Be careful of lifting restrictions says WHO’s Ryan

Dr Mike Ryan says that countries need to be “exceptionally careful” in lifting restrictions currently in place in an effort to halt the spread of Covid-19.

The Sligo man, who has become central to the World Health Organisation’s ( WHO) campaign to address the worldwide pandemic, told RTÉ Radio One’s Sean O’Rourke that while there are encouraging signs emerging from data in several countries, the virus remains a huge threat to societies all across the world.

“What we are seeing is that in countries that have implemented slow downs, lock downs, physical distancing measures that the number of contacts per case is dropping - in other words, when the case is detected the number of people that person has been in contact with is dropping because of the physical distancing measures so what we really need to do is detect those suspect cases,” the Curry native, who is Executive Director of the WHO’s Health Emergencies Programme, said.

“We need to be able to do two things at one time - we need to be able to save lives in our hospitals, support our hospitals, support our health workers but at the same time if we want a transition strategy out of this so-called lockdown phase, we have to put in place public health measures in finding contact tracing and quarantine measures because if we want to come back to a steady state. If we have to live with this virus until we have a vaccine, we can’t lurch from lockdown to lockdown to lockdown, we have to have an alternative and I think Ireland has been pursuing that strategy quite effectively over the last number of weeks.”

While Dr Ryan has praise for the Irish efforts, and those at a global level, he said that future health policy in all regions should seek to bolster health systems to ensure they are better able to cope with the increased demand an emergency such as this brings about.

“Protecting populations requires two very important systems - a strong public health system, and a healthcare system capable of scaling up quickly to deal with a surge of cases.

“All countries are struggling with those two issues, we have not invested enough in our public health systems and we have built a healthcare system that operates on a 100pc efficiency, health systems, that are non-elastic, they are rigid, they are working at 100pc 365 days a year and they have very little capacity to expand when things go wrong. We really do need to look at those issues going forward.” The additional measures introduced by the government last week - with Taoiseach Leo Varadkar advising people to stay in their homes in most cases - are set to remain in place until at least April 12 th. Dr Ryan says that putting people in their homes can help reduce the risk of community transmission, but explained that it shifts the threat from the community to the home. The importance of testing, he says, remains central.

“Each affected case has had less contact with other people than they would have had three weeks ago, which means the virus has had less chance to transmit. We still have to go and detect those suspect cases. Putting people in their homes is good in that it moves the risk away from the community but it puts that risk at the family level and now we have to be able to go and detect those cases, people who are in families, people at home and who feel unwell, who meet the case definition, who contact their GPs.

“We need to get rapid testing of suspect cases, everybody doesn’t need to be tested. What we need to ensure is that people fulfilling a case definition are tested quickly, they are prioritised because if we can get those individuals into isolation and we can quarantine those contacts we can further take the heat out of the epidemic. The first move was to create the space, now we need to exploit the opportunity that has been created.”