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'It's in a plateau position': People with Covid-19 now infecting less than one person

Professor Philip Nolan has said that any loosening of restrictions must be approached “exceptionally carefully”.

Updated Apr 16th 2020, 11:57 PM

covid 19 400 Chair of NPHET Irish Epidemiological Modelling Advisory Group Professor Philip Nolan. Source: Sam Boal/RollingNews.ie

THE CHAIR OF the modelling group advising on the country’s response to Covid-19 has said we are at a “plateau” in terms of the level infections but there is a “delicate balance” to be maintained. 

Professor Philip Nolan, chair of the NPHET Irish Epidemiological Modelling Advisory Group, said this evening that we could begin to see a decline in the number of cases in the coming weeks but that any loosening of restrictions must be approached “exceptionally carefully”.

Nolan provided fresh details this evening of what is known as the effective reproduction number, which is the number of other people infected by one confirmed case.

In the early stages of this epidemic, the reproduction number was somewhere between 2 and 4. Immediately after the early interventions it looks like the reproduction number was somewhere between 1.5 and 3. And then the last panel shows the pretty high level of confidence in this model that the reproduction number is now below one.

“If I could just say, if the epidemic had continued with that reproduction number of 2.4. We would have been looking at 7,800 cases today. Not closer to 700 cases,” he added.

The Department of Health confirmed this evening that there were 629 new cases of Covid-19 in the country, bringing the total here to 13,271

Nolan added that the most optimistic scenario was that a figure of 0.8 would allow us to see a reduction in new coronavirus cases by the end of the month.  

PastedImage-36687 The daily growth rate in cases has steadily declined over the past month. Source: Dept. of Health

This, he said, also served as a reminder that any loosening of restrictions must be done very carefully to ensure that an increase in cases doesn’t become unmanageable. 

He said that if the reproduction number increased to 1.1 or 1.2, then it could be suppressed again with the reimposition of measures without Covid-19 cases becoming unmanageable.

If it went above 2 we would get “a very sudden and almost certainly unmanageable spike in disease,” he said. 

PastedImage-63588 New cases per day at different reproduction rates. 0.8 is in green and 2.4 is in red. Source: Dept. of Health

“One of the difficulties with this virus is it’s easy to transmit it. It’s for that reason that, whatever changes that might occur after 5 May, have to be very, very carefully thought through and very imaginatively thought through,” Nolan added. 

Taoiseach Leo Varadkar said today that  has said he does not know if the current coronavirus restrictions will be lifted on 5 May.

Balance

Nolan explained that rather than thinking about the disease in terms of it peaking at a certain point, he said people should think about it in terms of maintaining cases of the disease low in the population for a long period of time. 

“We’re in a very delicate balance between suppression of the disease and potential future spike in the disease, so I prefer to think about it as it’s under control, we think, it’s in a plateau position,” he said. 

Asked therefore, why would the country not simply continue with the restrictions we are living under, Nolan said it only delays the question about how we control the virus long-term. 

“If nothing else happened, the disease would ultimately be suppressed on the island. But then, what do you do?,” he said.

At some point, we do have to get to this discussion about how are we going to think about the restarting of economic and social and activity and the things that are good for your mental health without losing control of the disease.

“So it doesn’t seem to me to be a viable strategy to maintain this level of restriction forever with the hope of eliminating the disease. Because then as soon as you do anything, the disease reappears, it just takes two or three people entering the country with the disease to restart it.” 

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Rónán Duffy

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