Without proper testing, roadmap will fail

AND so on Friday Taoiseach Leo Varadkar outlined the five phases of the roadmap which will lead us out of lockdown and back to some level of social normality.

Over the next 100 days we will see restrictions on our families and our lives lifted in stages — provided the virus does not start to spread again. We are not there yet, we are told. We have done well but cases are still too high.

Which leads me to my first concern. How high is too high? Coronavirus is here — it’s everywhere in fact. We have no vaccine treatments or immunity to it, so if and when we come in contact with it many of us will catch it.

Initially we were told we needed to flatten the curve, to allow the spread through our communities to take place in a slow, controlled fashion so our ICUs wouldn’t become overwhelmed, as happened in Italy and Spain. This was the focus of our efforts. And we did that. We slowed down the reproductive rate of the virus — how many people an infected person goes on to infect — from 2.4 to 0.5. It was no small feat. We did it by going nowhere. By staying home. Losing our jobs. Not seeing our friends or our families.

Our ICUs did not become overwhelmed. At time of writing we had 120 people in ICU. Our scaled-up ICU capacity is 800 beds. So our ICUs are about 15pc full.

Our private hospitals are roughly 20pc full. And our public hospitals are about 60pc full. In fact, I can safely safe I have never seen a time in my life that our hospitals were emptier.

The question has to be how empty is empty enough? Especially considering all the nonCovid health problems going undiagnosed and untreated while this goes on. There is no doubt in my mind we are storing up huge trouble for ourselves health-wise the longer we pursue this model.

We are also told that progressing from phase to phase in the Government’s plan will be dependent on what happens during the previous stage. If Covid case numbers climb we will pause or perhaps go backwards to a previous level of restrictions.

This is my main concern. Because of course cases will climb — how can they not? Unless we have eradicated the disease here — which is far harder to do than flattening the curve — if we mix more there will be more cases. The virus does not move. People move. And when they move the virus spreads.

If we know that is a given and if we say cases climbing is a reason to reintroduce lockdown, then we are saying at the outset that this plan is designed to fail. Therefore a certain level of new cases must be deemed acceptable. The question is how many cases?

Immunity is the key to all of this. A month ago I wrote about my own situation, after recovering from the virus. My presumption then was that I had immunity as a result. The WHO has since said immunity post-Covid is uncertain and those who have had it should continue to observe social distancing and all good public health guidelines. Good advice.

But it was also reported last week that previous cases of reinfection are now thought to have been false positives, and that it is not thought to be the case that there are credible reports of people catching it twice.

Immunity through a vaccine is the magic bullet and we are at the human trials stage of several vaccines around the world.

But we have no exact timeframe on when they could be rolled out. Herd immunity from catching the vaccine is less well understood.

An essay in The Lancet last week suggests that while 10-20pc of Covid patients have no discernible antibodies to the disease, up to 90pc appear to have a good immune response that correlates with the elimination of the virus from those patients.

We know in other coronaviruses that immunity occurs in the majority of patients and lasts between one and four years. But more emerging evidence on this new coronavirus is needed urgently before it is possible to say definitively whether herd immunity in the absence of a vaccine will ever be possible at all.

The bottom line is this though: we may need to live alongside this virus for many months to come — or even longer than that. And we cannot live under a lockdown that kills untold numbers of non-Covid patients and the economy but reduces Covid case numbers and call that a success.

What we have done well in this pandemic here was done by the people. Transmission of the virus was halted because Irish citizens turned their lives upside down. They saved the lives of the 3,500 extra people Simon Harris said our modelling predicted would have died without social distancing. They kept our hospitals and ICUs half empty. But unless the Government steps up and matches the actions of the people with better actions of its own, our plan to leave lockdown will fail.

Testing and contact tracing have been abysmal here, with far too few tests being done and those that were done being so slow to come back and so slow to be contact-traced as to make the whole exercise redundant and pointless.

Unless we provide a system where testing is available for all who need it, with results and tracing within hours, we will have to continue to live like this because the virus will not be contained.

In the exit from lockdown the people will be asked to maintain social distancing and hygiene, they will likely be asked to sign up to contact-tracing apps on their phones and advised to wear masks indoors in communal areas. The people keep doing what is asked of them.

But in the exit from lockdown, if public health continues to fail on the testing front there is no possibility we will progress out of this by August 10.

It is time for them to stop treating us like children who they can rely on to stay home and do what we are told without them playing their part as well. We deserve something more than “A lot done, a lot more still to do” and we deserve a testing system that underpins and supports our good work. The people have acted. The State now needs to do likewise.

‘It is time for them to stop treating us like children who will do what they are told...’