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With restrictions easing ahead of Christmas, what does this week's Covid-19 data tell us?

Ireland’s 14-day incidence rate has increased by more than 10% since last Thursday.

Updated Dec 18th 2020, 10:00 AM

CASES ARE RISING.

The question is, as travel restrictions ease from tomorrow and Christmas approaches, how quickly?

Health officials have confirmed a further 484 cases of Covid-19 and three more deaths. 

A total of 431 new cases were confirmed on Wednesday and 329 new cases were confirmed on Tuesday

That is a total of 1,244 cases compared to 757 cases over the same period last week and 822 cases the week previously. 

Ireland is now in a phase “rapid growth”, according to the National Public Health Emergency Team (NPHET).

Covid-19 is spreading throughout the country, in every age group, Chief Medical Officer Dr Tony Holohan warned.

The CMO said: “I cannot stress enough how important it is to limit your interactions now.

He warned that not doing so would result in exponential growth in January, a substantial increase in hospitalisations and a “risk to life”. 

The Taoiseach said this evening that people should expect new restrictions “before the new year”. 

Ireland’s national incidence rate is 94.2 cases per 100,000 of the population on a 14-day rolling average, according to data from the Health Protection Surveillance Centre – compared to 79 on this day last week and 79.7 the week previous.

That is a 19% increase since last week, when we reported a 24% drop over the previous 14 days.

Ireland’s reproductive number last week was estimated at 1. It is now estimated at between 1.1 and 1.3.

Chair of NPHET’s Irish Epidemiological Modelling Advisory Group Professor Philip Nolan told TheJournal.ie that Ireland’s disease growth rate is currently estimated at between 1.5% to 2% per day. 

“If we keep the R-Number below 1.2 and our growth rate below 2% over Christmas, it won’t be pleasant but it will be manageable,” said Professor Nolan. 

Looking at 14-day incidence rates in individual counties, these had decreased in recent weeks in line with case numbers. However, incidence in certain counties continues to rise. 

Donegal – which has the highest incidence of Covid-19 in Ireland – has seen its 14-day incidence rate rise from 230.5 cases per 100,000 last Thursday to 246.9 today.

As cases increase in Northern Ireland, cross-border transmission into Donegal is recurring, and Public Health officials here will be closely watching border-county transmission rates.  

Looking at Local Electoral Area data, Carndonagh LEA in north Donegal has an incidence rate of 795.8 cases per 100,000. Letterkenny LEA is currently at 228.3 cases per 100,000 – both considerably higher than Glenties LEA in west Donegal where the current incidence rate is 41.8 cases per 100,000. 

For a breakdown of incidence rates in LEAs around Ireland, see here

Louth is now the second-highest county in Ireland with a 14-day incidence rate of 207.9  – a 23% increase since last week. 

Kilkenny – which has seen a large hospital outbreak in recent weeks – has a 14-day incidence rate of 190.5 – an 8% increase since last Thursday. 

Cavan, which had the highest incidence rate yet recorded heading into Level 5 in October (1055.5), has gradually seen it’s incidence rate creep up again. 

The county managed to reduce its 14-day incidence rate by 94% to 63 cases per 100,000 by 1 December. However, incidence has once again risen in this key border county to 154.9 cases per 100,000 – a 53% increase over the past 14 days. 

Wexford has also seen a significant increase, rising from 24.7 cases per 100,000 last Thursday to 88.8 cases today. 

Counties with the lowest incidence rates include Clare (23.6), Cork (27.6) and Leitrim (28.1). 

download (40) Chair of NPHET’s Irish Epidemiological Modelling Advisory Group Professor Philip Nolan. Source: RollingNews.ie

Comparing Ireland to other European countries – many of which in recent days have implemented tight restrictions leading up to Christmas – Ireland’s 14-day incidence rate is lower than France (236.3), Germany (341.1), the United Kingdom (348.2) and Italy (428.3), according to the European Centre for Disease Prevention and Control (ECDC). 

The above countries, including Ireland, are still considerably lower than both Croatia, which has a 14-day incidence rate of 1208.8 cases and Lithuania, which has a 14-day incidence rate of 1205.9 cases per 100,000.

Screenshot 2020-12-17 at 14.56.33 - Display 2 Source: ECDC

Testing & Tracing 

Three weeks into Level 5, 77,718 tests had been carried out in the seven days up to 12 November with 77,292 tests having been carried out up to 19 November and 77,805 tests being carried out in the last seven days up to Friday 26 November. 

So, while the number of tests had dropped by 33% between Level 5 kicking in and the halfway point on 12 November, the number of tests each week since then had remained static at around 77,000.

However, approximately 83,000 tests have been carried in the past seven days, a further indication of rising incidence.  

The positivity rate – which had decreased to 2.4% last week (the lowest point since September) – has risen again to 3.2%. 

The average number of close contacts is another key indicator to watch.

For the last three weeks of Level 5, the average number of close contacts for a positive case was 3.2. Once Level 5 was lifted, the average number actually decreased to 2.8 for a number of days up until 8 December. 

Professor Nolan said this evening that the recent surge in transmission occurred between 1 December – day Level 5 lifted – and 7 December.

The average number of close contacts per cases is currently 3.8. 

Hospital & ICU 

There have been 11 hospital admissions in the last 24 hours and 9 discharges. 

There are – as of this morning – 205 confirmed Covid-19 cases in hospitals and 30 people in Intensive Care Units.

Last Thursday, there were 203 hospitalised cases of Covid-19 and 36 people in ICU. 

HSE CEO Paul Reid warned yesterday that what happens over Christmas will be a “determining factor” in the effect on hospitals in January. 

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As seen in the graph below, ICU cases have decreased since last week. 

Screenshot 2020-12-17 at 15.10.57 - Display 2 Source: Department of Health

Clusters & Outbreaks

An ‘Outbreak’ is created when Public Health teams link a case/cases of Covid-19 in a particular setting and manage that outbreak. This is determined by symptom onset indicating transmission between cases in that setting. 

Outbreak data, however, does not indicate source of infection. 

There were 334 new outbreaks linked to private homes notified up to last Saturday – a 13% increase since 5 December. 

Outbreaks linked to private homes are separated into two categories – ‘General’ and ‘Family’. The ‘General’ category indicates non-household visitors/co-habitants. 

There have been 7,884 outbreaks linked to private homes since 1 August. Of these, 5,885 are designated as ‘Family Outbreaks’ while there have been 328 ‘General’ outbreaks linked to private houses. 

It is important to note that Covid-19 transmits in households – creating outbreaks – after it enters these environments. Outbreaks occur in households after people mix in other settings such as workplaces, hospitality or at private gatherings. 

Screenshot 2020-12-17 at 15.32.16 - Display 2 Source: HPSC

There were 19 outbreaks linked to schools reported by the HPSC up to Saturday. There were 14 outbreaks reported in the 12 days beforehand.

The HSE last night confirmed 17 cases of Covid-19 at a school in Killorglin, Co Kerry. 

The HPSC notes: “These outbreaks are outbreaks associated with school children +/or school staff. Transmission of Covid-19 within the school has not necessarily been established in these outbreaks.” 

The total number of outbreaks since the start of the pandemic is 10,150. Of these, 5,703 remain “open” according to the HPSC.

For an outbreak to be considered “closed”, there must be 28 days from the last case diagnosed or becoming symptomatic.

There has also been a further 9 outbreaks linked to workplace settings, bringing to 38 the number of outbreaks in this setting between 28 November and today, as well as 9 new outbreaks in hospitals. 

According to the HPSC, there were 0 outbreaks linked to pubs, restaurants or cafés between 28 November and 12 December. 

However, restaurants and pubs were closed until 4 December. In addition, this data does not indicate absence of infection in these settings. 

Finally, there have been 4 new outbreaks in nursing homes – 34 outbreaks in nursing homes remain “open”.

Between 5 December and last Saturday, the number of outbreaks across all settings has increased by 16%.  

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