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Phased reopening on the cards from February - but only if ICU numbers remain stable

The number of patients in critical care will be the key metric government looks at over the next two weeks.

Image: Sam Boal

THE NUMBER OF patients in critical care will be the key metric the government looks at over the next two weeks when deciding how to phase out restrictions. 

The level of immunity following the high level of infections in the last month is also something the National Public Health Emergency Team (NPHET) are due to consider.

The public health experts are due to meet next Thursday to assess the latest Omicron data. But Chief Medical Officer Dr Tony Holohan struck a relatively optimistic note in a briefing with reporters today as he outlined the data that would be considered at that meeting. 

While the case numbers are expected to peak over the next couple of weeks, it is the ICU numbers that will be the key data set to consider. 

“Hospital figures are not the most important figures right now,” a senior health source told The Journal

It comes as Holohan confirmed today that the number of patients with Covid-19 in hospital but who were admitted for other reasons is about 30%, echoing comments made by Tánaiste Leo Varadkar yesterday. 

The senior source who spoke to the website said there are two conversion rates NPHET will look at next week – how cases translate into hospitalisations, and how hospitalisations translate into ICU admissions. 

Breaking the links between the different categories is paramount, said the source, who said the government is optimistic now that case numbers are not necessarily resulting in high hospitalisation numbers for the variant. 

The number in ICU remains stable at around 90, but if in the next week or so that figure edges up to 120, 130 or 140, it may give cause for the public health experts to pause any easing of restrictions, they said. 

Today there are 92 people in ICU with Covid. The numbers in ICU have remained under 100 since 22 December.

Speaking to reporters today, Dr Holohan said NPHET hopes to be able to move “optimistically”, but added that we they also “don’t want to get ahead of ourselves”.

“We still need sufficient time, which we think is a little bit more time to elapse to say ‘well, look, there are some things that we might have feared we would see, that we haven’t fully seen yet’. We need to be certain that we’re not going to see them before we give advice to government that we’re ready to to ease – ease or change some of the current measures.”

He said the detailed assessment of all of those questions will happen next week.

Ministers who spoke to the media in recent days have ruled out any easing of restrictions before February. The current measures, including the 8pm closure for hospitality, are due to expire at the end of the month. 

Speaking to reporters this afternoon, Tourism Minister Catherine Martin said: 

“I am hopeful for February because of where we are now but I think we have learned through Covid that guarantees aren’t a thing that anyone can give. I’d be hopeful for the easing of restrictions in February but we’ll have to see where we are by the end of January and see what NPHET advises.”

That particular restriction, the 8pm one is awful for music events, for theatres. But as I said we have to go with public health advice. The numbers are still extraordinarily high but I am still hopeful when we look at the ICU numbers, the stability there, that will we will be easing those restrictions in February.

Nphet 

The public health experts, ahead of their meeting next week, are set to estimate what the level of immunity is among the population now given the high infection rate over the last month and assess what level of restrictions can be justified.

Holohan said today: “What we’ll have to satisfy ourselves with is, what the current epidemiological situation is, what impact that’s having, what level of protection the population has either through the levels of immunity has arising either from vaccination or recent infection, and therefore what the continuing risk is likely to be to the population.

“And then consider what role continuing restrictions that are in place might play in adding protection or if any justification continues to exist for the adding of additional protection in light of that estimated impact.

Following next week’s meeting NPHET would be advising government, he said, “about the continuing role for restrictions, if any, with a view to the government making decisions in advance of the date that was timetabled on the 30th of January”.

“I think without getting ahead of exactly what the answers to those questions necessarily will be. I think those questions… they’re all very important. Those and others are the important questions that we have to consider next week and the advice in the beginning to government.”

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Senior ministers agree that it is “too soon” to ease restrictions right now, as they need to wait and see how the ICU numbers fare in the next two weeks. 

But if all goes well, and those numbers remain stable, it is understood that expectations are that restrictions will be eased on a phased basis. 

Government hopes to “step back” to where the country was prior to the latest restrictions being brought in, returning closing time for pubs and restaurants to 11pm first, and then two to three weeks later rolling the country back to the restrictions that were in place on 22 October, which would include nightclubs re-opening. 

Following that, two to three weeks later, the plan is to drop everything else – other than mask wearing in indoor public areas and Covid passes, sources said. 

- With reporting from Hayley Halpin and Rónán Duffy

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