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Halfway through Level 5, what does this week's Covid-19 data tell us?

Ireland’s 14-day incidence rate has dropped by over 50% in the past two weeks.

Updated Nov 13th 2020, 10:40 AM

WE ARE HALFWAY through Level 5.

This week has been dominated by travel, Christmas and discussion around easing restrictions but what does the latest Covid-19 data tell us about our efforts to suppress the virus? 

Health officials on Thursday evening confirmed 395 further cases of Covid-19 and one more death. 

A total of 362 new cases were confirmed on Wednesday and 270 new cases were confirmed on Tuesday

That is a total of 1,027 cases compared to 1,357 cases over the same period last week and 2,261 cases the week previously. 

Ireland’s reproductive number last week was estimated at between 0.7 and 0.9 having been at around 1 the previous week. It has since fallen further to 0.6. 

Chief Medical Officer Dr Tony Holohan has said a reproductive number of 0.5 over a sustained period would be a sufficient level of transmission to move out of strict restrictions.  

Ireland’s national incidence rate is 135.5 cases per 100,000 of the population on a 14-day rolling average, according to data from the Health Protection Surveillance Centre – compared to 212.7 on this day last week and 292.1 the week previous. That’s more than a 50% drop in two weeks.  

Screenshot 2020-11-12 at 14.50.04 - Display 2 Source: HPSC

The incidence rate in individual counties spiked in October but has since reduced even further over the last seven to 14 days.

Cavan, which had the highest incidence rate at the start of Level 5, now has an estimated 14-day average of 118.1 cases per 100,000, according to the Department of Health. 

It was 364.9 last week and stood at 753.5 cases per 100,000 on Thursday 29 October. 

That’s a significant decrease of 80% over a fortnight. 

Donegal, the county with the highest incidence rate in the country, continues to give health officials cause for concern. 

The county’s 14-day incidence rate is currently 281.4 cases per 100,000 – a slight decrease from 286.4 cases per 100,000 last week. 

Dr Holohan said yesterday that local Public Health teams in Donegal have noted problematic behaviours with funerals and religious services in the county, but said there is no reason why the whole country can’t move from Level 5 on 1 December. 

Limerick is now the second-highest in Ireland with a 14-day incidence rate of 197.5 cases per 100,000 – compared to 227.8 cases last Thursday.  That is still a reduction but not as marked as in other counties. 

Counties with the lowest incidence rates include Leitrim (40.6), Wexford (67.5) and Wicklow (71.6). 

By comparison to Europe, Ireland’s 14-day incidence rate is lower than France (940.7), Spain (599.1), the United Kingdom (471.8) and Italy (726.7), according to the European Centre for Disease Prevention and Control (ECDC). 

The 14-day incidence rate in each of the above countries has increased since last Thursday with Italy’s jumping by more than 22%. 

Screenshot 2020-11-12 at 14.50.17 - Display 2 Source: ECDC

The above countries, including Ireland, are still considerably lower than both Belgium, which has a 14-day incidence rate of 1060.4 and Czechia, which has a 14-day incidence rate of 1331.4 per 100,000. 

Chair of NPHET’s Irish Epidemiological Modelling Advisory Group Professor Philip Nolan told TheJournal.ie that if cases continue to decrease at the current level we should see an average of 100 cases per day by 1 December. 

“When we advised Government that Level 5 measures were necessary we really couldn’t be confident that the level of public buy-in would be such that we’d get to where we are today,” he said. 

“We’re in a really good state. People have done everything we could have asked of them in the last three weeks,” said Nolan. “We’re very much on target.” 

Testing & Tracing

Approximately 116,000 tests were carried out over the 7 days up to Thursday 22 October when Ireland entered Level 5. The positivity rate then was 6.9%. 

Approximately 103,000 tests were carried out in the 7 days up to 29 October with 88,547 tests have been carried in the seven days up to last Thursday. 

This week, approximately 77,718 tests have been carried out in the last seven days. 

The positivity rate is now estimated at 3.5% – a decrease from 4.6% last week. 

The HSE, meanwhile, said yesterday that it is to begin investigating where people are being infected with Covid-19 as part of a new “retrospective contact tracing” policy. 

The aim is to gather additional information on Covid-19 cases labelled as ‘community transmission’ – where the source of the infection is unknown – and will involve a series of questions in order to build a more accurate picture of where people are contracting the virus. 

The HSE has said that it is important to start enhanced contact tracing while the incidence of disease is low.

Under the new system, when confirmed cases are first contacted by tracers they will be asked “key questions” regarding visits to healthcare settings, visits to friends or relatives as well as questions around restaurants, pubs and cinemas in order to pinpoint if a particular setting is high-risk and requires intervention by Public Health teams. 

People will also be asked questions about visits to special events, including weddings and christenings, up to 14 days prior to symptoms developing.

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Hospital & ICU

There have been 10 hospital admissions in the last 24 hours and 23 discharges. 

There are – as of this morning – 275 confirmed Covid-19 cases in hospitals and 38 people in Intensive Care Units as of 8am this morning. 

Last Thursday, there were 295 hospitalised cases of Covid-19 and 38 people in ICU. 

As seen in the graph below, ICU cases peaked between Saturday 1 and Monday 3, fell back down to the lowest point since 28 October last Thursday, but have since risen again. 

Speaking at a HSE briefing yesterday, HSE CEO Paul Reid said that hospitalisations and ICU number are stable but that the health service had not seen the reduction it was hoping for. 

Screenshot 2020-11-12 at 15.40.17 - Display 2 Source: Department of Health

Clusters

The recent increase of outbreaks in schools has reduced again since last week. 

There were 24 outbreaks reported by the HPSC up to Saturday. There were 30 outbreaks reported in the 7 days beforehand and 56 outbreaks reported in the seven days before that. 

The HPSC notes, however: “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.”

Screenshot 2020-11-12 at 15.40.12 - Display 2 Source: HPSC

The total number of outbreaks since the start of the pandemic is 7,266. Of these, 4,202 remain “open” according to the HPSC’s recent data.

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

There were 443 new outbreaks in private homes up to last Saturday – a increase of 123 or 27% – from the previous week bringing to 5,285 the total number of outbreaks in this setting since the pandemic reached Ireland.

Of these, 3,428 remain open.

Finally, there have been 3 new outbreaks in nursing homes – 49 outbreaks in nursing homes remain “open”.

Overall, taking in every setting, there has been an overall increase of 16% in outbreaks since last week. 

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