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Why did the government reject NPHET's Level 5 recommendation?

The Tánaiste and other ministers have been outlining the reasons why over the past few hours.

THE GOVERNMENT HAS gone against advice given by NPHET to move the entire country into Level 5, instead opting to enforce a nationwide Level 3 for three weeks.

Ministers have been trying to explain the reasons for rejecting this advice last night and this morning. 

In a significant interview on RTÉ’s Claire Byrne Live programme last night, Tánaiste Leo Varadkar said there were three main reasons the Government rejected the Level 5 recommendation.

People will lose their jobs

The first was the wider societal impacts of lockdown such as hundreds of thousands losing jobs, businesses potentially closing permanently, and mental health implications.

Varadkar said it’s “not just about a virus”, death rates or statistics, it’s about how it “impacts on so many different people and so many different communities in so many different ways”.

The Restaurants Association of Ireland has said that Level 3 restrictions alone will mean that 180,000 people will lose their jobs, due to the restrictions that mean that people can only eat outdoors at restaurants and cafés and other hospitality sectors.

Under Level 5, only essential retailers would be permitted to remain open.

Taoiseach Micheál Martin made a similar comment in his address to the nation last night: “This is not about public health and businesses competing against each other, it’s about lives and livelihoods. We can’t have one without the other.”

It’s not what the plan is

The second was that the recommendation “was not in line” with the Living with Covid plan the government had agreed with NPHET.

When the five-level plan was announced last month, the Taoiseach said that “the higher levels will be used to deal with higher incidences of the disease”.

Moving from one to another would be based on a number of factors, including the 14-day and seven-day figures on new cases, the five-day rolling average of cases – by county and nationally.

For Level 5 specifically, NPHET said that the trigger points include: “high or rapidly increasing” incidence of the disease, multiple clusters, factors such as the R number, and the number of positive cases.

Also included in their criteria for moving to Level 5 is: high or rapidly increasing number of deaths, significant or rapid increase in admission to hospital and ICU, and a likelihood that hospital or critical care capacity will be exceeded.

Varadkar said there was “no sudden change in the last three days” – when NPHET last said that there was no need to move the entire country to Level 3 – that legitimised a move from Level 3 to Level 5.

Hospital capacity hasn’t been overwhelmed

The third was that NPHET’s assessment that hospitals were imminently facing the possibility of being overwhelmed – but this view wasn’t shared by the CEO of the HSE Paul Reid, as the HSE had not been consulted beforehand on this issue.

Intensive Care Unit capacity, seen as a key metric in assessing how seriously a country will be hit by Covid-19, was in particular focus.

NPHET said that admissions to critical care services have grown to an average of two per day, with 243 out of 281 adult critical care beds now occupied.

Around 20 of these beds have been occupied by patients with Covid-19 over the past week.

If current trends continue, NPHET said that 1,600 to 2,300 Covid-19 cases per day will be being reported by 7 November, with 43 people per day being admitted to hospital.

But the Government is insisting there is extra capacity there if needed: including a temporary surge capacity of up to 354 ICU beds, and the capacity to ventilate up to 1,000 patients, if required. 

With reporting from Sean Murray and Orla Dwyer

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