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Four weeks into Level 5, what does this week's Covid-19 data tell us?

HPSC data shows that the 14-day incidence rate in a number of counties is rising.

Updated Fri 9:00 AM

HAVE WE STALLED?

Much of this week’s discussion on Covid-19 concerns a rise in case numbers since last Friday, speculation about what our lives will look like post-Level 5 and what type of Christmas lies ahead. 

But what does the latest Covid-19 data tell us about our efforts to suppress the virus? 

Health officials on Thursday evening confirmed a further 429 cases of Covid-19 and four more deaths. 

A total of 379 new cases were confirmed on Wednesday and 366 new cases were confirmed on Tuesday

That is a total of 1,174 cases compared to 1,027 cases over the same period last week and 1,357 cases the week previously. 

Ireland’s reproductive number last week was estimated at 0.6 having been between 0.7 and 0.9 the previous week. It has risen again this week and is back between 0.7 and 0.9. 

This is not the downward trend we had been expecting. 

Ireland’s national incidence rate is 116.5 cases per 100,000 of the population on a 14-day rolling average, according to data from the Health Protection Surveillance Centre – compared to 135.5 on this day last week and 212.7 the week previous. That is a 45% drop in the past 14 days. 

However, the incidence rate had dropped by more than 50% between 30 October and 13 November, a further indication that Ireland’s rate of decline has slowed over the past seven days. 

Screenshot 2020-11-12 at 14.50.04 - Display 2 Outbreaks up to last Thursday. Source: HPSC

Chair of NPHET’s Irish Epidemiological Modelling Advisory Group Professor Philip Nolan told TheJournal.ie that “we have made huge progress” since 22 October. 

“We’ve come down from a daily average case count of 1,200 cases a day to 400 cases a day. We’re doing very well compared to European nations in general,” he said. 

“So that’s the good news. But what we have to point to is that this very rapid decline in case counts has now stalled. We’re now stuck at 400 a day and we’ve been stuck at 400 a day for a week.”

Looking at the incidence rate in individual counties, these spiked in October, then started reducing, and had reduced even further in the 14 days up to last Friday morning.  

However, HPSC data shows that the 14-day incidence rate in a number of counties is rising. 

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 264.5 cases per 100,000 – a slight decrease of 6% from 281.4 cases per 100,000 last week. 

Limerick is second-highest in Ireland with a 14-day incidence rate of 221.7 cases per 100,000 – compared to 197.5 cases last Thursday – an increase of 12% in one week. 

Waterford has had a significant spike in its 14-day incidence rate, rising from 115.3 last Thursday to 154.9. That is a 25% increase. 

005 Department of Health briefing Chair of NPHET’s Irish Epidemiological Modelling Advisory Group Professor Philip Nolan. Source: Sam Boal/RollingNews.ie

Analysing mobility data and close contacts data, Professor Nolan says health officials have concluded that people’s movements reduced massively from 22 October, through the mid-term break resulting in a “huge drop-off in detected attendances in workplaces”.

The number of close contacts also began to decline, but this has since risen back up to an average of 3 or more having been below 3 in late October. “We can literally see it happening at the end of the mid-term break. And it’s not the fact that kids are back at schools, it’s the fact that adults are leaving the home more,” said Nolan. 

This change is marginal, however, said Nolan. “So a little bit of extra effort over the next two to three weeks to reduce our contacts will have us back on the right road again.”

Counties with the lowest incidence rates include Wexford (37.4), Wicklow (56.9) and Galway (70.9), all of which have seen a reduction in 14-day incidence rates of between 7% and 20% over the last seven days. 

Cavan, which had the highest incidence rate at the start of Level 5, now has an estimated 14-day average of 90.6 cases per 100,000, according to the Department of Health. 

It was 118.1 last week and stood at 364.9 cases per 100,000 last Thursday. 

That’s a significant decrease of 75% over a fortnight. In total, Cavan’s 14-day incidence rate has reduced by more than 90% since Level 5 restrictions came into effect. 

By comparison to Europe, Ireland’s 14-day incidence rate is lower than France (778.7), Spain (513.3), the United Kingdom (497.1) and Italy (798.5), according to the European Centre for Disease Prevention and Control (ECDC). 

w45_46_COVID_subnational_Last_2week Source: ECDC

The above countries, including Ireland, are still considerably lower than both Austria, which has a 14-day incidence rate of 1083.7 and Luxembourg, which has a 14-day incidence rate of 1195.2 per 100,000. 

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. 

Last week, approximately 77,718 tests have been carried out up to 11 November. This week, approximately 77,292 tests have been carried in the last seven days. 

The positivity rate last week was estimated at 3.5% – a decrease from 4.6% the week previous.

A further indication that Covid-19′s suppression has stalled this week, Ireland’s positivity has risen again, to 3.8%. 

Hospital & ICU

There have been 18 hospital admissions in the last 24 hours and 25 discharges. 

There are – as of this morning – 290 confirmed Covid-19 cases in hospitals and 32 people in Intensive Care Units.

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Last Thursday, there were 275 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 on 4 October, rose again last week but have since declined. 

Screenshot 2020-11-19 at 14.45.59 - Display 2 Source: Department of Health

Clusters

So where are people contracting Covid-19?

In terms of clusters and outbreaks, Professor Nolan says Public Health teams are currently seeing small outbreaks in a variety of workplace settings.

“People are picking it up in the community in ways that we can’t detect. They’re picking it up at small, private social gatherings, be that a family get-together or a funeral. People find it very hard not to socialise, particularly if it’s a major life event. 

“But we’re also seeing it in workplaces, that’s a significant factor, and hospital outbreaks which we need to very careful about,” said Nolan. 

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

There were 10 outbreaks reported by the HPSC up to Saturday. There were 24 outbreaks reported in the 7 days beforehand and 30 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 2020-11-19 at 15.15.03 - Display 2 Source: HPSC

The total number of outbreaks since the start of the pandemic is 8,311. Of these, 4,992 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 954 new outbreaks in private homes up to last Saturday – a increase of 511 or 53% – from the previous week bringing to 6,228 the total number of outbreaks in this setting since the pandemic reached Ireland.

Of these, 4,210 remain open.

Finally, there have been 6 new outbreaks in nursing homes – 48 outbreaks in nursing homes remain “open”.

In the seven days up to last Thursday, there had been an overall increase of 16% in outbreaks across all settings. 

Overall, taking in every setting this week, outbreaks have increased by 45% since last week. 

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