Telling Nphet off is the last thing we need – just look at the US
LEO VARADKAR has said it is time for the National Public Health Emergency Team (Nphet) and the Government to “get back on the same page”. That’s the last thing we need. Nphet has a single public health mandate: to provide expert advice to the Government detailing the best way to address the pandemic.
Their recommendations should be grounded in medical evidence and science. On occasion, that advice will be politically unpalatable.
It will cause controversy, alarm and upset. It doesn’t matter. They must still feel free to deliver their unvarnished advice without fear of being publicly attacked by senior ministers.
Otherwise we risk Nphet beginning to dilute and second-guess its own advice, of hiding the true extent of the crisis behind a veneer of upbeat and confused analysis.
We’ve seen this happen elsewhere, notably the United States, where officials are more concerned with massaging Donald Trump’s ego than tackling the pandemic.
That cannot be allowed to happen here. The only consideration when Nphet drafts its advice should be public health, not any political fallout.
This is why Mr Varadkar’s extraordinary tirade against Nphet on RTÉ’s Claire Byrne Live on Monday night was so concerning. He didn’t just disagree with Nphet’s advice, he built a bonfire underneath it and set it alight.
At various points, he accused it of failing to think through its advice, of failing to consider the economic and social consequences and of being out of touch with the public, given its members would not have to worry about unemployment as a result of a Level 5 lockdown.
The last accusation was particularly unfair. There is a long tradition of politicians refusing to make personal criticism from public servants. Why?
Because they are prevented from defending themselves in a similarly forthright fashion. Given that chief medical officer Tony Holohan has just returned to work – having taken some time to help care for his wife, who has cancer – it can hardly be suggested that he is somehow living in an ivory tower.
Mr Varadkar’s apparent surprise that Nphet did not provide the Government with economic and social science analysis to support its recommendation is also baffling. It’s not its job to do that.
That is the job of government. All Nphet can do is to provide the best and most robust public health advice it can.
This information should then be assigned a priority and fed into the broader decision-making process used by ministers to make policy decisions.
It is reasonable for the Government to disagree with the advice it is given from Nphet and make a rational case for adopting a different approach.
But portraying this team, who have worked tirelessly since the start of this crisis, as a bunch of half-wits who don’t know what they’re doing is shameful. It is also incredibly short-sighted as it just stores up future problems for the Government.
If Mr Varadkar thinks so little of Nphet, what hope does he have of convincing the general public to continue abiding by restrictions it has designed?
Nphet’s advice may have come as a shock on Sunday night, and it is regrettable that it was leaked before the Government had any warning, but it was based on evidence, including some alarming statistics. Much has been made of the fact that Nphet did not recommend any increased restrictions after it met on Thursday. However, by Sunday, the five-day average of reported cases had increased from 310 a day to 462.
In its letter to Government, Nphet also expressed concern about the surge in cases among over-65s, with 254 cases reported over the previous seven days.
It also highlighted that there were 31 outbreaks in nursing homes, with seven of these reported in the last week alone. Yesterday we learned that 31 people, including 21 residents, in one nursing home in Laois had tested positive.
Nphet also pointed to the fact that hospital intensive care unit (ICU) beds are nearly at capacity. On Sunday, 243 out of an available 281 were occupied – meaning just 38 were available.
At the height of the pandemic, eight people were being admitted to ICU per day. On Sunday, the average number of admissions to ICU rose to two a day. If this rate of admission continues, where will we treat those patients?
In March and April, hospitals were cleared of non-Covid cases and the State leased private hospitals in their entirety to gain capacity to cope with a surge. Those options are not available now – and we are heading into the winter, which is a time notorious for hospital overcrowding.
In the Dáil yesterday, Micheál Martin said ICU beds had increased from 225 in March to 282 now, up by 57, and added there would be a further 17 added as part of the winter plan.
He said he had been repeatedly assured by the HSE that there was sufficient capacity in hospitals to cope with a surge.
However, a HSE memo on critical care capacity, dated April 2019, noted the number of ICU beds was 240 – more than evidently existed in March this year – and recommended an 80pc increase, to 430.
That memo also found that 52pc of ICU capacity in Ireland had “no air management (air exchanges) or treatment (HEPA filtration) to decrease airborne transmission of infection”. Hardly ideal in the fight against Covid.
Instead of attacking Nphet for proposing drastic measures to reduce community transmission of a deadly virus as ICUs near capacity, perhaps Mr Varadkar, a former Health Minister, could consider why that capacity seems to be running out before winter has even arrived.
It would also be wise to remember that, ultimately, Nphet is not imposing restrictions. The virus is. Society and the economy will never get back to normal unless we suppress it.
Nphet must feel free to deliver unvarnished advice without being attacked by senior ministers