions from those who are actually democratically elected,’ he said, unwittingly perhaps drawing attention to the huge democratic deficit at the heart of the crisis.
It’s now 85 days after the General Election and the self interest of our political parties means we are still nowhere near government formation. The bleak scenario of 14% unemployment, a 12.4% collapse in GDP and an ‘exceptionally significant’ bill for special Covid payments predicted by Paschal Donohoe’s address is not for the fainthearted. But it might be a less bitter pill to swallow if it was manufactured by elected politicians committed to the good of the nation, rather than self-interested public representatives with their eyes trained chiefly on re-election.