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Henry Street in Dublin city.
Henry Street in Dublin city.
Image: Leon Farrell

Explainer: The whole country goes to Level 3 from tonight, but has it worked in Dublin?

Transmission of the virus hasn’t actually declined, but the increase has slowed.
Oct 6th 2020, 6:00 PM 39,577 25

THE GOVERNMENT HAS staked its hopes on Level 3 restrictions stemming the increase of Covid-19 cases around the country.

It has taken the decision to move almost all of the country up one level, instead of the jump to Level 5 that the National Public Health Emergency Team (Nphet) recommended.

Part the government’s argument for going against Nphet was that Level 3 restrictions were working in Dublin. Both Health Minister Stephen Donnelly and Transport Minister Eamon Ryan referenced the capital last night as part of their reasoning.

“We want to see that Level Three measures have a chance, and the signals in Dublin are that that may be possible,” Ryan said.

So what has happened in Dublin so far under Level 3?

In the past week, health officials have shared some cautious optimism that the Covid-19 picture in Dublin is improving, but have nonetheless warned that a sustained improvement has not yet been shown.

In terms of population, Dublin alone accounts for 28.4% of the people living in this country, meaning that the county is always likely to have a large number of Covid-19 cases at a given time if the virus is active nationwide.

Despite this, even per head of population Dublin had for a period seen the highest incidence of Covid-19.

Almost four weeks ago, Deputy Chief Medical Officer Dr Ronan Glynn made a direct appeal to Dubliners to limit their contacts, saying that the county was seeing an average of 104 new cases each day.

At the time, Glynn highlighted that the capital had a 14-day incidence rate of 78 cases per 100,000 of the population. Later that week, the incidence rate had increased further and Dublin was moved to Level 3 on 17 September.

That day, the report from the Health Protection Surveillance Centre (HPSC) had a 14-day incidence rate for Dublin at 114 per 100,000, clearly above the second-placed county (Louth) at 92.

The 14-day incidence rate across the entire country at that time was 59, so Dublin had almost twice that figure.

PastedImage-38562 The picture when Dublin moved to Level 3 on 17 September. Source: hpsc.ie

In the intervening weeks the picture changed greatly, with Nphet making it particularly clear that spread of Covid-19 was becoming a national issue. In his letter to government on Sunday, Chief Medical Officer Dr Tony Holohan said the “national profile of the disease was now the main concern of Nphet”. 

In the week after Dublin was moved to Level 3, counties Waterford, Leitrim, Louth, Donegal, Offaly, Wicklow, Limerick and Roscommon were each namechecked as having a 14-day incidence rate rise to above or near 80. Donegal was subsequently moved to Level 3.

Speaking last Wednesday, Glynn said that he was ‘optimistic’ that the numbers in Dublin were stabilising, but cautioned that it was still too soon to say anything for definite.

“I fully appreciate the need for certainty. But what I would say is that the measures that were put in place last Friday week for Dublin, would only be beginning to take effect yesterday, today, tomorrow,” Glynn said at the time.

But we do need to see significant improvement over the coming days in Dublin and we’ve not seen it yet.

Two days later, Nphet’s epidemiological modelling advisory group chair Professor Philip Nolan said that the measures in Dublin “may be starting to work”, but went no further than that.

The latest HPSC data published yesterday shows that Dublin’s 14-day incidence has increased over the past three weeks, but at a much slower rate relative to the rest of the country.

Dublin no longer has the highest 14-day incidence rate, with Donegal and Monaghan ahead of the capital, and places like Roscommon and Longford also not far behind.

PastedImage-56936 The national picture as of midnight on Sunday. Source: hpsc.ie

Significantly over that three week period, the national 14-day incidence rate has almost doubled from 59 to 114, while Dublin’s has increased by less than half from 114 to 167.

So Dublin hasn’t actually reduced transmission over the past three weeks, but the rate of increase has certainly slowed – a fact the Health Minister was keen to press on RTÉ’s Morning Ireland earlier today.

“What we were seeing was very, very rapid growth in Dublin and what we’re seeing now, and this is borne out by the analysis shown to us yesterday, is a stabilisation in Dublin,” he said.

Donnelly added however that we need to see these efforts continuing:

What we need to see however, is we need to see the virus suppressed. So the virus being at several hundred per day and staying there, that is not an option that will work in the medium term for anybody who lives in Dublin, or indeed the rest of the country.

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Donnelly also spoke this morning about what were “essentially Level 3″ lockdowns in Kildare, Laois and Offaly having the desired effect in August.

Glynn also referenced this last week, noting that these and other counties had “turned around a negative trajectory”.

He noted however that the picture in Dublin does not have “one obvious target” to focus on, complicating the response. In Kildare, Laois and Offaly meat plants were a common source of clusters.

“It remains widely dispersed (in Dublin) amongst a whole range of different settings, which, on the one hand, is good news that we’re not having big clusters, on the other hand it makes it more difficult to control,” Glynn said.

In his letter to government on Sunday, Holohan didn’t make specific reference to Dublin and whether he felt Level 3 had worked, saying only that he felt a “graduated approach” would not sufficiently suppress the virus on a national scale. 

That question is likely to be asked of the CMO when he delivers his first media briefing since returning to his role. 

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Rónán Duffy

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