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Department of Health
Dear Health Minister

Here's the letter from Tony Holohan that recommended Level 5 for six weeks

The Chief Medical Officer sent the letter to Health Minister Stephen Donnelly last Thursday.

THE LETTER SENT from NPHET to the Government recommending that Level 5 be implemented for six weeks states that “broad societal buy-in and adherence” is needed to ensure that the measures have an effect. 

The 8-page letter sent by Chief Medical Officer Dr Tony Holohan to Health Minister Stephen Donnelly on Thursday 15 October outlines a number of epidemiological data about Level 3 restrictions. 

Many of these pieces of data have been shared publicly at the Department of Health briefings and during media interviews conducted in the past five days.

Some more interesting data sets included in the letter that haven’t been emphasised as much:

  • There have been 522 new clusters between last week and 3 October (a 10-12 day timeframe). In total, there are 2,475 open clusters, with the vast majority of these associated with private households (1,906). 
  • 99 outbreaks in this same period are associated with workplaces. 
  • In the fortnight to 6 October, 46% of cases are linked with community or possible community transmission. 

The letter also notes the escalating number of cases across Europe and expresses concern about hospital capacity. 

An aggressive strategy and societal buy-in

It was noted that Level 3 restrictions in place in Dublin since 19 September and in Donegal since 26 September had not had a “sufficient impact”.

It also noted that the ‘no visitors’ advice issued nationwide last Wednesday and Level 4 restrictions in border counties Cavan, Monaghan and Donegal were not “aggressive” enough to bring the virus under control in a short time period. 

Based on this, NPHET again recommended Level 5 restrictions for the entire country for six weeks. The letter also states that schools should remain open during these restrictions, and that consideration should be given to those who live alone. 

“NPHET firmly believes that an escalation to Level 5 is inevitable and that the earlier this proactive action is taken, the greater chance there is of quickly reversing the current trajectory of the disease,” Holohan’s letter stated.

It also states that the measures will only be effective if there is “broad societal buy-in and adherence to them”, adding that clear communications, cross sectoral leadership and enforcement arrangements would be needed to ensure this buy-in. 

NPHET said that it is giving consideration to the measures that will be needed for when restrictions are eased. This includes “further enhancement and investment in our public health response system” – meaning the test and trace system. 

Consideration is also being given to the efficacy of visors and visits to and from community housing units for people with disabilities. 

Modelling data shows that between 450-600 people with Covid-19 will be hospitalised, and 80-110 people will be in critical care by Halloween if the current trajectory continues.

To bring case numbers down to between 50 to 100 a day, the reproduction rate of the virus must be brought to R0.5. The national rate is currently around R1.4.

You can read the letter here.

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